Meaningful use promises to open data up to patients, improve the flow of information and drive efficiencies to maximize the level of care providers can offer. But meeting meaningful use requirements can be a daunting challenge, and as the federally mandated dates for IT adoption loom nearer, many providers are scratching their heads about how best to attest. Anita Karcz, MD, chief medical officer at IHM Services Company, MEDITECH’s strategic ally for clinical, quality and regulatory reporting, shares some thoughts on smart ways to implement technology on the road to meaningful use.
1. Don't ignore the human side. Installing new hardware and software is the first step. Bigger hurdles lie in building a system that accommodates the people who will be using it. Karcz says this is "changing the way workflow happens in a hospital. The way clinical people have been used to doing their clinical care have to now interact with information systems." She says that this is an initiative that can't be done in sprints. "You can't do 90 day heroics," she says. "That doesn't work any more." Instead of the "short term initiatives." Karcz says hospitals have historically pursued when implementing change, she advocates for a long term communicative process that focuses on the end goal of practitioners embracing the program and adapting their workflow to it.
2. Take a fresh approach. Recent changes in American healthcare have pushed the industry to deliver new kinds of care with fresh objectives in mind. "The thing about clinical providers is that their training is to focus on single patients," Karcz says. This is a good thing for a doctor's ability to interpret information and attend to the needs of the patient in front of him or her. Information technology helps sift through the massive amounts of data generated to help arrive at conclusions that were previously harder to reach, or had eluded medical professionals. "Rather than analyzing several hundred cases," Karcz says, "thousands or millions could be studied at a fraction of the cost and in a fraction of the time."
3. Do it with data. The influx of data has been driven by meaningful use and its requirement for electronic health records and computerized physician order entry. Karcz says this has been instrumental in the drive for the collection of structured data, which in turn paves the way for "opportunities to improve care in wider groups of patients." She says that the drive to use data has the ability to catch more people before they undergo a significant healthcare event, and that with a better-managed patient population comes more comprehensive reimbursements. Leveraging the information captured lets healthcare systems take a birds eye view, which Karcz says helps them address broader patient health questions. "How many patients do we have with a certain condition? How many are the same, how many are different?" she asks hypothetically. "This is when doing data analytics becomes important. If you see a pattern, you can address it much more effectively than when doing it one by one."
4. Recognize the importance of education. Forcing a massive new system on an entire organization can damage workflows, relations, and even the quality of care. "A lot of this is a two pronged approach: make sure clinical people are involved," says Karcz. "The other piece is educating, and getting those people involved." Akin to dipping a toe in to a pool before plunging in, Karcz says launching new IT initiatives department by department can save the system a shock. "Do it with a pilot group, then roll it out to the rest of the physicians," she says. Another must-do is treating the process as an ongoing evolution as opposed to a one-off implementation. "In setting up CPOE, the first piece is getting physicians to give you feedback," says Karcz.
5. Remember the roles. Healthcare IT makes inroads everywhere from scooping up at risk patients to providing clinical decision support. It can also make every aspect of a patient's healthcare record available to them in intimate detail. This is a lot of raw knowledge, Karcz points out, and without guidance and help interpreting the information, it won't do much to empower the patient or improve their literacy. "You could be looking at something that looks alarming but actually looks normal [to the doctor]," she says. "Being able to communicate that in some way along with the results is critical." Giving patients access to their data is the keystone of Meaningful Use and it has the power to enhance the level of healthcare dialogue between provider and patient. However, providers need to be clear about the ambiguities of raw data and how misleading or confusing it can be. Education goes hand in hand with opening up records and test results to patients, Karcz says. It's the only way to ensure that the information is actually actionable. "You can't just toss out numbers," she says.
6. Minimize risk, maximize benefit. Meaningful use has financial consequences tied to it. Not attesting leads to penalties, and that is often the incentive used to bring it to hospitals. Karcz sees it in another light, however. "To me, this is like buying a personal computer: I need one to do work in the 21st century," she says. Much of the power hospitals stand to gain in the ACA-centered landscape will result from smarter collection and use of data. Karcz says that this is "return on information, not return on investment." While there are laws and compliance penalties in place to prod adoption, she sees that the real driver to attest to meaningful use is all of the good that it can do for a patient population. That works out best for the bottom line, too.