Electronic Health Records

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What meaningful use means to non-meaningful users: CIO series

By Kyle Murphy, PhD

- Just because a provider is not eligible for or participating in the EHR Incentive Programs, that doesn’t necessarily mean that he can turn a blind eye to meaningful use. In all likelihood, other healthcare organizations in the care community that the provider does business with will be implementing changes to their certified EHR technology to meet the requirements of subsequent stages of meaningful use. As a result, the EHR Incentive Programs can still serve as a driver of health IT adoption for non-meaningful users, albeit indirectly, in order for these providers to streamline the business of coordinating and delivering care.

Such is the case of Pediatric Associates in Washington State, a physician-owned organization whose physicians are either ineligible for the EHR Incentive Program for Medicare or do not deem the Medicaid portion of meaningful use to be a worthwhile business investment. But that hasn’t stopped the organization from taking meaningful use into account when enhancements are considered for its EHR and health IT systems and services, says Pediatric Associates CIO Brock Morris.

In this installment of the CIO series, Morris explains what meaningful use means to a non-meaningful user and how requirements for the EHR Incentive Programs influence health IT-related business decisions for his organization.

Why isn’t meaningful use applicable to the organization?

We’re a physician-owned private pediatric practice on the East Side of Western Washington — Bellevue and the surrounding area which is across Lake Washington from Seattle — and it’s a relatively affluent area. We have seven clinics right now. We’re opening an eighth soon. We have 85 doctors. But most of our demographics don’t qualify our doctors or our doctors don’t see a high enough percentage of those patients to qualify. Now, we have a handful who do so we will be attesting to meaningful use for those doctors in the coming months or so, but part of that is from a project priority standpoint. Not that the work is too much, but really for a couple of doctors for a relatively small amount of money it doesn’t drive our strategic plans so to speak.

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Do you keep an eye on the meaningful use requirements and standards as a jumping-off point?

Absolutely, we’re very closely involved with our EHR vendor. We do a fair amount of data testing for them. We look at a lot of the meaningful use criteria, which is obviously what is driving much of the functionality. It’s really what drives the content for CCD and the sharing of that which is obviously very important to us still in the community with the local children’s hospitals, especially those we’re involved very heavily with right now in creating an HIE with them, piloting that, and hopefully we’ll eventually have that available in the community.

Obviously, a lot of the points of meaningful use play into other aspects of our business, so we just naturally want that ability anyways. We try to pinpoint those, focus our projects around those that are most important. We may not be getting the dollars for it, but it’s still a part of our strategic planning.

When was adopting an EHR system identified as a priority for the organization?

We recognized the change in healthcare back in 2008. We saw the transition to electronic health records and saw that the industry was finally moving from what was traditionally a best-of-breed approach — a separate system for practice management you interface with an EHR — to fully integrated products, more web-based, single database, all of those things. The timing was right from a medical marketplace standpoint. The timing was right from a technology standpoint. And really because of our organization’s size and governance, it played well into the way that we operate. We knew it was a key time to implement and adopt. And we knew meaningful use was coming; we recognized at the time that it was going to be a huge incentive necessarily, but that’s where a lot of focus was going to be put. We wanted to be at least slightly ahead of the curve if not right on the curve.

What is the value to pediatrics of adopting and use EHR and HIE?

It’s absolutely paramount for pediatric care, and that’s driven by the demographics of our patients and their parents, who are so important to us. You have to look at what they’re looking for. They’re looking for the same experience they have when they buy airline tickets, when they bank, when they buy movie tickets — they get to own the process from beginning to end. Promoting yourself as an organization that offers quality healthcare, that’s a standard now. That doesn’t get you anything with your patients. That’s an expectation. What they really want to know is how do you make it easier for me to interact with you through technology. That’s what their expectations are.

Why is EHR adoption an important starting point for improving healthcare, especially through patient access to health information?

When you talk about an EHR, it’s the beginning of being able to provide that patient-centered accessibility and transparency with their health record, giving them a portal not only to pay their bills but also to access their records. Especially in pediatrics, we go up and down throughout the year between a busy season and a sick season, but then the real busy season is just before school starts. There are support forms that need to be filled out, and immunization records they need for school registration — all of those things. EHR adoption is the beginning to providing that, and then it’s eventually being able to share that data across the care continuum, particularly in pediatrics. If a child goes to the ER for an accident, our doctors want to know about it. We’re a heavy referral source for the hospitals, so we want to be able to share our record with them and vice versa with our doctors rounding as well on the kids there.



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