As an organization that just received HIMSS Analytics Stage 6 recognition, we decided not to rest on our laurels but to fully explore the HIMSS Analytics Stage 7 requirements. We saw Stage 7 as not just recognition that an organization is basically “paperless,” but more importantly, as a commitment to improve patient care and the patient experience through the sharing of data across the continuum of care, while empowering the patient to participate in the maintenance of their health and creating a more comprehensive wellness approach. Additionally, the level of structured data allows for greater clinical use of data analytics to improve care, patient safety, and financial viability.
Once the decision was made to explore where we are in relation to being a Stage 7 entity, we scheduled a call with the HIMSS Analytics review team. They took the time to talk us through the requirements and evaluation/audit processes. Their interactive discussions, checklists, and explanations were incredibly valuable in helping us decide whether to explore Stage 7 viability further.
Using the checklist they provided as a basis for discovery, we decided our next step would be a gap analysis to see if Stage 7 was an option in the next year or two. Interestingly, we were well on the way with many requirements, including the need to use bedside medication verification on 95 percent of inpatients (we are almost at 100 percent), or data exchange with both public and private entities, which we do through HIXNY, one of our New York State RHIOs.
Some requirements would just entail ramping up utilization or compliance, like the use of CPOE to 90 percent inpatient, or increasing surgeon CPOE compliance. Others, though, posed a much greater challenge, either in terms of system capability, or process reengineering. I will address some process gaps first.
Since the idea behind achieving Stage 7 revolves around being paperless, it is required that ALL paper related to a chart or encounter be scanned in within 24 hours. With our current process all paper was being scanned in, but often there were much longer lags, some of which were not completed until after patient discharge. Reengineering this would require buy-in from various non-IT departments, along with an organizational commitment holding parties accountable to achieve that goal. It would also possibly require additional capital or staff to achieve.
This is a good place to step back and point out that achieving Stage 7 is not just an IT initiative and cannot succeed without total organizational buy-in, commitment, and a cross-organizational approach to making it happen. It affects providers, clinicians, admin staff, HIM, patient registration, finance, and a host of other departments — in short, the whole organization.
Getting that buy-in can be difficult, but one needs to stay focused on why it is being done. It is not about getting some award or recognition, but rather, about doing the right thing for the patient — improving care, engaging the patient, improving financials, increasing safety, and a host of other patient-centric factors. The patient is the reason we are here to begin with, so wouldn’t those factors alone push organizations toward this goal?
With everything an organization has on its plate, one might argue that adding the Stage 7 requirements is unrealistic. I counter by saying that, at least on the surface, most of the Stage 7 requirements are either by-products or deliverables of initiatives you are already working on, such as achieving Meaningful Use goals, care improvement processes, CMS-related reporting requirements, RHIO participation, or other existing projects. In other cases, it may require some process reengineering that would likely either benefit the patient or organization.