As many hospitals are struggling to generate clinical quality measures, the American Hospital Association is calling for slowing the pace of transitioning to electronic reporting. In a report, released July 25, the AHA calls for “redirecting” the existing requirements for digital clinical quality measures. As it stands, the process raises costs and effort for providers, AHA said, without leading to accurate data.

The process is not sustainable, the report argues.

“This study demonstrates that successful implementation of current policy requirements for eCQMs must be redirected so that the EHRs are working for the clinicians rather than the clinicians spending extensive amounts of time working for the EHRs.”

The AHA conducted case studies at four separate hospitals for the report, and it highlighted challenges found in program design, technology, and also clinical and strategic challenges.

AHA put forth five policy recommendations:

1. Slow the pace of the transition to electronic quality reporting with fewer but better-tested measures, starting with Stage 2.
2. Make EHRs and eCQM reporting tools more flexible so that data capture can be aligned with workflow and interoperable so that data can be shared across hospital department systems.
3. Improve health IT standards for EHRs and eCQM reporting tools to address usability and data management to achieve meaningful use expectations. Additional EHR fields to capture structured clinical information disrupts the usual clinical workflow, increases time on narrative and structured data documentation and decreases time for patient care.
4. Carefully test eCQMs for reliability and validity before adopting them in national programs. Implement eCQMs within hospitals as part of testing to ensure information flow is accurate and there is no adverse impact on quality and patient safety.
5. Provide clear guidance and tested tools to support successful hospital transition to increased electronic quality reporting requirements. For example, develop and disseminate an accurate, complete and validated crosswalk from SNOMED-CT to ICD-10-CM for conditions and ICD-10-PCS for procedures.

Slowing down the pace of electronic quality reporting, contends AHA, would allow:

• Policymakers to create a reliable policy process for eCQM implementation, a mechanism to provide eCQM updates, and a robust EHR testing/certification program;
• Vendors to develop tools that support logical workflows, produce accurate measures and leverage all data already in the EHR; and
• Hospitals to implement the tools in a way that supports their quality goals without excessive burden or risk to patients.