The last few months I’ve said those two words, “Meaningful Use”, more times than I can count. I’ve shared our plans with physicians, executive teams, community members and blogs. Almost every discussion, email, blog post and article that I see or hear relates to the same focus – what products are we going to use and what do we have to do to obtain some stimulus funds or stay away from the penalties. We need to dig deeper to and tune into who we are making the systems and processes meaningful FOR.
Let’s take two examples, one where you might think you already comply with the IFR and one potential product decision.
The latest IFR states we must document basic demographics that include race, ethnicity and preferred language. In talking to some health systems and seeing reference data I get the sense that, while I have the technical ability to force these fields to be completed during registration, the process and questions that are asked to get the right information is not standardized. If you want to check if your registration staff are standardized in how they record this information compare your race & ethnicity statistics in your EMR with the census data for your service area. If there is a significant discrepancy, you have an opportunity. A standardized process requires a careful script to ensure you appropriately ask each patient question that accurately represents their demographic information. This data is important not just to get a bill out the door, but also indicating key data that may be vital to their health.
Another example relates to providing electronic access to patient information within 96 hours. This is great, but if this information is not portable does it really service a patients long term need and best interest? My son is a good example as he visits multiple specialists over the course of a year for routine follow-up care. These specialists are located throughout the state and are affiliated with multiple providers and health systems. Having three portals to visit and collect the information is confusing and can be potentially dangerous. There are a lot of questions for CIO’s in this space. How are we going to support (or deny) interface requests to foreign PHR’s and portals? Who is going to support patient questions about the use of the portal / PHR? (Saying the application service provider will support them isn’t thinking deeply enough). The key HAS to be – make the information easy to use and useful for the patient. Don’t sign a contract with a provider just to place a checkmark in the box – think about portability and support for the patient.
While these two examples show how a health system can “comply” with the regulation, they may not be meaningful for the patient. The IFR contains many pitfalls of false compliance – meaning that you could appropriately attest that you comply but don’t serve the core of what we all should be doing, which is to make electronic medical information more meaningful for the patient and their care.
Anthony Guerra says
The devil is certainly in the details, right? I mean, you can’t just take what the government has put out and follow it, because you might end up with useless data. David Muntz said there were some areas of MU that are very specific, and other areas that are very loosely defined.
The bottom line is you can’t count on the government to ensure you are doing things that make sense, in a way you can later make sense of them. All data collection projects have to be thought through to the final stage — the actual use of the data. If it will not be usable due to a lack of standardization, the whole venture will have been for naught.
Thanks for a great post.
Steve Huffman says
The majority of MU has much more to do with process than IT. While this sounds like a broken record as many of us say it with every IT project it is no different with MU. This will be a grand awakening soon.