For the most part, the American Academy of Family Physicians, an advocate for health IT, supports the meaningful use criteria that the Centers for Medicare and Medicaid Services released at the end of last year. They have an issue, however, with the reporting requirements of the Notice of Proposed Rulemaking.

AAFP anticipates that the reporting requirements might post major challenges for smaller physician practices. In reality, the ability to report is going to be a problem for large hospitals and health systems, too, even with those that have established EHRs. So small physician practices are not alone.

Reporting is critical for population health management and improving the quality of care. That's obvious. Not obvious to me is why healthcare organizations are unable to generate reports out of their EHRs. It seems like a basic functionality you'd want to have, but I'm sure there's a lot I don't understand about the technology side of things.

I mentioned the widespread lack of reporting capability of hospitals with EHRs to a friend of mine who works for a large integrated delivery network, who shall remain nameless, that has an EHR system. She works in the area of diabetes education and management. She was not surprised at all by the news because she has been unable to extract reports from her IDN's EHR system. And like me, she didn't understand why this wasn’t possible.

CCHIT has updated its EHR certification programs to conform to the newly issued standards rule. I'm assuming reporting was addressed. I'm also assuming EHR vendors are developing or bolstering capabilities needed to meet the reporting criterion.

As far as the finalization process is concerned, could CMS resolve this problem by giving providers more time to be able to derive reporting from their EHR systems than what is laid out in the NPRM? Or does this somehow weaken or slow down efforts to improve the quality of care through health IT?

Regardless, it's an issue that has come to the forefront. So let's address this problem from all fronts - CMS, HHS/ONC and health IT vendors - and move on to the next legitimate bone of contention with the NPRM.