Electronic Health Records

Adoption & Implementation News

How have HRSA grants helped or hindered EHR meaningful use?

By Kyle Murphy, PhD

Has $176.9 million in Health Resources and Services Administration (HRSA) grants to networks of health centers sufficiently increased the meaningfulness of their EHR adoption and use? According to the Office of Inspector General, the answer to that question is both yes and no.

A recent OIG report on EHR implementation through HRSA grants to health center controlled networks (HCCNs) reveals that most recipients are capable of capturing data in line with objectives in the first phase of the EHR Incentive Programs, Stage 1 Meaningful Use; however, fewer of these HCCNs have the capacity to enable the sharing of information.

“Establishing the capability for objectives relating to sharing data often requires health centers to incur additional EHR-related costs,” the report states. “Although 76 percent of health centers reported facing financial sustainability challenges, grantee progress reports contained limited information related to the financial sustainability of EHR systems at health centers.”

The backstory is that the American Recovery and Reinvestment Act (ARRA) was the primary source of these sizeable HRSA grants for health IT with the goal of ensuring that health centers were able to implement EHR systems and approximate meaningful use even though such criteria weren’t in effect in 2009 and 2010 when these grants were disbursed.

Here’s brief breakdown of the findings:

• 14 percent (32 of 233) were capable of achieving Stage 1 Meaningful Use;

• 72 percent (168 of 233) were capable of meeting all the core objectives related to capturing data;

• 24 percent (56 of 233) of health centers could meet all the core objectives related to sharing data;

• Most the health centers (192 of 233) had the capability to meet at least 5 menu objectives, but only 36 percent (83 of 233) could achieve the 1 of 2 public health menu objectives related to sharing data.

The big takeaway from these OIG findings is that financial sustainability could threaten the long-term use of EHR systems by these health centers. “Additional costs incurred by health centers as they establish the capability to share data can contribute to financial sustainability challenges. Health centers’ use of their EHR systems and their ability to provide services may be negatively impacted if health centers are not able to overcome such challenges,” the report concludes.

The report makes three recommendations to HRSA, all of which the federal agency has concurred with:

Use data to understand progress towards meaningful use objectives and to provide guidance and technical assistance to health centers;

Ensure that HCCN grantees provide information on the financial sustainability of EHR systems at health centers;

Examine the feasibility of collecting information directly from health centers regarding the financial sustainability of their EHR systems.

Considering that EHR adoption (and meaningful use for that matter) is a journey rather than a destination, the inability of healthcare organizations to sustain their use of this technology poses a major problem. However, in light of the timing of these grants — that is, prior to meaningful use being properly determined — these health centers were seemingly placed in disadvantageous position to begin with.

Read the full report here.

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