The phased approach of meaningful use demonstrates that EHR adoption is a process with many steps and just as many applications for care coordination and quality improvements. This is particularly evident in regions of the country with high levels of EHR adoption and health systems, hospitals, and physician practices investigating ways that their EHR systems can serve as catalysts of change for providers and patients.
The Wisconsin Health Information Technology Extension Center (WHITEC), the division of the nonprofit quality improvement organization MetaStar and the state’s regional extension center (REC), faces such a situation. “Wisconsin is actually fairly adopted, so we’re past the conversation of if or what electronic health record we’re going to select,” says WHITEC Project Director Jesi Wang.
“Now we are really to the conversation about what do we do with it and how do we use it the best way,” she continues. “We would agree that meaningful use is the starting point of some of those conversations and that we have a ways to go in those conversations.”
Currently, the Wisconsin REC is considering ways that the organization can sustain its operations beyond its initial mission to help eligible providers in Stage 1 Meaningful Use. Given the history of the REC and its parent organization, the healthcare industry’s movement toward accountable and patient-centered care models appears to be a logical fit. But it could very well be the case that the support WHITEC provides has less to do with technology and more to do with implementing other changes in the clinical environment.
“This emphasis on trying to help these practices transform what they’re doing to make it more patient-centric — it’s really not about the IT; it’s about the culture and redesigning workflows and things like that,” explains Stacey Novogoratz, Field Operations Manager at WHITEC. “That’s sometimes a soft type of assistance in the minds of providers and feels a little intangible, but it can make such an impact to shift that culture and shift some of those workflows so that you are trying to make things more patient-centered.”
As with EHR adoption, the form this support is likely to take will depend on the characteristics of each practice. “What we’ve learned through this journey is that meaningful use and all the other initiatives have their challenges for all those different sizes of organizations and the assistance we can provide is going to be different but that everyone can use some,” adds Novogoratz.
In the context of accountable care and population health initiatives, WHITEC’s history working with an array of providers should help bridge the gaps between care settings and bring greater alignment to collaboration between providers. But the task still poses many challenges.
“As we look at accountable care and population health we need to make sure we’re aligning the big and small practices,” says Wang. “We as a convener and facilitator can help with that piece and being able to connect through health IT all of the care that’s happening and again looking at that community perspective of how do we make sure that the patient is flowing through the care system in a way that is patient-centric and capable of improving care and reducing cost.”
While the case of Wisconsin may not be indicative of EHR adoption in other states, it does provide insight into how a well implemented health IT infrastructure can serve as the foundation for achieving the real meaningful use of EHR systems in the context of more complicated and complex care coordination and quality improvement projects. Source
