Hospitals and eligible providers have been rushing to install electronic health records and other health information technology to attest for the federal government's meaningful use incentives. By the end of 2012, all hospitals and providers must achieve stage 1 of meaningful use to receive maximum Medicare incentives. On the Medicaid side, the time frame is more prolonged, as incentives go on through 2021, but providers still must start by 2016 to receive the maximum Medicaid incentives.
However, hospitals and providers should not get caught up in the wave of technology requirements, says Josh Seidman, PhD, director of meaningful use at the Office of the National Coordinator for Health Information Technology. He says there are ways to ensure meaningful use, and hospitals and physicians can achieve it if they keep the main theme in mind: improved patient care for the 21st century.
Ways to ensure meaningful use
There are several things hospitals and physician practices can do to achieve and attest for meaningful use. There are 25 meaningful use objectives for eligible providers, and there are 24 meaningful use objectives for eligible hospitals and critical access hospitals. Mr. Seidman says as providers implement their EHRs, they should confirm their EHR system is certified for meaningful use. Many larger hospitals and practices have already implemented their EHR systems successfully, but some hospitals and practices that provide medical care to underserved populations have not.
That's where regional extension centers can help, Mr. Seidman says. RECs are another vital outlet for small practices and critical access hospitals, especially those with limited IT departments. RECs were set up through the Health Information Technology for Economic and Clinical Health Act to help providers become adept and meaningful users of EHRs. RECs provide training and support services to assist physicians and other providers, offer guidance with EHR implementation and give technical assistance whenever needed. "One of the ideas behind this is for providers to share best practices and learn about how other providers in the same settings have approached EHR implementation," Mr. Seidman says.
The ONC, the Agency for Healthcare Research and Quality and several medical societies also offer several online tools to help organizations track their progress and look at the clear set of meaningful use objectives, he adds.
Meaningful use misconception
As providers progressively make the switch to EHRs, Mr. Seidman says a common fallacy develops regarding the meaningful use criteria. Meaningful use is not a homework assignment — it's a way to improve care coordination, reduce harm, reduce morbidity and mortality and keep patients engaged in their own health. "Sometimes people look at the list of 24 or 25 meaningful use objectives as just a checklist, but in reality, there's a methodology to it," Mr. Seidman says. "If you look at it, there are goals of making care safer, reducing errors and including foundational data to improve care coordination."
Hospital and physician concerns
There have been concerns, though, with the deadlines of meeting the meaningful use incentive programs. Hospitals and providers certainly don't want to miss out on the maximum financial incentives the federal government is offering, and the ONC has incorporated many suggestions from providers and medical groups to make meaningful use as transparent a process as possible, Mr. Seidman says.
However, he reiterates the crux of the program is to develop criteria for care quality, and he says the input the ONC has received has been tied into that. For example, stage 3 of meaningful use, which will expand on the baseline of electronic data capturing and information sharing for future rules, is not expected to be implemented until 2015. "This is not about technology," Mr. Seidman says. "It's around the meaningful use of technology to improve the quality, efficiency and safety of care, but at the same time, that has to be balanced with what is actually feasible for hospitals and physicians today. That's part of the reason why we've come up with the stage approach to develop the meaningful use objectives."
Future of health IT
With the rapid growth of EHR implementation, Mr. Seidman says there will clearly be a need for a wide range of health IT support and expertise. The Community College Consortia Program, an offshoot of the ONC, graduates students from various community colleges in several different health IT backgrounds such as implementation support specialists and information management redesign specialists. Health IT jobs will be available, as roughly half of hospitals and physicians practices are expected to have EHRs implemented in three to five years, Mr. Seidman says.
In the last year alone, the use of EHRs by physicians has gone from 20 percent to 30 percent, he adds. The ability to retrieve information from mobile devices is also complementing the EHR trend, and these types of technologies to improve patient care are simply becoming an accepted change. "You can see from those organizations that have made the transition to EHRs that there is a sense of 'We're never going back,'" Mr. Seidman says. "As we pass that tipping point, it'll just become an expectation to better organize and transmit health information and a cost of doing of business, just like any other industry."
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However, hospitals and providers should not get caught up in the wave of technology requirements, says Josh Seidman, PhD, director of meaningful use at the Office of the National Coordinator for Health Information Technology. He says there are ways to ensure meaningful use, and hospitals and physicians can achieve it if they keep the main theme in mind: improved patient care for the 21st century.
Ways to ensure meaningful use
There are several things hospitals and physician practices can do to achieve and attest for meaningful use. There are 25 meaningful use objectives for eligible providers, and there are 24 meaningful use objectives for eligible hospitals and critical access hospitals. Mr. Seidman says as providers implement their EHRs, they should confirm their EHR system is certified for meaningful use. Many larger hospitals and practices have already implemented their EHR systems successfully, but some hospitals and practices that provide medical care to underserved populations have not.
That's where regional extension centers can help, Mr. Seidman says. RECs are another vital outlet for small practices and critical access hospitals, especially those with limited IT departments. RECs were set up through the Health Information Technology for Economic and Clinical Health Act to help providers become adept and meaningful users of EHRs. RECs provide training and support services to assist physicians and other providers, offer guidance with EHR implementation and give technical assistance whenever needed. "One of the ideas behind this is for providers to share best practices and learn about how other providers in the same settings have approached EHR implementation," Mr. Seidman says.
The ONC, the Agency for Healthcare Research and Quality and several medical societies also offer several online tools to help organizations track their progress and look at the clear set of meaningful use objectives, he adds.
Meaningful use misconception
As providers progressively make the switch to EHRs, Mr. Seidman says a common fallacy develops regarding the meaningful use criteria. Meaningful use is not a homework assignment — it's a way to improve care coordination, reduce harm, reduce morbidity and mortality and keep patients engaged in their own health. "Sometimes people look at the list of 24 or 25 meaningful use objectives as just a checklist, but in reality, there's a methodology to it," Mr. Seidman says. "If you look at it, there are goals of making care safer, reducing errors and including foundational data to improve care coordination."
Hospital and physician concerns
There have been concerns, though, with the deadlines of meeting the meaningful use incentive programs. Hospitals and providers certainly don't want to miss out on the maximum financial incentives the federal government is offering, and the ONC has incorporated many suggestions from providers and medical groups to make meaningful use as transparent a process as possible, Mr. Seidman says.
However, he reiterates the crux of the program is to develop criteria for care quality, and he says the input the ONC has received has been tied into that. For example, stage 3 of meaningful use, which will expand on the baseline of electronic data capturing and information sharing for future rules, is not expected to be implemented until 2015. "This is not about technology," Mr. Seidman says. "It's around the meaningful use of technology to improve the quality, efficiency and safety of care, but at the same time, that has to be balanced with what is actually feasible for hospitals and physicians today. That's part of the reason why we've come up with the stage approach to develop the meaningful use objectives."
Future of health IT
With the rapid growth of EHR implementation, Mr. Seidman says there will clearly be a need for a wide range of health IT support and expertise. The Community College Consortia Program, an offshoot of the ONC, graduates students from various community colleges in several different health IT backgrounds such as implementation support specialists and information management redesign specialists. Health IT jobs will be available, as roughly half of hospitals and physicians practices are expected to have EHRs implemented in three to five years, Mr. Seidman says.
In the last year alone, the use of EHRs by physicians has gone from 20 percent to 30 percent, he adds. The ability to retrieve information from mobile devices is also complementing the EHR trend, and these types of technologies to improve patient care are simply becoming an accepted change. "You can see from those organizations that have made the transition to EHRs that there is a sense of 'We're never going back,'" Mr. Seidman says. "As we pass that tipping point, it'll just become an expectation to better organize and transmit health information and a cost of doing of business, just like any other industry."
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