Impact Insights

Week in Review 10/10/14

Eligible Professionals (EPs) are failing Meaningful Use (MU) audits at an alarming rate, according to data obtained by Health Security Solutions. Of the more than 8,400 pre- and post-payment MU audits of EPs completed thus far, the provider has failed almost 23% of the time. Hospitals have fared better to date, failing only 4.9% of the 613 audits that have been finished. The numbers, which to our knowledge have never been made public before, were obtained by Health Security Solutions through the Freedom of Information Act.

Impact Advisors’ Thoughts: The concerning rate of failure by EPs is likely due to the fact MU performance occurs on an individual EP level. In small or solo practices, EPs may be attesting on their own, likely without the bandwidth or resources to fully digest the incredible complexities of each measure. In larger practices (where someone usually attests on behalf of the EP), there may be a dedicated MU team. The challenge is effectively monitoring and accurately reporting the performance of potentially hundreds of individual providers – each with their own numerators, denominators, and exclusions.


Health Information Exchange (HIE) initiatives report that cost is the top barrier to interoperability, according to the 2014 eHI Data Exchange surveySpecifically, when asked about interoperability challenges, the most frequent response was “cost of interface development” (cited by 59% of HIE initiatives), followed by “getting timely response from EHR vendor interface developers” (51%). Overall, more than 60% of HIEs charge participants dues or fees; and for more than half of those (54%), the revenue from those dues and fees is enough to cover all operational expenses.

Challenges Related to Interoperability (n=125 HIE initiatives)

HIE Graph

(Source: “Post HITECH: The Landscape of Health Information Exchange,” eHealth Initiative, October 2014)

Impact Advisors’ Thoughts: We found the relatively low ranking of challenges related to “normalizing data feeds” and “patient matching” to be interesting. We don’t want to read too much into the results of a single survey, but we have to wonder if the reason HIEs don’t see those as key barriers is because many initiatives are still largely focused on trying to obtain and aggregate data, rather than using data from trading partners to support analytics and population health efforts.