Like many hospitals and health systems across the country, Chicago-based Presence Health has been struggling with meaningful use stage 2.
As at many other organizations, the transmission of care requirement has proved challenging for Presence Health, mostly because the organization's referring partners don't have the necessary technology to share care summaries electronically, CMIO Bradley Howard, MD, told attendees at HealthIMPACT Midwest Monday in Chicago. "The people who need to receive these documents, the physicians, they can't receive them, so they're getting faxes," he said. The Chicago area is also home to a large number of independent hospitals and physician organizations, meaning it is often difficult to find the correct recipient, he said.
To solve the problem, Presence Health is implementing a health information service provider to facilitate data exchange as well as working with physicians and staff whose workflow has been interrupted by the new discharge procedure.
Presence Health is also working on increasing its computerized physician order entry rates, particularly to get to the 60 percent medication order threshold required for meaningful use stage 2. Dr. Howard was surprised few of the other attendees signaled this was a problem for them as well, though he suggested they may not realize how much of a challenge this requirement will be. "Do you have house staff, residents? Do you have hospitalists? And is it broad coverage? Is your CEO more concerned about volume, still, than meaningful use compliance?" he said. "Because if so, you may look at the stage 2 requirements and find out it will be a challenge for you."
One of the executives not experiencing challenges with the CPOE requirement was Dr. Howard's co-presenter, Maggie Ratliff, vice president and CIO of Sarah Bush Lincoln Health System in Mattoon, Ill. Presence Health mostly affiliates with, rather than employs, physicians, which encourages the organization to focus on keeping physicians happy rather than imposing new workflows on them. Sarah Bush Lincoln, which mostly employs hospitalists, doesn't have that problem. "I won't say mandate, but we can encourage them to use it," she said. "Our CPOE rate is very high, and it's because all our hospitalists are using it."
However, like Presence Health, Sarah Bush Lincoln is struggling with patient portal usage rates and patient engagement. "Having that 5 percent of patients sign on and view, download, transmit — that was a challenge for us," said Ms. Ratliff. The organization took an active role in signing patients up for the portal, completing the registration process with inpatients and then reminding patients of the portal at discharge. Sarah Bush Lincoln's mobile app, featuring a variety of health and wellness resources as well as access to the portal, is designed to increase portal access and use, and waiting rooms at Sarah Bush Lincoln have an iPad with the health system's app installed and employees standing by to show waiting patients how to use the app and access the portal.
Both Sarah Bush Lincoln and Presence Health offer incentives for patients to use the portal — Sarah Bush Lincoln hosts contests and giveaways for portal users, and Presence Health worked out a coupon deal with Walgreens where patients who responded to prescription reminders through the portal could qualify for a 20 percent off coupon at the drugstore chain.
However, what will truly incentivize patients to use the portal is the presence of useful information within it. "If your patients see value in the patient portal, they'll go to it," said Dr. Howard, which is why he is working with the health system's physicians to add more information to the portal and to actively engage with patients through the platform.
"Plenty of patients still see their physician as an important person in their life," said Dr. Howard. "And when that person shows them interest, when they want to communicate with you, that's powerful."
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