5 ways providers can get a jump on MU

Don't wait for vendors to take the lead
By Tracy Hume
08:53 AM
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Too many eligible providers are waiting for their EHR vendors to take their hands and tell them how to navigate the next stage of meaningful use.

[See also: Practices badly lagging on ICD-10]

But Derek Kosiorek, principal at MGMA Healthcare Consulting, wants EPs to know it doesn't have to be that way.

"There are steps providers can take to get ahead of meaningful use without waiting for their EHR vendors to get them there," he said.

[See also: Outpatient impatience]

A common misconception is that meaningful use is all about the technology.

"People think meaningful use is a technical matter, but it's really not," said Kosiorek. "It's much more about workflow and process than it is about technology.

"When I talk to groups about meaningful use, I try to take the word 'technology' out of it," he added. "Because people just throw their hands up and say, 'I'm not a computer person.' But if we remove the word 'technology' from the equation, it makes it a lot easier to understand what needs to be done and when it needs to be done."

Kosiorek outlined several steps eligible providers can make meaningful use work for their practices without waiting for their IT vendors to do it for them.  

"First, understand your workflow," he said. "A lot of practice groups rely on their EHR to dictate their procedural workflow. They think that since it's an EHR company, they must have worked out a better workflow. That's not necessarily the case. Sometimes the workflow developed by the EHR is what is easiest to do in the application, not what best practice is."

After providers have a solid understanding of their own workflow, they need to understand how the EHR can augment and improve it.

"Is the EHR helping your workflow? Or did it overtake and dictate your new workflow?" Kosiorek said. "It's important to marry your workflow with the capabilities of the EHR system, rather than completely overhauling your workflow to fit what the EHR does. You want to make sure you understand what your practice's needs are first, and then use the tool to your advantage."

The third step is to designate a point person within the practice who will commit to understanding meaningful use.

"Somebody on the staff needs to understand the rules and regulations, the incentive requirements, and the deadlines," said Kosiorek.

The meaningful use point person is usually someone who works directly for the CEO, such as the person in charge of quality assurance. Sometimes it is the IT person, but it doesn't need to be, he said.

"Whoever the point person is, they need to be in touch with the patient services folks, the nurses and the doctors," said Kosiorek. Implementing meaningful use often "changes the workflow," so the point person has to have the authority to work directly with nurses and doctors to make the necessary workflow changes.

Understanding meaningful use and the EHR incentive program is not as complicated as people think.

"Stage 1 was mostly about tracking the information many practices already had," Kosiorek said. "Pulling that data out is a lot of what Stage 1 Meaningful Use was. It was just a reporting package to say 'Yes, we did this' and 'No, we didn't do that' and how many times and what patient population was affected.

"Most of the time, Stage 1 was about little tweaks that needed to be made: data that needed to be tracked, reports that needed to be done," he added. "Now, with Stage 2, we are getting to the point where some action needs to be taken with the patient, such as exchanging information with the patient through the portal. The requirements have stepped up for Stage 2."

Plenty of resources are available to help people understand the rules and regulations surrounding meaningful use.

"You can bone up on this with an hour of reading the PowerPoints on the CMS website," Kosiorek said.

In addition, "many specialties have affinity groups or resources specific to that specialty, that will tell them, for instance, what the best PQRS measures are for their specialty. A lot of times you can just do a Web search on 'meaningful use' or 'orthopedic surgeon,' for example, and it will come back with specifics about that."

Kosiorek read the final rule for Stage 1 meaningful use when it was published in the Federal Register.

"It was a decent read, and it was pretty easy to understand," he said. "It was written in a straightforward, conversational tone, rather than boring, lawyer jargon."

After providers have developed an in-house expert on meaningful use, it's time to talk to their EHR vendor.

"Find out what the vendor's timetable is to perform an upgrade and ready themselves for Stage 2," Kosiorek said.

At this point in the process, "you have the knowledge of the regulations, you know what you need to do, and you know what the vendor's capabilities are. Next you have to do a gap analysis between where you are and where you need to be," he said.

The final step is to "develop and implement a compliance plan, based on your gap analysis." Is meaningful use compliance ultimately worth the trouble it takes to implement it?

Kosiorek believes it is: "Without meaningful use, we would still be in the Wild West of crazy definitions: what is an EHR? What does an EHR do? With meaningful use, we are defining what we are capable of, and then we are executing on that.

"That's why I'm an optimist about meaningful use," he added. "I think it brought us years ahead of where we would have been without it."