According to data CMS released in June, eight hospitals have attested to meaningful use stage 2. DuBois (Pa.) Regional Medical Center was among the first.
The organization's 90 days of attestation was the product of more than five years of work, says Tom Johnson, CIO of Penn Highlands Healthcare, DuBois Medical Center's health system. Creating a strong foundation through stage 1 preparations and attestation helped pave the way to stage 2.
"When we did stage 1 [of meaningful use], we focused on exceeding every measure," he says. "We didn't do 10 percent of this or 5 percent of that, we tried to do 100 percent of everything, even the optional measures. That positioned us really well for stage 2."
There were challenges for DuBois, particularly the two main aspects of stage 2 that were not a part of stage 1— health information exchange and patient engagement. "Because our doctors were already using the [electronic health record] technology, the only challenges were what was outside of our four walls," says Mr. Johnson.
To meet the data exchange requirement, the four-hospital Penn Highlands system leveraged its strong ties to community organizations and the collaborative relationships it enjoys with its affiliated physicians. The data exchange goal did require DuBois officials and exchange partners to have conversations about what patient information would be exchanged, and how the information-sharing would affect affiliated physicians' relationship with their patients. "It was definitely something that was challenging to do in a short time frame," says Mr. Johnson.
The other hurdle was the patient portal requirement. DuBois serves a large Medicaid and Medicare population, and many of the system's patients aren't tech-savvy, says Mr. Johnson. A large swath of the patient population doesn't have email, and many didn't seem to care about getting online access to their medical records. To enroll as many people as possible, DuBois made brochures explaining the benefits of the portal and assigned a nurse to meet with every patient to "sell them on the portal," he says. "They meet with the patients and their families, describe the value of the portal and help them sign up."
For other hospitals and health systems working on stage 2, Mr. Johnson recommends making attestation an organizationwide priority. "You need incredibly focused leadership who [are] all on the same page," he says. "It needs to be a part of everyone's roles, and if it's not, you will struggle."
He recognizes many hospitals are struggling, some due to vendor delays that left organizations with too little time to implement required updates. This was not lost on CMS; in May, the agency issued a proposed rule saying providers that encountered vendor delays would be allowed to attest using 2011 Edition software or attest to another year of stage 1.
While the rule has not gone into effect, Mr. Johnson is one of the stakeholders who sees more relaxing of meaningful use regulations as potentially undermining the program.
"I understand the position of CMS and ONC, they need broader adoption and they [therefore] need to make it easier," he says. "It may encourage backsliding, and I don't want to see that happen… we need to keep pushing for more adoption and more automation."
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