nevillefm wrote on Friday, June 17, 2011:
“Meaningful use” is important even to us using openEMR outside the US.
Authors and Disclosures
Author(s)
Scott Irwin
Director, State Partnerships and Regional Extension Center Services, NextGen Healthcare, Horsham, Pennsylvania
Disclosure: Scott Irwin has disclosed that NextGen Healthcare provides EHR, financial, and HIE solutions for hospitals, health systems, physician practices, and other healthcare organizations.
From Medscape Business of Medicine
Don’t Get Too Hung Up on ‘Meaningful Use’ in an EHR
Scott Irwin
Posted: 06/16/2011
Introduction
There’s been so much attention and focus lately on meaningful use that some physicians are overlooking a vital fact: Meaningful use is only a starting point in healthcare reform - not the endgame. The electronic health record (EHR) system that you select must be able to meet broader goals as well. Be wary of getting too caught up in individual objectives. Don’t lose sight of the forest for the trees. In this case, the “forest” is the overall quality of healthcare.
Lawmakers have coined the term “meaningful use” to describe ways in which EHRs can be used to measure, report, and exchange health information. The Health Information Technology for Economic and Clinical Health (HITECH) Act offers Medicare and Medicaid incentive payments to those who use certified EHR technology to achieve meaningful use objectives.
Currently, 25 objectives have been defined including the following goals: employing electronic prescribing, using computerized provider order entry (CPOE), and maintaining active electronic medication allergy lists. These are all part of Stage 1 of meaningful use.
You’re not expected to use EHRs in a meaningful way all at once. In fact, objectives are being set in 3 distinct stages between now and 2015. Stage 1 primarily begins to standardize the electronic capture and use of health information. Physicians must meet at least 20 of the 25 current objectives to earn Stage 1 incentive money.
Stage 2 criteria are expected to be released by the end of 2011 and take effect by 2013. They will further underscore the concept of using standardized formats and fields to foster the exchange of data and will gradually solidify support for Stage 3. That’s when more population-based health goals are expected to come to the forefront. In theory, by the time we reach Stage 3, we should be using electronic tools to enhance clinical decision-making, improve patient self-management, and encourage “wellness” activities.
Certain government websites offer more information about meaningful use.
How to Use EHRs to Your Own Benefit: Make “Meaningful” mean “Quality”
Right now, the country spends an inordinate amount of money treating the symptoms of disease rather than treating the causes. Healthcare reform is aimed at using technology and restructured reimbursement to instead promote overall patient wellness.
Meaningful use is only one piece - albeit a crucial piece - of healthcare reform. Intense short-term focus on meaningful use exists because it sets the critical technology foundation necessary to achieve the bigger, longer-term goal of improved patient care.
The end goal of meaningful use is to connect patients to their own healthcare information via technology. No matter where a patient goes, his or her healthcare data should be able to move right along to the same place. Data-enriched “best-practices” treatment protocols should be available to help keep patients well.
So, what does all of this mean for your EHR selection? It means reviewing system functionalities with an eye toward two things:
•Enabling patient-centered information flow; and
•Measuring short-term workflow gains against long-term data needs.
The key to both is making sure that all data points are collected in a “data-centric” way. For instance, free-form and voice files seldom support vigorous data measurement and reporting. Choosing an EHR system that relies heavily on such files may initially provide faster workflow, but may make future data gathering efforts more difficult. On the other hand, functionalities that rely on putting information into specific data fields may require a learning curve for some providers but offer the structured data capture essential to future information flow.
This doesn’t mean that meaningful use objectives can’t benefit your immediate workflow. In fact, you can make meaningful use fit your workflow.
Let’s say that you receive automated test results from your lab. Great; one of the current meaningful use objectives is to incorporate clinical lab test results into the EHR as structured data. Perhaps you already have met this goal. However, are you able to take the next step, using those automated results to improve care?
Here’s how: Rather than dumping all lab alerts into a given physician’s in-box, you could set it up so that all normal lab results are sent to office staff. Ancillary staff then shoulders the work required for normal test results, freeing physicians to focus only on those who most need their attention.
This scenario exemplifies the way in which you must evaluate EHR functionalities. Meeting a meaningful use objective is the first criterion. However, beyond that, it’s smart to question how it ultimately will help deliver better care.
Prepare for the Long Term
When evaluating EHRs, find a trusted source that understands not only current meaningful use objectives but the overarching direction of healthcare reform. Regional Extension Centers (RECs) provide one option for small practices. Their job is to vet various vendors, setting up the ground rules for demonstrations and proposals to ensure that you see each product’s workflows within meaningful use parameters. Other considerations:
• How well does an EHR vendor demonstrate a track record of helping small practices improve patient care quality? Ask how they currently enable successful participation in programs such as the Physician Quality Reporting Initiative (PQRI), Patient-Centered Medical Home (PCMH), or e-prescribing. If the answer is positive, it is a good indicator that the vendor’s eye is on the long-term picture as well as the initial meaningful use criteria.
• How will the vendor support future needs? Dig deep. Ask each vendor, “Where do you see healthcare going? What services and support can you offer to get me through healthcare reform?” Make sure that you look for support geared toward smaller practices, too. That includes ongoing training, access to other clients with whom you can network, and documentation availability.
• Is the vendor able to grow with you? Although a solid base of smaller clients offers a good gauge of a vendor’s responsiveness to your needs, do not look for those that exist only in the small-practice niche. Focus instead on those that serve clients of all sizes. You want to see success across the board. Why? Because just as with meaningful use, you never know what the future may bring. If your practice grows, you want to make sure that your EHR systems can grow with it.
Meaningful use is a journey, not a destination. Be careful not to get “stuck” there when evaluating your EHR options. Although the ability to meet meaningful use criteria is important, an EHR must also be flexible enough to meet future needs. Keep one eye on meaningful use and the other down the road - on improving patient care.
Medscape Business of Medicine © 2011 WebMD, LLC