The General Accountability Office (GAO) last week issued a report focused on health IT and meaningful use. It addressed how and why U.S. Department of Health and Human Services (HHS) contractor National Quality Forum (NQF) lagged behind deadlines for delivering electronic versions of meaningful use criteria.
Interesting. While we thought the proposed delays in meaningful use stage 2 enforcement was the Center for Medicare and Medicaid Services (CMS) showing a benevolent side — giving a break to beleaguered health care CIOs already hip-deep in new tech implementations for ICD-10, HIPAA compliance and accountable care organization or related quality-based incentive programs offered by private insurers — it appears as if benevolence might not have been the primary motivator on the part of the federal health insurance behemoth.
While the nuts and bolts of the report are summarized elsewhere on the Web for those who don’t feel like downloading the 81-page GAO report from the horse’s mouth (such as here, here and here), the upshot was this: CMS got a raw deal, because the EHR Incentive Program quality measures came in late, exceeded estimated development costs and 44 of 63 measures contained errors.
HHS wasn’t exonerated in this mess, completely. While NQF failed to report on problems it was having developing the criteria, GAO points out that CMS should have been monitoring the projects more closely as written into the original contract, and yo, it’s never too late to start – so let’s start doing that that now, moving forward.
“To help ensure that HHS receives the quality measures it needs to effectively implement its quality measurement programs and initiatives within required time frames,” the report’s summary reads, “the Secretary of HHS should use monitoring tools required under the NQF contract to obtain detailed and timely information on NQF’s performance and use that information to inform any appropriate changes to time frames, projects, and cost estimates for the remaining contract years.”
For its part, the NQF — given the opportunity to respond to the report’s findings and get the last word in a letter published as an appendix to the document — did own up to the delays and didn’t dispute the negative findings. However, NQF CEO Janet Corrigan did point out in the letter that the uncertainties and “novelty” of the project were at least in part responsible for the cost overruns of initial estimates, and slack for such uncertainties was built into the contract.
As for the delays, she blamed the NQF’s “consensus-based environment,” among other things – such as HHS’s “lack of a comprehensive plan for using the work NQF has produced under contract.”
Speaking of health IT contractors, deadlines, dollars and cents, and all that fun stuff, anyone wondering what other federal health IT contracts are kicking around…there’s a Web dashboard for that. Knock yourself out. Maybe with the GAO sniffing around and examining how well the contractors utilize monitoring and progress reporting tools, such dashboards will publicly reveal more information on what’s happening behind the curtain of these giant CMS projects that potentially affect every day work of health IT and health care knowledge workers.