Although meaningful use is still in its infancy with Stage 2 Meaningful Use just about to begin, valuable lessons are already emerging as eligible hospitals and professionals make preparations for this next phase of the EHR Incentive Programs. Most important of those may very well be the harm of treating each stage of meaningful use individually rather than as part of an ongoing effort.
“One of the things that we’ve seen with our organizations that are successful is that they fully understood the concept of Stage 1 Meaningful Use as a foundation,” says Linda Lockwood, Partner of Advisory Services at Encore Health Resources. “They used that as a platform to define how they were going to calculate and report those electronic measures and really how they were going to lay that foundation for quality.”
This philosophy stands in stark contrast to the one taken by those “other” organizations, the one-off approach to meaningful use, which is likely responsible for many of the headaches eligible providers are experiencing as they gear up for Stage 2 Meaningful Use.
“Some large organizations that have a serious commitment to this, just felt like that wasn’t something they could bite off,” Lockwood explains. “Now they’re going back and they’re challenged with that and they have to do the heavy lifting because when you have a portal and the patient’s problems aren’t really the patient’s problems, that patient is going to be concerned. And when you go to transfer that patient and you truly don’t have an active problem list, then you have an issue in continuity of care.”
According to Lockwood, Stage 2 Meaningful Use represents an opportunity for hospitals and physicians to shore up any inefficiencies caused by their decision-making in Stage 1 and prepare their certified EHR technology and staff for the long-term commitment that is EHR adoption.
“The key to this is seeing it as an opportunity,” she argues. “If you didn’t do it the first time, it’s all not lost. How do we go back and do that? What are the best practices? What is that programmatic approach? It’s standardization. It’s improving workflows like medication reconciliation. It’s documenting at the point of care.”
So how can organizations that didn’t prepare for the long haul during Stage 1 Meaningful Use change gears before moving on to Stage 2? Lockwood and Encore’s programmatic approach involves the following tactical steps and recommendations:
· Identify and act upon lessons learned.· Embrace a big vision; leverage the meaningful use effort.· Understand the scope and level of effort required; don’t underestimate Stage 2 challenges: thresholds, interoperability, and patient portal and engagement.· Include all stakeholders; align with quality and performance improvement.· Develop program management and governance.· Focus on adoption and change management.· Understand vendor approach; challenge and check.· Create an auditable defense portfolio and an audit plan.· Budget for upgrades, software and services; understand how this will affect the timeline.· Establish a comprehensive portal plan to include security, access, outreach, content, policies and procedures.· Pay special attention to the summary of care: the complexities, the content to include physician documentation for care planning.
In the end, continued success in the EHR Incentive Programs comes down to commitment from all levels of the healthcare organization.
“The ones that did it well realized it’s more than an IT project,” says Lockwood. “They got senior leadership around the table in the beginning when they did their kickoff. We had some frank and open discussions about if they were going to be able to commit the time and money and bring the clinicians to the table to make these decisions, to standardize their workflows and processes so that they could be assured that they were going get the out.” Source
