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Stalking the elusive meaning

July 01, 2009 | Bernie Monegain, Editor
From the July 2009 print issue

Many of us probably have had our fill of talk about “meaningful use.” Perhaps some of us thought we would have the last word on it on June 16 when the federal Health IT Policy Committee provided some recommended criteria to the nation’s healthcare IT chief David Blumenthal.

But, no. The policy committee sent its workgroup back to the drawing table. A new set of recommendations is expected at the July 16 meeting, and there may still be some defining work left to do after that.

We think the conversation has just begun. In fact, that’s what Blumenthal called the process: “The beginning of a conversation that is going to last for some time.” No one has defined “some time.”

It’s critical to define meaningful use so that everyone has a fair shake at the stimulus funds earmarked for encouraging the uptake of healthcare IT. It’s important also to have as many voices as possible heard from providers, the marketplace, government, consumers and policymakers – not necessarily in that order.

The work of transforming healthcare is unavoidably complex and messy. Some have said it’s like trying to get a fix on a moving target.

“The definition of meaningful use will be evolving in the next 60 days,” said John Halamka, the CIO of Harvard Medical School and co-chairman of the federal Health IT Standards Committee, at a meeting of the committee on June 23. “This will require the standards committee to coordinate their work with ‘a set of evolving criteria.’”

Hospitals and physician practices that are undertaking projects now can be guided by the discussion so far and more broadly by a common sense definition of what is meaningful. We know that the point of making sure a project falls under the correct definition is reimbursement. But if they keep care of the patient at the forefront, use IT to improve that care and become more efficient at the same time, it would be meaningful.

Healthcare systems have been engaged in meaningful work on the healthcare IT front for decades. There are models to look to. President Barack Obama named a couple – Intermountain Healthcare in Salt Lake City and Geisinger Health outside of Philadelphia – in a talk he gave last month in Green Bay, Wis.

But they are not alone. There’s Eastern Maine Medical Center in Bangor, Maine, which was recently recognized by the Healthcare Information and Management Systems Society with the Davies Award for its – dare we say it – meaningful use of healthcare IT. 

EMMC is just one of countless hospitals and healthcare systems across the country that saw the promise of technology long ago and took steps to realize the potential.

The difference today is that the effort is more concerted than it’s ever been. The stakes are high and the energy is high. It’s time.

We know this much: The use of CPOE, compliance with HIPAA and documentation of procedures are included among the panel’s long list of criteria to demonstrate “meaningful use” of healthcare information technology. It seems likely those guidelines will stay. It’s a start.

Step by step, standard by standard, definition by definition, the system will change. But, as far as “meaningful use” goes, we have not heard the end of it yet.

 

Related Topics:
  • July 2009
  • David Blumenthal

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