More than half of responding hospitals believe they will incur penalties for failing to demonstrate "meaningful use" by 2015, according to a report from the American Hospital Association.

The time lines set by the American Recovery and Reinvestment Act (ARRA of 2009) for health care providers to move toward electronic health records (EHR) are too stringent and impossible to meet, the AHA reported.

"[The] extremely aggressive time line in the [ARRA] stimulus package places enormous pressure on health care practitioners and their organizations to rapidly implement EHRs, often forcing them to install technology without taking the time to tailor systems to organization realities...Such rapid implementations could lead to significant patient safety events," said Dean Sittig of Memorial Hermann Health System and David Classen of the University of Utah in the Journal of the American Medical Association.

As part of a Congress-backed plan, the ARRA will offer incentives to hospitals and health care providers that participate in an EHR program. The goal of this program is to get providers to use EHRs, which are seen to be beneficial to patient care.

Providers involved in the program, which will provide incentives through Medicare and Medicaid, must demonstrate meaningful use by 2015 in order to avoid paying penalty fines. Meaningful use is defined as meeting very specific objectives that move the provider toward an EHR system.

Some objectives include recording patient demographic information, maintaining medication lists and up-to-date problem lists, providing patients with electronic copies of their health information, providing care instructions upon discharge, performing medication reconciliation at each transition of care and using computerized provider order entry (CPOE).

The AHA is concerned with the definition of meaningful use, according to a report e-mailed to DOTmed News.

"The definition...presents many obstacles for hospitals that seek to become meaningful users of EHRs," the report said. "The two key difficulties presented by the rule are the inadequate phase-in period and the 'all-or-nothing' approach proposed by CMS."

The AHA report found that most hospitals involved will have an extremely difficult time fulfilling these requirements on deadline.

Sixty-six percent of critical access hospitals and 56 percent of rural hospitals did not expect to demonstrate meaningful use, according to the report, which based its information on 795 non-federal, short-term acute care hospitals. As of 2008, there were 5,010 hospitals in the United States, AHA spokesman Mike Fenwick told DOTmed News in an e-mail.

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