What’s Useful About Meaningful Use?

In partnership with CHIME, healthsystemCIO.com has developed a blogger series featuring insights from hospital and health system CIOs and other key IT leaders representing organizations from around the country. The blogs, which will be featured on our site on a biweekly basis, will focus on the major issues affecting CIOs, including the health IT workforce shortage, mobile device management, and federal regulations.

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There are so many parts to MU — money, software, measures, adoption — so why are we really doing this? It cannot just be about the money because, though tempting, it only offsets a small portion of the time and investment that is required. Also, it’s a carrot now and stick later for non-compliance, so that can’t be the answer as to why to participate.

The software, apart from interoperability, is moderately challenging. Therefore, picking a good EMR, CPOE, and analysis/reporting tools are prerequisites. Is that worth the effort?

Measures have turned out to be a challenge. Who thought these up anyway? They don’t seem particularly relevant to some, with not enough choices. Can I make them fit into the clinical issues that I see in my organization, or is this someone else’s idea of what high quality care looks like? It’s a struggle setting and then collecting information for measures. Accrediting/certifying bodies have their own view of quality, and I have my own areas to improve from near misses, etc.

There needs to be a balance of what I need to do for myself with what they think I should be doing. Who knew, for example, there were so many places we were documenting smoking that it would thus take months to redesign and educate? I guess we’ll have to learn patience in this process, but there’s no time.

We’ve been good at clinical adoption. Now it has to be as close to 100% as we can get. Whereas a few minutes delay in a physician process was painful before, it’s now a target for immediate improvement. We can’t blame providers for wanting this fixed, as minutes and seconds count. We need to bring out the workflow analysts to see what’s happening before, during, and after these critical steps to see if we can make this faster. Mobility, quick logons/logoffs, and ‘follow me context’ from device to device is now required. I’m not sure anyone had planned to get all this software and hardware just to make access that much easier.

So what’s the reason for doing this after all? Apart from my questions about how the program was designed, isn’t it what we really want to do anyway? Do all the above; get good software, measure, set improvement targets, and then use the software in our clinical practice?

Maybe we just needed the incentive to do what was in our plans to begin with.