How 25-Bed Cottage Hospital Reached MU2

Although Cottage Hospital in Woodsville, N.H., was one of the first hospitals to attest to meaningful use stage 2, had it not been for a clerical error they may have been able to attest even sooner.

A government contractor made a mistake in determining the critical access hospital's eligibility to attest, says Maria Ryan, PhD, APRN, CEO of Cottage Hospital, so the hospital could not begin the attestation period until the eligibility issue was resolved. "It ended up costing us several months — we were ready," says Dr. Ryan.

Cottage Hospital has a reputation for being ready for technology. Despite its small size, the organization has consistently been a leader in health IT efforts — it was the first critical access hospital in New England to reach meaningful use stage 1, attesting in July 2011, and was the first hospital in New Hampshire to be able to provide surveillance information to the state on public health issues . The hospital's reputation for leading the way in health IT has helped the organization attract staff who have the talent and drive to help Cottage Hospital remain on the cutting edge.

The organization's dedication to health IT is why Dr. Ryan's frustrations regarding the delay went beyond money. "It had always been part of our business strategy to attest, but it was more for the staff who had worked so hard," she says. "I wanted them to get that recognition."

That is not to say the attestation process was not without its challenges. To avoid clinician resistance or apathy to the new technology, attesting to meaningful use was made an organizationwide effort from the start. "This was not an IT project or a clinical project, this was our project," says Dr. Ryan.

To create this unity, focus was kept on the benefits for the patient — by using the new technology, exchanging information and embracing the patient portal, patient care would be more seamless, efficient and better, leadership told the physicians.

Dr. Ryan invested in a nursing informatics position to act as a liaison between the IT and clinical departments to help "bridge the gap" that can exist between these two sides. She also was in contact with the hospital's electronic health record vendor, MEDHOST, conveying needs as they arose and working with MEDHOST to find solutions.

She gives the example of the medication reconciliation process. "Through our hospitalists' clinical understanding of patient care, we were able to facilitate a discussion between our vendors MEDHOST and ExitCare, our discharge instructions solution, on collaboratively working together on a more effective process for medical reconciliation."

For other organizations still working on meaningful use stage 2, Dr. Ryan recommends all senior leaders be actively involved in the attestation process. Meetings about attestation should be closer to weekly than monthly and executives should be interacting with the process on a daily basis. "It needs to be made a priority within the organization," she says. "If it's not, [attestation] will take a long time, if it happens at all."

More Articles on Meaningful Use Stage 2:

CMS: 10 Hospitals Have Attested to MU2
DuBois Medical Center's MU2 Journey
8 Hospitals That Have Attested to MU2

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