Government questions providers on EHR entry methods

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One of the greatest challenges faced by hospital and healthcare organizations these days is the implementation of Meaningful Use and EHRs. The process is so long and taxing on a facility’s resources that the temptation to cut corners is strong.

Apparently, the Department of Health and Human Services’ Office of the Inspector General (OIG) is all too aware of this temptation, and it is intent on ensuring that providers are not being fraudulent in their EHR usage.

According to Scott Mace, senior technology editor at HealthLeaders Media, this coming Friday, Oct. 26, 2012, is the deadline for an 18-page, 54-question survey that inquires about a provider’s “electronic health record system data entry habits, security practices, and more.” This is part of OIG’s overall 2012 work plan that placed a priority on “identifying fraud and abuse vulnerabilities in the electronic health record systems.”

As Mace relates, the New York Times has reported “that some providers have used EHRs to inflate Medicare charges,” reports that caught the suspicious eyes of Congressional Republicans and incited calls for an investigation of Meaningful Use.

What are some of their concerns? Mace reports that questions on the survey include, ”How diagnoses and procedures are coded”; “User authorization methods” and “access management”; “Whether outside entities such as payers can access the EHR, and if so, how such access is tracked”; “Numerous questions about audit log practices and availability”; “Whether narrative nursing notes are directly entered into the EHR or handwritten and scanned into the EHR, and if so, why; “EHR copy and paste policies at the hospital”; etc. etc.

The last one listed is of great concern to the OIG since one timesaver providers are using includes cutting and pasting notes across several patient records.

Critics are saying that the 2012 presidential election is a motivating factor behind the survey. Pamela McNutt, vice chair of the policy steering committee of the College of Healthcare Information Executives (CHIME), charged that “the survey is ‘all over the place, from HIPAA privacy and security questions to coding practices, copy and paste functions, and detailed questions on audit log functionality.’”

Whatever the motivating factors may be, we can only speculate that this is the first of many accountability measures the government will institute in order to hold providers accountable for how they’re using EHRs and implementing Meaningful Use.

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