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Is Meaningful Use a Floor or Ceiling?

Posted on June 9, 2011 I Written By

I was witness to an interesting discussion earlier this week at the Wisconsin Technology Network’s Digital Healthcare Conference in Madison, Wis.: Is meaningful use a floor or a ceiling?

One panelist, Judy Murphy, VP of information services at Aurora Health Care in Milwaukee, said Stage 1 meaningful use has caused the health system to alter its own IT plans by activating a patient portal and moving more toward interoperability sooner than intended. “We wouldn’t have decided to give electronic copies of clinical summaries at discharge [without meaningful use],” Murphy said.

But Murphy believes it’s a floor for many of the criteria, such as the requirement that 30 percent of patients have at least one medication order entered electronically. “No one would go into an implementation shooting so low,” she said. As a member of the Health IT Policy Committee as well as the Meaningful Use Workgroup of the Health IT Policy Committee, Murphy actually had a hand in shaping the standards. (Remember, though, the original proposal called for 10 percent for hospitals and 80 percent for physicians. The final Stage 1 rule set the threshold at 30 percent for both.)

Gartner analyst Vi Shaffer offered a counterpoint. “Meaningful use is not the floor,” she said. “All the existing quality measures that have been out there so long should be considered the floor.” Shaffer expressed frustration that so many 12-year-old National Quality Forum performance measures still haven’t been met.

According to Shaffer, the idea behind meaningful use is to “lift people up,” particularly when it comes to safety-net providers like critical-access hospitals. Shaffer said policymakers didn’t want to see “oligopolies” in local markets because smaller providers were forced to merge with large health systems because of EHR requirements.

Session moderator Dr. Barry Chaiken, chief medical officer at Docs Network Imprivata, and a former HIMSS chair, said he believes health IT will raise the norm for all providers and “lock in” better behaviors, suggesting that in some ways, meaningful use could be a floor.

By holding the conference in Madison, WTN was able to land the publicity-shy Judy Faulkner, CEO of Epic Systems in nearby Verona, Wis. Faulker noted that Epic shows a simpler version of its core EHR in overseas markets because the company had to add some functions for regulation and liability purposes in the U.S.

While plenty of providers are viewing meaningful use as a ceiling right now–perhaps an unattainable one–Murphy believes acceptance will come rapidly. “I think in 2015, we’re gonna look and say, ‘How did we even have healthcare without computers?'” Murphy said. She then said she had heard that HCA would attest this year to meaningful use at all of its U.S. hospitals.

Being the occasionally motivated reporter that I am, I tweeted this statement, asking for verification. Wouldn’t you know, HCA replied with this tweet: “Nearly all HCA facilities should achieve requirements 4 Stage I this yr. An exciting, important step for high-performance hcare!”

So maybe meaningful use is not a floor or ceiling, but the new norm.

What are your thoughts?

CORRECTION, June 13: Chaiken’s one-year contract with Imprivata is over, so he’s no longer affiliated with that company.

 

HIT Policy Committee Has No Small Practice Representation

Posted on April 5, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

One of my loyal readers and colleagues in the EHR field recently sent me a link (pdf) to the list of members that were announced on the Health Information Technology (HIT) Committee. Take a look at the list of members on the HIT Policy Committee:

  • Christine Bechtel, vice president, National Partnership for Woman and Families
  • Arthur Davidson, director, Public Health Informatics, Denver Public Health Department; director, Denver Center for Public Health Preparedness; medical epidemiologist; director, HIV/AIDS Surveillance, City and County of Denver
  • Adam Clark, research and policy director, Lance Armstrong Foundation
  • Marc Probst, chief information officer, Intermountain Healthcare
  • Paul Tang, vice president and chief medical information officer, Palo Alto Medical Foundation
  • Scott White, assistant director, technology project director, 1199 SEIU Training and Employment Fund
  • LaTanya Sweeney, director, Data Privacy Lab, Carnegie Mellon University
  • Neil Calman, president and chief executive officer, Institute for Family Health
  • Connie Delaney, dean, University of Minnesota School of Nursing
  • Charles Kennedy, vice president, Health Information Technology, Wellpoint
  • Judith Faulkner, founder, CEO, president and chairman of board, Epic Systems
  • David Lansky, president and CEO, Pacific Business Group on Health
  • David Bates, medical director for clinical and quality analysis, Partners HealthCare/Brigham and Women’s Hospital

I think the person that sent it to me was surprised that someone from Epic, a private vendor, was on the committee. What was more interesting to me was that there wasn’t one representative on the HIT policy committee from a small doctor’s office. There was plenty of hospital representation and public health but no one to speak for the small doctors offices. Sad part is that small doctors offices make up the major part of the US healthcare system and should be the ones who really need to access the HITECH Act EHR stimulus money.

Looks like my list of HITECH Act EHR stimulus winners is becoming more true every day. My list didn’t include small doctors’ offices and neither did their committee.