- Based on their work with eligible professionals and hospitals in Stage 1 Meaningful Use, regional extension centers (RECs) have a good read on where providers are in their EHR adoption journey and how they are likely to fare in the next phase of the EHR Incentive Programs.
With Stage 2 Meaningful Use raising the bar on previous thresholds and including entirely new measures for eligible providers, continued success in demonstrating meaningful use is coming to come down to having the right amount of resources, says Randy Hountz, MBA, Principal Advisor-Operations for Purdue Healthcare Advisors.
According to Hountz, requirements for coordination and exchange of health information between providers have the potential to challenge one subset of the meaningful use provider population in particular — that is, the small providers. In this Q&A with the Purdue REC, Hountz highlights how transitions of care are an example of the challenge facing these providers in Stage 2 Meaningful Use.
How prepared are providers in Indiana for Stage 2 Meaningful Use?
It’s been fascinating to watch Stage 2 unroll as compared to Stage 1. We’re in the same spot where people glance at a lot of the requirements and metrics and think, “That’s not that hard especially after I’ve done Stage 1. This is just a few new things; it’s not going to be that difficult.”
Just as we saw in Stage 1 when people started to dig into the details, they are realizing that it may be a little bit more complicated than what they had anticipated. It’s not surprising but Indiana folks in Indiana are starting to realize that Stage 2 is hard and they’re going to need some help to get there. Obviously, we’re in a good position to do that.
What factors will determine whether an eligible provider is successful or unsuccessful in Stage 2?
The challenge is going to be different based on the size of the organization. In Indiana, we have a significant amount of provider employment, employed by hospital systems specifically, and they have to look at global solutions for transitions of care. They can’t look at one doctor out of 475 doctors — one a provider to provider basis — and just his transitions of care and how to they get to 10 percent. They have to be thinking of some global solutions for that. We are very fortunate to have a very good HIE in the state that has a global solution and for them now it’s a matter of getting in queue. It’s bandwidth from an HIE standpoint for them to get all aligned and integrated.
For a small provider it’s much more difficult because they probably can’t buy that solution. They’re going to have to do a little more of that detailed work of whom am I referring out to and then they’re going to have to do some more work to determine if those providers are on Stage 2 software or a piece of a HISP somewhere because if they’re not this HISP to HISP thing doesn’t work. That’s the biggest challenge I see for small providers — that physician they are referring to has to also be on a HISP to get that transition of care piece to work.
Is the Purdue REC in communication with these HIEs in order to help providers?
Absolutely, we talk to them if not every week then every other week. Our main HIE in the state also does work with syndromic surveillance messaging to the state’s Department of Health as well as immunizations. We’re fortunate in the state to have several HIEs, and we keep open communications with all of them. The whole transitions of care — that has really just started to crystallize in the last two months as far as what is a real process that can happen to make it work. We’ve been talking about hypothetical HISPs, HIEs, and eHealth partners. Now it’s shifted to workable plans.
Is integrating HIE into clinical workflows going to pose a problem?
It is. For large providers, they’re probably going to make that workflow fairly straightforward for providers or their staff. It’s going to be a concern for small providers and it’s going to depend on the software. On top of that, they’re going to have to configure their software to set up where that referral is going and what their Direct address is and their EHRs need to verify their security key and all those technical components. It’s really going to be tough.