Physician advocates key for achieving MU, says Kansas CMIO

By Diana Manos
10:22 AM

One of the greatest boons on the journey toward achieving meaningful use is having physicians champion health IT, according to Greg Ator, MD, chief medical informatics officer for the University of Kansas Hospital, an academic medical center based in Kansas City.

In an exclusive interview, Ator told Healthcare IT News the hospital pays 20 physicians to be physician informaticists, assisting their peers through the entire health IT transition.

"Its a journey," Ator said, noting that change takes place with doctor-to-doctor interaction, with some physicians embracing HIT adoption right away and others pushing back at first.

[See also: Mostashari to providers: MU is not about 'hoop jumping'.]

According to Ator, the hospital has paid for the physician informaticists to take short courses on healthcare IT. “We’re trying to get them beyond `I like EMRs and I can support their use,’ to being aware of the informatics concepts involved,” he said.

The University of Kansas Hospital is planning to attest to meaningful use shortly, Ator said. In June, the hospital went live with 240 evidence-based order sets with Zynx Health’s computerized provider order entry (CPOE), deployed via Epic's EHR system.

"It's not just about having evidence, doctors need to perform to the evidence," Ator said. "Accountability is important, but more important are accountable individuals and how they interact and operationalize."

"People see meaningful use as just another government program with negative connotations, Ator said. "We’ve rebranded meaningful use to 'meaningful outcomes.'"

Convincing doctors of the power of health IT
"We aren't simply selling EMRs to the doctors," said Ator. "With meaningful use, we're  bringing up the concept that you need to be using all the power of the system."

 Take the problem lists, for example, Ator said. They help provide better care and better outcomes. When viewed from this perspective, it helps the doctors to not focus so much on the number of clicks they're required to make on their computer.

"We're trying to have conversations around [meaningful use] and do it in a workflow cognizant fashion," he added. "We're trying to hold people accountable."

KU Hospital began using EHRs in 2007. The hospital began using CPOE "across the house" six months ago, with 100 percent adoption. “We didn't allow anyone to opt out,” he said. The hospital is currently working on getting its two physician practices up and running on CPOE.

According to Ator, KU Hospital has gone from saying to its physicians, "[Health IT] is something we're going to give you as a tool set as we cajole you into using it," to now saying, "meaningful use is our floor."

"We're saying to our academic practices, if you use the system and embrace the project you'll be meaningful use compliant," he added.

Redesigning clinical process
One useful aspect of adoption has been redesigning the clinical process to requiring licensed nurse practitioners (LPNs) to perform a more defined list of tasks related to meaningful use compliance.

According to Ator, the LPNs enter a whole data set into a patient's EHR, including medication lists and past medical history. The doctor verifies it during the visit.

“In preparation, we are requiring the LPNs to keep this data on paper now,” said Ator – adding, “it has been somewhat of a challenge.”

Working with vendors
Another challenge has been working with vendors, said Ator. "They aren't perfect, and they aren't mind readers. It's a delicate dance between what a vendor can do and how much change our practices can tolerate."

He said that, "to help with that process, we have a very dedicated group of optimization folks. They determine what functionalities we need to work on. We want to know what doctors are spending their time doing and make sure the people processes are there and optimize that."

[See also: Texas Health Resources CMIO tells how the system earned $19M for Stage 1.]

Follow Diana Manos on Twitter @DManos_IT_News.