Farzad Mostashari, MD, ScM, National Coordinator for Health Information Technology, realizes implementing and utilizing electronic health records for meaningful use may be easier said than done. However, he is optimistic about the changing ecosystem of healthcare and the role meaningful use will play.
"I know it may be easier said than done, but I also know that many [hospitals and providers] are doing it. I have confidence that by working together we will be able to do what we couldn't have done on our own — reach a brighter future for medicine," said Dr. Mostashari during the CMIO Leadership Forum: Transforming Healthcare Through Evidence-Based Medicine held Oct. 4-5 in Chicago.
Dr. Mostashari did not deny that it is a hectic time in the healthcare industry. He cited the quick change of pace and uncertainty with hospital consolidation as reasons the environment around meaningful use is challenging. However, he argued that these reasons are also what makes meaningful use important. "Medical information and health information technology are at the fulcrum of the industry's transformation," said Dr. Mostashari.
Here are four key takeaways from Dr. Mostashari's presentation.
1. Meaningful use is up to you. According to Dr. Mostashari, meaningful use is up to the healthcare industry because it will be defined and determined by healthcare professionals and organizations. "[The federal government] can put the tools and the rules for meaningful use into your hands, but ultimately, if it ends up being meaningful it is because of you," said Dr. Mostashari.
2. Optimism over skepticism. Dr. Mostashari said he understands why there are skeptical professionals and hospitals when it comes to meaningful use. The call for higher quality yet lower cost is a significant challenge. However, he is optimistic about what meaningful use can bring.
"It is hard to feel that this time it is different. There are those of us who have been around [the industry] for a couple of decades and have seen various forms of payment come and go. We have seen various forms of technologies come go. There is a great sense of anxiety about the future of medicine," said Dr. Mostashari. "I think that while it is true we going to need to find a way to deliver care that is higher quality at a lower cost, it is still a tall order. [However,] that is what we are asked to do, so that is what we have to do."
The reason Dr. Mostashari is optimistic about meaningful use is because the healthcare industry has tools that it never had before. In addition, since the change is three fold — lower costs, higher quality and more patient engagement — it may end up being more effective and long lasting.
"If the industry was trying to engage patients without increasing the quality of care, it would not work. If the industry was trying to lower costs without engaging the patient it would not work. Since the movement is multi-fragmented with tons of actors, the changes may come together in a more effective way," said Dr. Mostashari.
3. Stage 1 provides the foundation. Meaningful use stage 1 has set the foundation for data collection and data use, which is necessary for population health management and improvements in quality, according to Dr. Mostashari. For instance, when a physician asks how many of his or her patients received flu shots, electronic medical records can find this information by sorting and analyzing data.
"Before you can do population health management you have to have the right data. That's the work of stage 1. The question of how many patients in your population received a flu shot can't be answered with paper, at least not in a Muggle universe. In a magical universe you would flourish your wand and the paper charts of the patients with flu shots would separate from those without," said Dr. Mostashari. "That's population health management. That's meaningful use. To get there is not easy. Before you can there, you have to have the right data."
4. Focus on the "why" and the "how," not the "what." Dr. Mostashari emphasized the importance of they "why" and the "how" with meaningful use rather than just the "what." When hospitals and providers focus on only what they have to do for stage 1 and the upcoming stage 2, it is a waste of time, said Dr. Mostashari.
"Focusing only on the 'what' — what you have to do check a box — misses an opportunity to change culture and to change mission. How many of you have experienced cultural issues raised and resolved as part of the technology roll out?" asked Dr. Mostashari. "That is what meaningful use stage 1 is about. It is about improving quality and safety. There are organizations in this country that are making it meaningful and making it their own."
How are those organizations making meaningful use their own? According to Dr. Mostashari, it is because they focus on why they are implementing and advancing EMRs and other forms of health IT. It is hard to sell physicians and hospital staff on programs that reduce cost without improving care. According to Dr. Mostashari, meaningful use is aligned with what is best for the patient. The organizations that see and focus on that are successful.
"We always have to go to the 'why'. Believe me every single one of [the stage 1 and stage 2] requirements are for patients. If you come across measures where you really find yourself thinking, 'Why is this good for the patient?' Call me. I can tell you that everyone single [measure in stage 1 and stage 2 is included] because they are best for the patient," said Dr. Mostashari.
Dr. Mostashari closed his presentation by sharing his confidence in meaningful use and the ability of hospitals and providers to meet the requirements. "I believe that true meaningful use of the tools, standards and functionalities in EMRs will lead to success. If you embrace it, if you make it your own, it will be the foundation for your success. It will lead you to population health management and care that is coordinated," said Dr. Mostashari.
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"I know it may be easier said than done, but I also know that many [hospitals and providers] are doing it. I have confidence that by working together we will be able to do what we couldn't have done on our own — reach a brighter future for medicine," said Dr. Mostashari during the CMIO Leadership Forum: Transforming Healthcare Through Evidence-Based Medicine held Oct. 4-5 in Chicago.
Dr. Mostashari did not deny that it is a hectic time in the healthcare industry. He cited the quick change of pace and uncertainty with hospital consolidation as reasons the environment around meaningful use is challenging. However, he argued that these reasons are also what makes meaningful use important. "Medical information and health information technology are at the fulcrum of the industry's transformation," said Dr. Mostashari.
Here are four key takeaways from Dr. Mostashari's presentation.
1. Meaningful use is up to you. According to Dr. Mostashari, meaningful use is up to the healthcare industry because it will be defined and determined by healthcare professionals and organizations. "[The federal government] can put the tools and the rules for meaningful use into your hands, but ultimately, if it ends up being meaningful it is because of you," said Dr. Mostashari.
2. Optimism over skepticism. Dr. Mostashari said he understands why there are skeptical professionals and hospitals when it comes to meaningful use. The call for higher quality yet lower cost is a significant challenge. However, he is optimistic about what meaningful use can bring.
"It is hard to feel that this time it is different. There are those of us who have been around [the industry] for a couple of decades and have seen various forms of payment come and go. We have seen various forms of technologies come go. There is a great sense of anxiety about the future of medicine," said Dr. Mostashari. "I think that while it is true we going to need to find a way to deliver care that is higher quality at a lower cost, it is still a tall order. [However,] that is what we are asked to do, so that is what we have to do."
The reason Dr. Mostashari is optimistic about meaningful use is because the healthcare industry has tools that it never had before. In addition, since the change is three fold — lower costs, higher quality and more patient engagement — it may end up being more effective and long lasting.
"If the industry was trying to engage patients without increasing the quality of care, it would not work. If the industry was trying to lower costs without engaging the patient it would not work. Since the movement is multi-fragmented with tons of actors, the changes may come together in a more effective way," said Dr. Mostashari.
3. Stage 1 provides the foundation. Meaningful use stage 1 has set the foundation for data collection and data use, which is necessary for population health management and improvements in quality, according to Dr. Mostashari. For instance, when a physician asks how many of his or her patients received flu shots, electronic medical records can find this information by sorting and analyzing data.
"Before you can do population health management you have to have the right data. That's the work of stage 1. The question of how many patients in your population received a flu shot can't be answered with paper, at least not in a Muggle universe. In a magical universe you would flourish your wand and the paper charts of the patients with flu shots would separate from those without," said Dr. Mostashari. "That's population health management. That's meaningful use. To get there is not easy. Before you can there, you have to have the right data."
4. Focus on the "why" and the "how," not the "what." Dr. Mostashari emphasized the importance of they "why" and the "how" with meaningful use rather than just the "what." When hospitals and providers focus on only what they have to do for stage 1 and the upcoming stage 2, it is a waste of time, said Dr. Mostashari.
"Focusing only on the 'what' — what you have to do check a box — misses an opportunity to change culture and to change mission. How many of you have experienced cultural issues raised and resolved as part of the technology roll out?" asked Dr. Mostashari. "That is what meaningful use stage 1 is about. It is about improving quality and safety. There are organizations in this country that are making it meaningful and making it their own."
How are those organizations making meaningful use their own? According to Dr. Mostashari, it is because they focus on why they are implementing and advancing EMRs and other forms of health IT. It is hard to sell physicians and hospital staff on programs that reduce cost without improving care. According to Dr. Mostashari, meaningful use is aligned with what is best for the patient. The organizations that see and focus on that are successful.
"We always have to go to the 'why'. Believe me every single one of [the stage 1 and stage 2] requirements are for patients. If you come across measures where you really find yourself thinking, 'Why is this good for the patient?' Call me. I can tell you that everyone single [measure in stage 1 and stage 2 is included] because they are best for the patient," said Dr. Mostashari.
Dr. Mostashari closed his presentation by sharing his confidence in meaningful use and the ability of hospitals and providers to meet the requirements. "I believe that true meaningful use of the tools, standards and functionalities in EMRs will lead to success. If you embrace it, if you make it your own, it will be the foundation for your success. It will lead you to population health management and care that is coordinated," said Dr. Mostashari.
More Articles on Meaningful Use:
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ONC Issues Meaningful Use Call to Action for Critical Access, Rural Hospitals