GAO: Hospitals struggle to collect quality data

By John Moore
Wednesday, May 09, 2007

Information technology systems provide some assistance for hospitals' data-collection initiatives but fall short of completely automating the processes involved.

That's one finding of a Government Accountability Office report on hospitals' efforts to collect data on a series of quality measures specified by the government. The Centers for Medicare and Medicaid Services' Annual Payment Update program requires hospitals to submit that data quarterly to avoid reductions in their Medicare payment update.

For the report, GAO conducted case studies at eight hospitals.

"Our case studies showed that existing IT systems can help hospitals gather some quality data but are far from enabling hospitals to automate the abstraction process," the GAO report states. Abstraction involves examining a patient's medical record to locate the relevant data.

GAO found that IT systems helped hospital workers abstract information and helped them do it faster. But the study cites a number of technology limitations, including the use of both paper and electronic records, "which required staff to check multiple places to get the needed information."

The GAO report also lists the "prevalence of data recorded as unstructured narrative or text" and a lack of integration among hospital systems, "which required staff to access each IT system separately to obtain related pieces of information."

Most officials at the hospitals under study considered full-scale automation of quality data collection and submission as a long-term prospect at best, the GAO report states. The main barriers to complete automation include physicians' reluctance to use IT systems to record clinical information and the intrinsic complexity of the data CMS requires, the report states.

GAO recommended that the Health and Human Services Department identify steps for promoting the use of IT in collecting and submitting data to CMS, and inform interested parties about those steps and the milestones for completing them.