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MU Concerns, Counsel Offered at HIT Standards Committee Hearing
By Juliann Schaeffer

In January, the HIT Standards Committee hosted a hearing on early adopters of meaningful use (MU), aiming to discern the varying factors leading to HIT implementation success as well as the obstacles frequently faced by healthcare organizations attempting to achieve MU.

The hearing, "Real World Experiences Working With Meaningful Use," featured panels of eligible professionals and large and small integrated delivery networks seeking attestation as well as regional extension centers and certifiers, with witnesses including both those seeking to attest for MU in 2011 as well as those not expecting to participate until next year.

In their testimony, panelists largely agreed with the reasoning that EHRs in general, and MU of the technology in particular, will lead to improved patient care—eventually. Yet the path to MU has been less clearly labeled than many panelists had hoped and, especially with the rapid timeline set forth for stage 1 MU in order to receive federal incentives, there seems to be unrest in the healthcare community about whether the incentive monies promised by the federal government will actually appear after an organization finally achieves meaningful use. Only time and effective incentive dispersing will remedy such worries.

More than one panelist noted the overwhelming amount of information available regarding achieving MU. Regional health centers were noted as one possible guide through the information overload, and another panelist mentioned how integral clinical informaticists were to his implementation team in making sense of it all.

There was also some concern noted by panelists in regard to EHR certification, considering the large number of systems certified for stage 1. One panelist, Robert L. Murray, medical director of informatics at Hunterdon Medical Center in New Jersey, mused about practices that may have hastily chosen certified EHRs yet might not be able to meet later stages of MU: “What happens to the physicians who chose them in a rush to claim MU incentives?” The result of such also remains to be seen.

To gain some insight into individual panelists’ MU strategies and impressions of how the process is going thus far, For The Record recently posed a set of questions to two of the hearing’s panelists, both of whom have been utilizing the NextGen Ambulatory EHR: Dan Nelson, practice administrator for Desert Ridge Family Physicians in Phoenix, and Careen Whitley, MD, a family physician who works in private practice in Oakland, Calif., as part of Hill Physicians Medical Group.

FTR: What was your overall MU strategy?
Whitley: Our first goal is to install and test all required elements into our database and then deploy to our providers. We hope to be ready to report by spring or summer of this year. In the meantime, we have established a task force to review each of the measures and develop steps to insure all providers are successful at reporting. We have been disseminating information to our practices and will continue to do so. This will include on-site training sessions, written materials, etc.
Nelson: The requirements of meaningful use did not pose a significant challenge for us. We began using NextGen over six years ago, so it is well established in our practice. For the MU measures that we have not met, we were easily able to fit their integration into our existing practice improvement roadmap.

FTR: What is your impression thus far of how it’s working?
Whitley: It is still early, but we are confident we will be successful.
Nelson: We are very satisfied with the meaningful use program. It has complemented our previous efforts in measuring and improving quality. But we are more enthusiastic about the interest and improvements that we are seeing in the healthcare industry and the growing focus on efficiency, quality, and exchange of information. We are also impressed by the level of assistance that we have seen from our regional extension center. They have great personnel who have been knowledgeable and helpful.

FTR: Have you come across any surprises?
Whitley: Not really.
Nelson: I’m most surprised that there are so many certified EHRs. And I’m also surprised that some practices are so resistant to implement an EHR, despite the incentives and the resulting improvements.

FTR: Are you planning to apply for the incentives? If so, by when? 
Whitley: We hope our providers will be ready by spring or summer of 2011 if they desire to proceed. I personally am undecided whether we will apply in 2011 or 2012.
Nelson: We will be applying for the incentive in the second half of 2011.

FTR: How much time/money have you spent gathering the data to apply?
Whitley: No money spent but a significant amount of time. NextGen webinars and white papers have been very helpful.
Nelson: We have not begun to gather data yet.

FTR: How are you gathering the data, and who is doing the gathering?
Whitley: We expect to use NextGen reporting tools. Some will be done by Hill Physicians internally but others will be done at the practice level.
Nelson: Some of our data will be extracted by us via canned Crystal Reports included within our EHR, and some data will be gathered by a data collection and reporting tool from NextGen.

— Juliann Schaeffer is an associate editor at Great Valley Publishing Company.