Electronic Health Records

Adoption & Implementation News

How will transitions of care challenge meaningful users?

By Kyle Murphy, PhD

- Stage 2 Meaningful Use places new and greater requirements on eligible hospitals and professionals. What makes this next phase of the EHR Incentive Programs a greater challenge is the need for providers to work together not only with other providers but also patients.

In this first installment of a two-part interview with Stephen Beck, MD, FACP, FHIMSS, the Catholic Health Partners CMIO explains how transitions in care could trip up providers on the inpatient side.

How is Catholic Health Partners handling preparation for Stage 2 Meaningful Use?

What we’re doing at CHP is trying to keep up with the pieces that our organization doesn’t have much control over. One challenge is lab system certification and dependency on third-party systems and their ability to upgrade. That frankly has delayed some of our work. That being said, the vendors are working very hard to assure we’re up and running so we can have our attestations completed for Stage 2. The changes of the thresholds, for the most part we are more comfortable with as we already have the established workflows, and providers aware of what they need to do to meet those measures.

When will eligible providers be ready to attest for the first year of Stage 2?

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Best case scenario is that we meet appropriate thresholds for our ambulatory providers in the first reporting period. On our inpatient side, we’re waiting on the lab certification placing us on a very tight timeline. It makes me feel like we’re starting in the middle of a calendar year for Stage 1, for example, where you know you want to get it done and you think you can, but you know you have a shorter timeline.  I’m more confident we’ll have our transitions of care worked out by that time, but transitions are very high on the list as well.

How do you then train clinicians for tools that they can’t get their hands on?

That’s a big challenge trying to explain a workflow that’s not solidified yet. Through our informatics groups, we’re continuing to work on regular education to the providers. That is a little easier on the ambulatory side because most workflows are cut and dry. On the inpatient side, we are less worried about the providers and we’re engaging the nursing staff to assist with the transitions of care as well. We’re putting together communication and education pieces around the expected workflow and how in a shared record we can engage both the nurses and the providers in the eligible hospitals to ensure that the transitions of care are occurring.  This improves communication, and quality of patient care.

Why do transitions of care present such a challenge on the inpatient side?

Personally, I think it’s one of the most important pieces that is in Stage 2 but is also the most challenging. We’ve been working on enrollment with Healtheway — not all organizations have decided to do so, but we felt it was important for us to be a little more aggressive about making that connection — but beyond this are connections with other outside organizations – basically foreign electronic records.

We are working with another EHR vendor on a connection to our EHR system. The most challenging part is getting both vendors together to reach the same goal of data exchange; this is a unique challenge in Stage 2. In Stage 1 as long as your EHR vendor was working hard with you it was a bit easier to complete everything. Now where there are more pieces to the puzzle.

Why are transitions of care so important? And why must an organization spend so much time tracking them?

This measure excited me. The functionality has the potential to deliver better care, better continuity, and better assurance that patients are actually getting their follow-ups. It is one of those measures that make a lot of sense. This will improve patient care, satisfaction, and quality – supporting the mission of CHP and many other organizations.  The challenge is in getting it all done and getting all those moving parts working together to meet those meaningful use measures.

We’ve been audited several times, both on the ambulatory and inpatient sides. We want to have total assurance and confidence that we’ll meet the measures with any audit moving forward, so that’s really important for us — we’re very deliberate about the workflow, expectations, and tracking so that we can pass an audit with flying colors.

Check later this week for part two.



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