Slides from the Hielix Webinar discussing how achieving meaningful use in hospitals is more than just a technology upgrade. Full webinar is available on Vimeo (https://vimeo.com/user7074907)

1. Meaningful Use
More Than IT

2. Meaningful Use for Hospitals
Meaningful Use: Using certified EHR technology to improve quality,
safety, efficiency, and reduce health disparities in healthcare.
Goals of Meaningful Use:
• Engage patients and families in their healthcare
• Improve quality of care
• Improve care coordination
• Improve population and public health
• Maintain privacy and security

3. Biggest MU Attestation Challenges
• Understanding the requirements
• Hospital staff buy-in
• Physician/clinician trust
• Vendor scheduling
• Clinical quality measure reporting
• Interdepartmental coordination
Source: HIMSS

4. Reaching Stage 1
• 110,000 Eligible Professionals attested & received funds (20% of
all eligible professionals)
• 2,400 Hospitals attested & received funds (48% of eligible
hospitals)
Source: Health Data Management

5. Meaningful Use Timeline
Source: http://assistancecenter.missouri.edu

6. Meaningful Use Objectives
Eligible Hospitals must complete (Stage 1):
• 14 core objectives
• 5 objectives out of 10 from menu set
• 15 total Clinical Quality Measures
Eligible Hospitals must complete (Stage 2):
• All requirements build on Stage 1 reqs.
• 16 core objectives
• 2 objectives out of 5 from menu set
• 49 total Clinical Quality Measures

7. KPMG Study
• 71% of hospitals report being more than halfway to completion of
the adoption of EHR, but only 48% confident they will meet Stage
1 of MU
• Barriers reported:
– Difficulty understanding the requirements
– Training and change management efforts
– Data capture
– Generating the metrics required

8. RWJF Study
• Those close to accomplishing MU:
– 40% had not implemented drug-drug and drug-allergy interaction
checks
– 35% could not provide patients with a copy of their record
– 30% had not implemented computerized physician order entry
(CPOE)

9. Heart of the Issue
• Clinician resistance
– Getting clinicians to use the EHR as part of their daily work,
particularly those physicians that are affiliated with, but not
employed by the hospital
• Security and compliance
– Unattended workstations/devices with patient data
– Passwords that are shared, written down
– Tightening security creates more tasks for clinicians, creating a
vicious circle

10. Solution Approaches
• Study and understand workflows
– Workflows vary significantly from department to department
– Focus on functions throughout the clinician’s day and across
departments
– Understand the value of order sets and coordinate their use within
the EHR system
• Identify advocates and super-users
– Clearly identify workflow improvements and other visible clinician
benefits
– Focus on those clinicians who are most difficult and take the time to
get them the one-on-one support they need

11. Solution Approaches
• Use clinicians to train clinicians
– Provides the trainee with the support of someone who understands
the delivery of care
– Make training available at the convenience of the physician
– Have on-demand training tools available
• Implement single sign-on
– Particularly where security has been increased, tasking the clinicians
with signing in and out repeatedly creates frustration
– Immediately unburdens the clinician from password management
– Consider passive proximity devices and biometrics

12. Solution Approaches
• Re-authentication for ePrescribing and CPOE
– Consider similar proximity/bio-authentication approaches
• Support clinical roaming
– Virtual desktops allow clinician access wherever they may be in the
facility
– Allows opening a patient record in one location, then accessing it
immediately in another

13. Potential Impact of Stage 2 Criteria for MU
• Increased thresholds
• Menu measures moving to Core measures
• Impact of 40% imaging requirements
• Clinical decision support rules from one to five required
• “Packed” versus “unpacked” order sets

14. IT/Operational Issues Impacted by MU
• Inpatient EHR/PM
• Ambulatory EHR/PM (if different from inpatient)
• Mobility platform
• Storage, data backup/archive
• Hospital’s progress to the cloud
• Privacy & Security
• Clinical workflows
• Hospital/physician alignment

15. Wrapping up
• Meaningful Use is a strategic, long-term program for hospitals
• It impacts both legacy systems as well as newly adopted
technology
• Meaningful Use is primarily a human challenge, solid clinical
workflows are imperative for success
• Can’t attack MU as IT vs. Operations – the two must work together
and coexist

16. Thank you for attending!
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www.slideshare.net/Hielix/
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