After the July 13 release of the final rules of meaningful use, providers all over the country are examining the 15 core regulations and 14 "a la carte" regulations to determine how and when they will quality for incentive payments. Here are five tips from three experts in meaningful use for preparing to meet these regulations.
1. Focus on the long-term benefits, not the short-term incentives. Providers seem to agree that a hospital or health system that focuses on implementing an EMR to achieve incentives, rather than to reduce error and improve quality of care, is doomed to continuously be behind the curve on implementation. Don't settle for the minimum amount of effort required to meet standards. Instead, accept that EMR is an integral part of the future of healthcare and will eventually provide great benefits to your administrators, physicians and patients — even if it doesn't seem that way during implementation.
"I think we do a lot of things that improve care and advance care, but very little of it really saves money," said John Connolly, Ed.D., CEO of Castle Connolly, a healthcare research, information and publishing company that identifies the top doctors and hospitals in America. "I think the real savings will be in the management of chronic diseases, preventing duplicate tests and being able to access a patient's entire medical history. Obviously that's going to result in better care. I'm not optimistic about cost savings. I think improved quality should be the focus."
Karen Burton, in-house healthcare expert for integrated information and technology solutions provider Logicalis, says that the hospitals who are struggling with implementation are those who "only started on it because of the regulation." At first, she says the hospital administrations looked at the requirements for incentive payments and asked, "What can we do with the limited funds we have?" They failed to note that the less they did to implement a successful EMR, the more it would cost them in reimbursements every year from 2011 to the foreseeable future. It's not just about the payments in 2011; make your implementation as thorough, permanent and successful as possible to guarantee the highest reimbursements from here on out.
Focusing on long-term benefits means getting your organization's leadership team on board with EMR for the long haul. "No EHR implementation is going to be successful just because there's a regulatory or reimbursement reason," says Randy Thomas, vice president of integrated product management and marketing for Premier healthcare alliance, a performance improvement alliance of 2,300 non-profit hospitals.
2. Build pockets of connectivity. Ms. Thomas says that while it may not be obvious now, connectivity between EHR systems is happening incrementally all over the country. "With each additional connection point, it begins to get to that tipping point for greater and greater connectivity," she says. "We're not going to flip a switch five years from now and suddenly connect everyone, but one of these days we'll look at the big picture and see that a lot of connectivity has been built over [these gradual implementations]."
Ms. Burton also recommends that facilities plan to submit data to state and local health information exchanges. By submitting data to an HIE, an organization can move clinical information among disparate healthcare information systems and help more organizations provide safer, timely, patient-centered care. The 2012 core meaningful use regulations require organizations to electronically submit clinical quality measures to government agencies, and getting used to sharing data electronically can prepare your organizations for these kinds of requirements.
In addition, hospitals should extend their EMR to their affiliated physicians and to their patients. The core regulations for EMR use require providers to "implement capability to electronically exchange key clinical information among providers and patient-authorized entities."
3. Plan for the staged deadlines. Don't plan your implementation around the requirements for 2011 and assume that the work is over. "The thing that people need to understand is that the requirements are fairly minimal for 2011 and then they get much tougher in 2013 and much, much tougher in 2015," says Ms. Burton. For example, she says, imaging for radiology and cardiology is not required to be integrated until 2015, but Logicalis recommends that hospitals start thinking about it now. "It's a pretty complicated thing to do, and there's some technology infrastructure that needs to be in place so that you can do it effectively."
In determining how your organization should plan its implementation to meet meaningful use requirements by 2011, Susan Kanvick, healthcare knowledge leader for Point B's healthcare practice, says you should read over the list of "a la carte" regulations and pick those that are easiest to meet by the first deadline. "I recommend prioritizing by level of effort required to meet and have at least one or two as contingency," said Ms. Kanvick. "It also depends on timing. If they are delaying to the last possible time frame to meet "meaningful use" regulations, they might want to consider getting as close as they can to all ten, because they will become part of the core regulations in the next stage."
4. Look at your existing quality reporting processes. Quality reporting will be an integral part of meeting meaningful use requirements, as providers will be required to report clinical quality measures to state or federal organizations through attestation in 2011 and electronically in 2012. Ms. Kanvick recommends examining your existing reporting functions. "They are likely by necessity fairly reactive and distributed through the organization," she says. "Consider how to better approach the collecting, interpretation of and reporting on quality data."
5. Choose a vendor that will help you get to meaningful use. Don't get too bogged down in the details of how to meet each requirement that you lose sight of your plan, Ms. Burton says. In her experience, many hospitals that started with a "best of breed" system, in which several different applications are used for different hospital needs, are taking a look at their eventual goals for meaningful use and instead deciding to spend the money on an integrated system. "Highly integrated enterprise EMR applications kind of guarantee you'll get to meaningful use," she says.
When picking a system, Dr. Connolly says it's important to pick a system that seems to have the potential be compatible with other systems. "Choosing carefully is very important," says Dr. Connolly. "You want to choose a system where you can connect hospitals to community-based physicians and to patients and to other hospitals."
1. Focus on the long-term benefits, not the short-term incentives. Providers seem to agree that a hospital or health system that focuses on implementing an EMR to achieve incentives, rather than to reduce error and improve quality of care, is doomed to continuously be behind the curve on implementation. Don't settle for the minimum amount of effort required to meet standards. Instead, accept that EMR is an integral part of the future of healthcare and will eventually provide great benefits to your administrators, physicians and patients — even if it doesn't seem that way during implementation.
"I think we do a lot of things that improve care and advance care, but very little of it really saves money," said John Connolly, Ed.D., CEO of Castle Connolly, a healthcare research, information and publishing company that identifies the top doctors and hospitals in America. "I think the real savings will be in the management of chronic diseases, preventing duplicate tests and being able to access a patient's entire medical history. Obviously that's going to result in better care. I'm not optimistic about cost savings. I think improved quality should be the focus."
Karen Burton, in-house healthcare expert for integrated information and technology solutions provider Logicalis, says that the hospitals who are struggling with implementation are those who "only started on it because of the regulation." At first, she says the hospital administrations looked at the requirements for incentive payments and asked, "What can we do with the limited funds we have?" They failed to note that the less they did to implement a successful EMR, the more it would cost them in reimbursements every year from 2011 to the foreseeable future. It's not just about the payments in 2011; make your implementation as thorough, permanent and successful as possible to guarantee the highest reimbursements from here on out.
Focusing on long-term benefits means getting your organization's leadership team on board with EMR for the long haul. "No EHR implementation is going to be successful just because there's a regulatory or reimbursement reason," says Randy Thomas, vice president of integrated product management and marketing for Premier healthcare alliance, a performance improvement alliance of 2,300 non-profit hospitals.
2. Build pockets of connectivity. Ms. Thomas says that while it may not be obvious now, connectivity between EHR systems is happening incrementally all over the country. "With each additional connection point, it begins to get to that tipping point for greater and greater connectivity," she says. "We're not going to flip a switch five years from now and suddenly connect everyone, but one of these days we'll look at the big picture and see that a lot of connectivity has been built over [these gradual implementations]."
Ms. Burton also recommends that facilities plan to submit data to state and local health information exchanges. By submitting data to an HIE, an organization can move clinical information among disparate healthcare information systems and help more organizations provide safer, timely, patient-centered care. The 2012 core meaningful use regulations require organizations to electronically submit clinical quality measures to government agencies, and getting used to sharing data electronically can prepare your organizations for these kinds of requirements.
In addition, hospitals should extend their EMR to their affiliated physicians and to their patients. The core regulations for EMR use require providers to "implement capability to electronically exchange key clinical information among providers and patient-authorized entities."
3. Plan for the staged deadlines. Don't plan your implementation around the requirements for 2011 and assume that the work is over. "The thing that people need to understand is that the requirements are fairly minimal for 2011 and then they get much tougher in 2013 and much, much tougher in 2015," says Ms. Burton. For example, she says, imaging for radiology and cardiology is not required to be integrated until 2015, but Logicalis recommends that hospitals start thinking about it now. "It's a pretty complicated thing to do, and there's some technology infrastructure that needs to be in place so that you can do it effectively."
In determining how your organization should plan its implementation to meet meaningful use requirements by 2011, Susan Kanvick, healthcare knowledge leader for Point B's healthcare practice, says you should read over the list of "a la carte" regulations and pick those that are easiest to meet by the first deadline. "I recommend prioritizing by level of effort required to meet and have at least one or two as contingency," said Ms. Kanvick. "It also depends on timing. If they are delaying to the last possible time frame to meet "meaningful use" regulations, they might want to consider getting as close as they can to all ten, because they will become part of the core regulations in the next stage."
4. Look at your existing quality reporting processes. Quality reporting will be an integral part of meeting meaningful use requirements, as providers will be required to report clinical quality measures to state or federal organizations through attestation in 2011 and electronically in 2012. Ms. Kanvick recommends examining your existing reporting functions. "They are likely by necessity fairly reactive and distributed through the organization," she says. "Consider how to better approach the collecting, interpretation of and reporting on quality data."
5. Choose a vendor that will help you get to meaningful use. Don't get too bogged down in the details of how to meet each requirement that you lose sight of your plan, Ms. Burton says. In her experience, many hospitals that started with a "best of breed" system, in which several different applications are used for different hospital needs, are taking a look at their eventual goals for meaningful use and instead deciding to spend the money on an integrated system. "Highly integrated enterprise EMR applications kind of guarantee you'll get to meaningful use," she says.
When picking a system, Dr. Connolly says it's important to pick a system that seems to have the potential be compatible with other systems. "Choosing carefully is very important," says Dr. Connolly. "You want to choose a system where you can connect hospitals to community-based physicians and to patients and to other hospitals."