To help guide institutions as they scramble to receive American Recovery and Reinvestment Act (ARRA) electronic health record (EHR)  incentives while maintaining a thoughtful approach to implementation, ECRI Institute (www.ecri.org) has published a Health Devices guidance article outlining what hospitals need to be thinking about -- and doing -- right now. ECRI Institute, an independent, nonprofit organization that researches the best approaches to patient care, also emphasizes the need for hospitals to report EHR problems through a centralized Problem Reporting System.

Currently, only about 9 percent of the nation's hospitals utilize some type of EHR. And the majority of those hospitals have implemented only the most basic system. "That's not enough to be in compliance with the new standards or to warrant any incentive payment," said Jason Launders, MSc, lead author of the article and senior medical physicist at ECRI Institute.

The HITECH Act -- the portion of ARRA containing the EHR provisions -- states that Medicare and Medicaid incentives, which may total almost half of what it costs to implement an EHR system, will be awarded to hospitals that achieve "meaningful use" of the system under an aggressive timeline, starting as early as October 2010. While a precise definition of "meaningful use" has not yet been released, it will require widespread use of the EHR system throughout the organization, with the capability of exchanging data with outside entities, such as a physician's practice. Hospitals that do not implement an EHR within the designated timeline will receive penalties until they are in compliance.

Four of ECRI Institute's recommended steps for successful EHR implementation are:

1.      Map out the existing workflow and clinical data flow at your organization.

2.      Identify the costs of paper information.

3.      Prepare existing medical records for transition to electronic records.

4.      Address all security and privacy concerns.

ECRI Institute has run a medical technology problem reporting system for over 40 years. In recent years, the system has expanded to include review and analysis of problems related to computer-based medical technologies like radiation therapy systems and EHRs.

Hospitals can report problems with EHRs and other computer-based medical technologies through ECRI Institute's free and voluntary problem reporting network at https://www.ecri.org/PatientSafety/ReportAProblem/Pages/default.aspx.

For more information about the Health Devices guidance article, e-mail clientservices@ecri.org.