Meaningful Use: No Physician Left Behind

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Changes in meaningful use implementation for 2011 reduce the minimum standards for adoption, provide more latitude, and allow for a more orderly and incremental approach to implementation.

But health systems should be warned: the 2013 and 2015 requirements will incorporate most of the reductions gained in the short term, and failure to get assessment and implementation strategies underway to deliver meaningful use by 2015 will mean penalties in the form of reduced Medicare and Medicaid payments.

The goals, while challenging, are worthwhile:

• integrated delivery systems to share data effectively to promote quality care and a healthier patient base;

• improved compliance by both patients and clinical staff lead to better outcomes; and

• better communication with patients and medical professionals enhance coordinated care.

The final meaningful use ruling serves as a catalyst for change by establishing a minimum standard across the healthcare industry. No doubt, accreditation bodies, certification boards and private insurers will use this to establish more stringent requirements.

Clinical data-sharing among healthcare entities is essential for meeting meaningful use. It levels the playing field in terms of providing the clinical information necessary to provide quality healthcare, and builds a framework from which competition is based upon the transparency of quality and service levels.

Moreover, the rules have evolved to provide a component-based offering that enables organizations to start with a base solution designed to achieve requirements for 2011. This means that IT solutions can be implemented and used as a base system to allow organizations to evolve to meet meaningful use standards for 2011 - and further down the road.

New Changes in Meaningful Use Rules
The relaxation of some of the aspects of the implementation of meaningful use accommodates much of the feedback that was provided from the providers of healthcare. These changes include both the reduction in the minimum standards for some aspects of adoption, as well as providing some latitude in measures to meet meaningful use within each organization. In the short term, this will allow a more orderly and incremental approach to implementation of information technology to meet them, which should in turn improve the possibility of successive implementation.

The important thing for all healthcare providers to understand with the final ruling is that the timeframes have not changed. If health systems and their associated providers have not begun an assessment of their current status in achieving meaningful use and developing a strategy for mitigating gaps, they run the risk of falling behind. Right now is the best - the only, really - option to begin this complicated process.

Something to keep in mind is that non-governmental entities generally influence the delivery of healthcare and adopt and accelerate change more quickly than governmental organizations.

Meaningful Use & Competition
Meaningful use is set to change the competitive landscape of healthcare entities in a significant way. Once viewed as a competitive advantage, clinical data sharing among disparate healthcare organizations will become integral to meeting the minimum requirement of meaningful use.

Going forward, competing healthcare organizations will be obliged to create relationships to meet the intent of meaningful use regulations. In this climate, healthcare delivery systems will have to differentiate themselves based upon how healthcare is delivered, improved and enhanced as a result of the data's use, rather than simply on the fact that one facility is more technologically advanced than its competitor. In years to come, patients and payers will assume that their healthcare organization is wired in a robust collaboration that creates the best healthcare possible.

Biggest Meaningful Use Challenge
Community hospital use of computerized physician order entry (CPOE) is at 12 percent and generally has achieved lower penetration than larger counterparts.¹ Therefore, the biggest challenge to meeting meaningful use requirements will be the lack of sharing partners for the exchange of data within the healthcare community.

Finding easily adopted, inexpensive and non-workflow-intrusive ways to allow physicians to participate in this sharing process will be key to successfully meeting the intent, rather than simply the "letter of the law" intent of meaningful use. Technology that bridges the gap between the providers with no technology, some technology and the latest technology must be employed to create a road equally traveled toward meaningful use - leaving no physician behind.

Profound Changes Ahead
Meaningful use promises profound changes across the healthcare landscape. It's important for healthcare leaders to maximize this opportunity and begin making incremental changes now - rather than later when it will be too late - to improve the delivery of healthcare and, ultimately, the health of the population served.

According to former Health and Human Services Secretary and former governor of Wisconsin Tommy Thompson, "Reform will go through, no matter who is in power and despite legal challenges in several states."² To support the widespread changes ahead, healthcare organizations should look for a solution that will serve the community as a whole and bridge the technology disparity within the community.

Without a patient-centric, inclusionary strategy, true disease management, care coordination, effective transitions of care and the advancement of quality cannot be achieved. This collaborative approach will pay off with a climate of ownership, accountability, and sustainability in our nation's healthcare system.

References
1. Hess, J. (2010). KLAS Research. CPOE digest 2010: Traffic jams on the road to meaningful use. Retrieved Dec. 6 from the World Wide Web: http://www.klasresearch.com/Download/Download_Docs.aspx?productID=565&filename=sample_CPOE_2010_Traffic_Jams_on_the_Road_to_Meaningful_Use_129205095904384005.pdf&filepath=samples
2. Diana, A. (2010). IT and a healthy dose of politics. Healthcare IT. Retrieved Dec. 6 from the World Wide Web: http://everythingchannelevents.com/core/uploads/conferencereport/uploaded_pdfs/xchange/hits_day1_web_82.pdf