Road to meaningful use bumpy for some

By Bernie Monegain
08:45 AM

CIOs told a federal panel Tuesday about the roadblocks they have faced on their way to achieving meaningful use of electronic health records. Among those who testified before the Implementation Workgroup of the federal Health IT Standards Committee were five members of the College of Healthcare Information Management Executives (CHIME).

Meeting all requirements necessary to demonstrate meaningful use of electronic health records will be challenging for many hospitals, testified Joanne Sunquist, CIO at 440-bed Hennepin County Medical Center, a safety net teaching hospital in Minneapolis.
The hearing, "Real World Experiences Working with Meaningful Use," featured panels of eligible professionals and large and small IDNs, as well as regional extension centers and certifiers.

Four CHIME members, including Sunquist, participated on the hospital experience panel, which shared various perspectives from early adopters on installing electronic health records systems and achieving meaningful use objectives.

Another CHIME member took part in the implementation support panel to discuss the efforts involved in collaborative health information exchange. CHIME members who testified in addition to Sunquist were:

  • Russell P. Branzell, vice president and CIO, Poudre Valley Health System, Fort Collins, Colo.
  • Charles E. Christian, CIO, Good Samaritan Hospital, Vincennes, Ind.
  • Denni McColm, CIO, Citizens Memorial Hospital, Bolivar, Mo.
  • Linda Reed, vice president and CIO, Atlantic Health, Morristown, N.J.

The testimony before the HIT Standards Committee hearing is expected to help the Implementation Workgroup formulate recommendations to the Health IT Standards Committee and to David Blumenthal, MD, the national coordinator of health information technology, on early adoption of meaningful use.

"Creating the reports for eligible hospital MU objectives and quality measures has become an onerous, difficult and time-consuming process," Sunquist said. "This is in spite of the fact that we are working closely with our certified vendor who has provided certified reports. We are concerned that the difficulties organizations will face in producing the reports will result in significant delays in attestation, while not inherently adding value to the overall intent of MU."

Christian (pictured at right), CIO of a 232-bed community hospital in rural Southwest Indiana, told the panel his organization was fortunate to get a head start on implementing technology.

"GSH was early to realize the importance of the appropriate implementation of technology in the effective and safe provision of care," Christian said. The hospital and medical staff worked together to identify applications "that would improve the care process and create a safer environment in which to deliver high-quality care."

Christian points out that through hard work and a dedicated team, Good Samaritan Hospital has been very successful. However, its outcomes and experiences cannot be considered routine.

"In smaller facilities, the IT departments are much smaller and the spectrum of responsibility and effort ranges from management duties all the way to pulling and installing network cable," he said. "In many critical access hospitals, they have to depend upon the talents and services of outside expertise, as they cannot afford to employ certain positions on a full-time basis. In my conversations with smaller facilities, there is a concern that they will not be able to retain the level of expertise that the identified efforts will require."

Discussing health information exchange, Atlantic Health's Reed noted that achieving the meaningful use objective is more than a technology issue for most healthcare organizations.

"HIE ... includes appropriate use cases and the incorporation of acquired data into the physician EMR workflow," Reed said. "In various discussions with physicians in my organization, it is clear that they want autonomy in choosing technologies, but also expect to be able to send and receive data at will. The trouble is that many of them do not know what is required for this or whether they have capable systems."