GAO: HHS falls behind EHRs, lacks plan for implementation

The U.S. Government Accountability Office (GAO) has released a report on the evaluation of HHS efforts to improve electronic health records (EHR) for post-acute care. The GAO report states that the HHS “lacks a comprehensive plan to meet its goal of increasing the proportion of post-acute care providers electronically exchanging health information.”

When patients are discharged from the hospital, some continue to receive care in post-acute care settings. The ability for patients' information to follow them, wherever they seek care, is important in streamlining the industry's health information exchange.

The GAO interviewed HHS officials and 20 relevant stakeholder groups to compile a list of the five key factors affecting the use of EHRs and the digital exchange of health data in post-acute care. The key factors included:

1.      Cost: With limited financial resources, EHRs and the exchange of information are too stressful on many organizations.

2.      Implementation of standards: The many varying standards in implementation practices often halt the process toward the exchange of health information in post-acute care.

3.      Workflow disruption: The implementation of EHRs cause many care facilities to take time away from patients, which can disrupt the workflow of care.

4.      Technological challenges: Outdated devices and EHRs not capable of exchanging health information electronically present obstacles in the secure exchange of information.

5.      Staffing: Care staff often lack knowledge in EHRs. With high staff turnover, the constant need to educate new staff can be overwhelming and time consuming.

The GAO did not find many positives in reviewing HHS’s mission to improve EHR. The report stated HHS has not measured the effectiveness of its recent endeavors to increase EHR use and does not have a concrete plan to meet its goals.

“HHS cannot determine if its efforts are contributing to its goal or if they should be adjusted,” stated the report. “In addition, although HHS’s goal depends in part on actions by post-acute care providers and EHR vendors, HHS lacks a comprehensive plan with specific action steps to achieve this goal. HHS’s planning also does not address how to overcome key external factors that may adversely affect its key efforts. Without a comprehensive plan to address these issues, HHS risks not achieving its goal of increasing EHR use and the electronic exchange of health information in post-acute care settings.”

The GAO recommends HHS should evaluate its key efforts for effectiveness and develop a comprehensive plan.