She shared ways to approach these surprises in a presentation during the Becker’s Hospital Review 5th Annual Meeting in Chicago May 17.
Audits
CMS sends meaningful use audit notices via email — the email that was used to register for the meaningful use program a few years ago. “Make sure you can get in that inbox” if the person who originally registered is no longer with the organization, Ms. Stewart says. There could be an audit notice the organization wasn’t aware of. “That’s not a good surprise to find,” she said.
Incomplete documentation can also raise audit problems for organizations. Ms. Stewart recommended having someone look at meaningful use reports each month and also have them look at the repository where the documents are kept to make sure everything is there.
Vendors
“Make sure you have a good relationship with your vendor,” Ms. Stewart said.
Vendors can cause all sorts of meaningful use issues. For example, they may deliver a new version of the EHR on time technically but leave little time for organizations to install and use it.
Sometimes, vendors just quit without telling the organization, she said, which she has seen happen to several physician practices. “If [the vendor] is still making stage 2 promises and haven’t delivered that yet, I’m so sorry, but you should probably be shopping for a replacement,” she said.
Employees
Sometimes, how employees use the EHR system can throw a wrench into meaningful use plans. For instance, many systems have weak processes, like for physician documentation or medication reconciliation.
Nurses in particular are good at finding efficient ways to do things, which can be a blessing and a curse, according to Ms. Stewart. “They come up with creative ways to be more efficient in documentation but use a field that the system doesn’t count” for meaningful use purposes, she said, urging organizations to keep an eye on that.
Overall, Ms. Stewart stressed the importance of communicating with vendors and doing a monthly meaningful use review to avoid as many of these surprises as possible.
