Rarely have two words garnered as much attention from healthcare professionals as "meaningful use" has in recent years. Yet despite the volume of the discussion, there are still significant gaps in understanding the requirements of meaningful use and a lack of clarity about how to achieve it. Many know that technology is a component of meaningful use; that there are deadlines, incentives and penalties for non-compliance; but not much beyond that. With much at stake for providers, we expose seven common myths regarding meaningful use.
Myth #1: I'm implementing a certified electronic health record system, so my organization will have achieved meaningful use once we turn on the system.
The truth: A certified EHR is a foundational element to enable meaningful use compliance, but simply turning on a certified EHR is insufficient to meet meaningful use. A much broader set of operational, organizational, financial and governance actions are necessary to achieve compliance. Most organizations find that they need to revise or institute new workflows, alter responsibilities and establish accountability for performing the actions required by meaningful use.
Myth #2: The vendor who is implementing my EHR will take care of meaningful use achievement.
The truth: The EHR vendor provides certified technology that will enable your organization to achieve meaningful use. Other technology vendors will likely be a part of the overall solution to supporting meaningful use compliance. However, your organization is responsible for ensuring that all of the necessary actions have been taken to not only implement the appropriate technology, but more importantly, to assure that the EHR is used in a manner that meets or exceeds the minimum requirements of meaningful use. Assuring this requires you to undertake the appropriate administrative, operational, organizational and financial change.
Myth #3: Meaningful use is a technology project, so it should be run under the direction of my organization's IT department.
The truth: Meaningful use compliance requires enterprise-wide participation and effort. To focus attention and resources, as well as to drive timely achievement, a meaningful use oversight committee should be established and meet regularly. This oversight committee should include representatives from clinical, operational, information technology and financial leadership. A member of the executive team should be assigned responsibility for your organization's meaningful use initiatives. Many organizations have also designated a meaningful use coordinator. This individual should have strong skills in large-scale program/project management, a cross-disciplinary understanding of care delivery and provider operations, the ability to engender a collaborative approach and an aptitude for compliance. Meaningful use coordinators may be drawn from IT, quality/compliance, finance or other departments.
Myth #4: Achieving Meaningful use compliance is a one-time, discrete event.
The truth: Achieving meaningful use is not a discrete event. Once providers achieve meaningful use for 90 days in the initial year, they will need to demonstrate continuous compliance in all subsequent years, which will require constant monitoring and corrective action. In addition, all providers will need to adjust their meaningful use compliance efforts as meaningful use requirements evolve through Stages 2, 3 and beyond, although the timeframe for these stages is not yet known.
Myth #5: There is plenty of time to determine my organization's meaningful use strategy.
The truth: As achieving meaningful use requires substantial time and effort, it is not something that can be left until the last minute. Near-term action is required to maximize the receipt of EHR incentives: providers who do not achieve meaningful use by 2015 will be penalized. Preparing for meaningful use takes time, as it requires analysis of many clinical and administrative processes, as well as mobilization of significant resources. Adequate time needs to be allotted to conduct the appropriate assessments and to implement required changes and corrective actions prior to actual deadlines.
Myth #6: My organization's meaningful use strategy can be easily compartmentalized as an ongoing compliance initiative.
The truth: Your meaningful use strategy should receive attention from across the organization as it has far-reaching implications and should be viewed among a broader set of strategic organizational initiatives. Many of the decisions related to meaningful use — such as technology selection, operational change and patient mix — have material financial and organizational ramifications. A lack of clarity regarding meaningful use may result in hasty decision-making in these areas, resulting in later rework and the need to revamp inefficient processes and suboptimal workflows — which will be costly and disruptive.
Myth #7: Achieving meaningful use will only require the input of a few key individuals.
The truth: Effective organizational governance, both formal and informal, will be required at multiple levels to ensure appropriate implementation and oversight of meaningful use achievement. Managing a diverse group of stakeholders across the enterprise, with varying perspectives and priorities, will be a significant challenge. Each of these groups must part of working towards a common objective of achieving meaningful use; and then be held accountable for ongoing compliance. The sheer number of personnel involved, including medical staff and employees, requires that a robust governance framework be established to facilitate and expedite communications, decision-making and issue resolution.
Gerard Nussbaum is the director of technology services in Kurt Salmon's Health Care Group; he may be contacted at 212.508.8396 or at gerard.nussbaum@kurtsalmon.com. David Kim is a manager in Kurt Salmon's Health Care Group; he may be contacted at 212.508.8372 or at david.kim@kurtsalmon.com.
Myth #1: I'm implementing a certified electronic health record system, so my organization will have achieved meaningful use once we turn on the system.
The truth: A certified EHR is a foundational element to enable meaningful use compliance, but simply turning on a certified EHR is insufficient to meet meaningful use. A much broader set of operational, organizational, financial and governance actions are necessary to achieve compliance. Most organizations find that they need to revise or institute new workflows, alter responsibilities and establish accountability for performing the actions required by meaningful use.
Myth #2: The vendor who is implementing my EHR will take care of meaningful use achievement.
The truth: The EHR vendor provides certified technology that will enable your organization to achieve meaningful use. Other technology vendors will likely be a part of the overall solution to supporting meaningful use compliance. However, your organization is responsible for ensuring that all of the necessary actions have been taken to not only implement the appropriate technology, but more importantly, to assure that the EHR is used in a manner that meets or exceeds the minimum requirements of meaningful use. Assuring this requires you to undertake the appropriate administrative, operational, organizational and financial change.
Myth #3: Meaningful use is a technology project, so it should be run under the direction of my organization's IT department.
The truth: Meaningful use compliance requires enterprise-wide participation and effort. To focus attention and resources, as well as to drive timely achievement, a meaningful use oversight committee should be established and meet regularly. This oversight committee should include representatives from clinical, operational, information technology and financial leadership. A member of the executive team should be assigned responsibility for your organization's meaningful use initiatives. Many organizations have also designated a meaningful use coordinator. This individual should have strong skills in large-scale program/project management, a cross-disciplinary understanding of care delivery and provider operations, the ability to engender a collaborative approach and an aptitude for compliance. Meaningful use coordinators may be drawn from IT, quality/compliance, finance or other departments.
Myth #4: Achieving Meaningful use compliance is a one-time, discrete event.
The truth: Achieving meaningful use is not a discrete event. Once providers achieve meaningful use for 90 days in the initial year, they will need to demonstrate continuous compliance in all subsequent years, which will require constant monitoring and corrective action. In addition, all providers will need to adjust their meaningful use compliance efforts as meaningful use requirements evolve through Stages 2, 3 and beyond, although the timeframe for these stages is not yet known.
Myth #5: There is plenty of time to determine my organization's meaningful use strategy.
The truth: As achieving meaningful use requires substantial time and effort, it is not something that can be left until the last minute. Near-term action is required to maximize the receipt of EHR incentives: providers who do not achieve meaningful use by 2015 will be penalized. Preparing for meaningful use takes time, as it requires analysis of many clinical and administrative processes, as well as mobilization of significant resources. Adequate time needs to be allotted to conduct the appropriate assessments and to implement required changes and corrective actions prior to actual deadlines.
Myth #6: My organization's meaningful use strategy can be easily compartmentalized as an ongoing compliance initiative.
The truth: Your meaningful use strategy should receive attention from across the organization as it has far-reaching implications and should be viewed among a broader set of strategic organizational initiatives. Many of the decisions related to meaningful use — such as technology selection, operational change and patient mix — have material financial and organizational ramifications. A lack of clarity regarding meaningful use may result in hasty decision-making in these areas, resulting in later rework and the need to revamp inefficient processes and suboptimal workflows — which will be costly and disruptive.
Myth #7: Achieving meaningful use will only require the input of a few key individuals.
The truth: Effective organizational governance, both formal and informal, will be required at multiple levels to ensure appropriate implementation and oversight of meaningful use achievement. Managing a diverse group of stakeholders across the enterprise, with varying perspectives and priorities, will be a significant challenge. Each of these groups must part of working towards a common objective of achieving meaningful use; and then be held accountable for ongoing compliance. The sheer number of personnel involved, including medical staff and employees, requires that a robust governance framework be established to facilitate and expedite communications, decision-making and issue resolution.
Gerard Nussbaum is the director of technology services in Kurt Salmon's Health Care Group; he may be contacted at 212.508.8396 or at gerard.nussbaum@kurtsalmon.com. David Kim is a manager in Kurt Salmon's Health Care Group; he may be contacted at 212.508.8372 or at david.kim@kurtsalmon.com.