University of Missouri Health Care in Columbia was one of the first health systems to attest to meaningful use stage 2, completing their 90-day attestation period on June 6. Their secret: planning ahead.
Working under the assumption the deadline for both stage 2 attestation and the switch to ICD-10 would be Oct. 1, 2014, the system had planned to attest to stage 2 during the first quarter reporting period, October to December 2013.
"With that ICD-10 date looming, we wanted to move ahead and get through stage 1 early so we could get going on stage 2 early," says CIO Bryan Bliven. "We knew we were going to have to work through difficulties with the software and the reporting — and we thought we had to leave time to address ICD-10."
Overseen by an executive committee and several task forces, the hospital began installing the 2014 release of the electronic health record with the goal of being done by August 2013. However, the process did not go exactly as planned. First, the Direct messaging technology was a stumbling block because few others outside the health system had the required functionality. Additionally, the health system wasn't able to reach the required levels of patient portal participation and clinical document exchange during the first attestation period.
However, starting so early afforded University of Missouri Health Care time to tackle these issues. The organization got the Direct messaging working well by September by working closely with local partners and affiliated providers to increase data exchange and meet transitions of care requirements. The health system also had hospital employees visit patients in their rooms and teach them how to use the patient portal to help increase the number of patients accessing the portal after discharge.
The health system was also able to start on stage 2 requirements early thanks to a partnership with Cerner through which University of Missouri Health Care receives early versions of new software. The health system gets new software first, works through the installation and optimization process and then shares issues encountered and solutions found with Cerner and its other clients. "[That partnership] was a leadership decision, and it was the right thing to do," says Mr. Bliven. "It aligned with our goal of doing it early, although it is a lot of work."
For other hospitals working on stage 2, Mr. Bliven recommends taking time to ensure understanding of all of the requirements and potential stumbling blocks, and plan ahead as much as possible. And it's not all about planning the organization's internal processes, technology and workflows — stage 2 requires hospitals to reach out to referring partners to ensure they have the necessary technology to exchange patient data and to start reaching out to patients to promote use of the patient portal. "You have to be thinking about how to cross those gaps and that means reaching out early," he says.
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