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EMRs, ICD-10 Pave the Way to Business Intelligence

Posted on June 16, 2011 I Written By

Two articles I’ve written in the last 24 hours have gotten me thinking that we’ve already entered the post-implementation era of EMRs, even as implementation remains in progress at so many healthcare organizations. While the vast majority of hospitals and physician practices in the U.S. still don’t have full-featured EMRs in place, many are already looking well into the future.

As you may already know, HIMSS on Tuesday released its first-ever survey on “clinical transformation.” According to HIMSS and survey sponsor McKesson, “Clinical transformation involves assessing and continually improving the way patient care is delivered at all levels in a care delivery organization. It occurs when an organization rejects existing practice patterns that deliver inefficient or less effective results and embraces a common goal of patient safety, clinical outcomes and quality care through process redesign and IT implementation. By effectively blending people, processes and technology, clinical transformation occurs across facilities, departments and clinical fields of expertise”

As I reported for InformationWeek, 86 percent of organizations surveyed had a plan for clinical transformation in place or at least under development, and just 12 percent of respondents called organizational commitment a barrier to reporting on quality measures. And though nearly 8o percent indicated that they still gather quality data by hand and 60 said they don’t capture data in discrete format, more than half already had software specifically for business intelligence. This tells me that analytics is here to stay.

I kind of knew that anyway, since the bulk of the program at last week’s Wisconsin Technology Network Digital Healthcare Conference was devoted to BI, data governance and advanced analytics tools, even in the context of Accountable Care Organizations. (My story about this for WTN News appeared this morning.)

“I’m ready to declare the era of business intelligence,” said Galen Metz, CIO and IS director for Madison-based Group Health Cooperative of South Central Wisconsin. Though he criticized the proposed ACO rules for being too “daunting” for the average provider, Galen and other speakers said that it’s time to harness all the new, granular data being generated by EMRs and, soon, ICD-10 coding.

It may seem “daunting” now in the midst of all the preparations for ICD-10 and meaningful use, but it’s good to know that many healthcare organizations see a light at the end of the tunnel and know that the future bring better healthcare information in exchange for all the hard work and investment today.


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.