CSC report lists top 10 challenges that doctors face when it comes to meeting the stage 1 meaningful use requirements. Here’s the list:
1. Capture the data–that includes collecting and entering data in a structured formats so that data can be sorted and selected for reporting purposes, said Zywiak.
2. Establish effective workflows to reinforce data entry, including medication reconciliation. For instance, “often, an organization’s workflow needs to be modified to make sure data is entered,” while patients are being cared for, whether it’s vital signs like blood pressure or allergy updates, said Zywiak.
3. Drive provider involvement in adoption of the EHR. “The primary users of these systems need a say” in what’s selected, said Zywiak.
4. Computer-based provider order entry (CPOE). “In ambulatory settings, 80% of orders, including tests, referrals and medication prescriptions, will need to be entered electronically,” he said.
5. Start e-prescribing. “Do this as soon as possible,” he said.
6. Develop a process for managing clinical decision support. This could include different clinical reminders for individual doctors in the same multi-specialty practice. For instance, a primary care doctor might need different alerts than a dermatologist caring for the same diabetic patient.
7. Implement patient health information exchange workflows. As a healthcare provider, “you’ve got to provide patients access with information–but will you do this via a patient portal or through a [third party] personal-health record” site, such as Google Health, said Zywiak.
8. Formulate a provider health information exchange strategy. “How will you exchange patient summary data with hospitals, specialists?,” he said.
9. Ensure privacy and security compliance. “Most primary care organizations haven’t been on an EHR, so they think of HIPAA in terms of protecting paper-based information,” he said.
10. Initiate EHR-based quality performance measurement support.“You’ll need to report quality measures to Medicare and Medicaid,” he said.
How does this list make you feel about the meaningful use guidelines?
Excellent succinct list; now I wish I’d read your blog before posting this morning. I think #3 is crucial to consider, since getting the providers on board at the beginning will fuel everything that comes afterwards.
I think all the MU guidelines are worthy goals to strive for, but they’re going to be very time-consuming to get right in individual practices, especially smaller ones without a lot of IT support.
The bottom line (as I wrote today) is that EHR adoption requires a lot of careful upfront planning to make it successful. I don’t think being first in line for HITECH is a realistic goal at this point, unless you’ve got an EHR mostly doing everything already that requires minor tweaking to qualify. Even so, that system’s got to be certified, and we’re almost in May with no ONC-ATCBs ready.
The best goal is probably taking these measures as a baseline, with the idea “We’d like to achieve these specific ones eventually, what parts can we successfully implement now and what parts should we hold off on until we’re ready?” Take the intense time pressure of HITECH off and these measures seem much more doable.
Michelle,
I’m disappointed to hear that reading my blog isn’t the first thing on your list each morning;-)
I agree with you about the goals and the way people need to approach MU. Sadly, too many of them are in an EMR stimulus money trance.