MEANINGFUL USE REQUIREMENTS ARE LESS THAN A LOOK AT THE STATE OF EHRS IN TODAY’S PRACTICES By Marc Oestreich he mandate from Uncle Sam is clear as a bell: create a complex digital system of recording, storing, sharing, and manipulating secure patient information in and across your campuses. Ensure that this new technology operates seamlessly with your current systems. Do it too slowly and you’ve lost your $44,000 carrot. Slower still, you’ve cost your organization significant sums in fines. Do it wrong? Privacy litigators will smell blood for miles. never fear, though; your government has the requirements set in stone and they are specific and attainable. your so very lucid goal? “meaningful use.” With nearly 700 pages of ideas, rules, regulations, and legislator-speak in just the stage 1 rules (if you made it through those, pop some popcorn for episode 2… it’s a page-turner), the best we could do for an implementation goal is “meaningful use.” at this point, we are well into the implementation window. so, how are we doing? the numbers are strong; Health Affairs reported that nearly 69% percent of health care providers have adopted some form of ehr. not quite on pace for full adoption, but chugging right along. everything looks strong, so long as you don’t ask those pesky staff members like doctors, nurses, and administrative staff. FLEXIBLE TIMELINES a poll of 2,000 physicians who have adopted an ehr under the new mandate shows that nearly one-fifth are actively MEANINGFUL pursuing a vendor switch. 79 percent told Black Book that their ehr decision was rushed and that they did not adequately assess their needs before implementation. come on, guys! you have got five years to implement a complete restructuring of how data is captured, stored, and sent at every facet of your establishment; that is more than enough time. okay, you spent the first year focusing on a myriad of other monumental changes in health legislation, the following year was marred with confusion about whether the mandates would stick, the next two years were used finding and hiring a team of legal and technical consultants, and the next six months were spent identifying and procuring the best solution. you still have a half-year window to get this bad boy rolling (and transition to icd-10, but that’s another story). Well, you need to prove 90 days of patient use before the deadline, and you will probably want a bit of time for training and testing. We’ll call it three months to implement a system that forever changes the way you do everything you do. not a problem. MAJOR INCENTIVES the incentives to implement are great, though. how could you resist? 44 stacks! 44 large! 44 grand! i mean, that’s enough to employ more than half of a nurse’s aide. don’t put that paperwork through too quickly, though. the average cost of an ehr, according to to Health Affairs, sits just above $46,000 per physician. assuming your practice indeed has a physician, you are already in the hole. We all know about growing pains, and the ehr has its share. the first year of adoption results in an average loss of $100,000 in revenue. T the journal of the healthcare billing and management association 37
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