Meaningful Use Interview with HVCA Administrator Barbara Watkins, R.N.

Posted on May 4, 2011 I Written By

John Lynn is the Founder of the 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 and John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

My last meaningful use interview went over so well, that I decided that I should do some more. When I saw the news that a GE Centricity customer met meaningful use, I decided that would be a good opportunity for my next meaningful use interview.

I’m certainly interested in doing more interviews from a variety of EMR vendors, specialties, and regions. I’d be happy to interview someone who’s deciding to wait or to forgo meaningful use completely. If you are a doctor or practice manager interested in being interviewed, just drop me a note on the EMR and HIPAA contact us page. Now some background on Barbara Watkins and HVCA.

Heart & Vascular Center of Arizona (HVCA) Administrator Barbara Watkins, R.N., helped lead the practice’s six cardiologists through the process of preparing for attestation to meet Stage 1 of Meaningful Use. The practice serves more than 15,000 patients and the providers started preparing for attestation actively in fall 2010.

An interview with Heart & Vascular Center of Arizona (HVCA) Administrator Barbara Watkins, R.N.

How long have you been using an EMR? Which EMR do you use?

We’ve been using GE Healthcare’s Centricity Practice Solution since June 2008.

Did you have to upgrade your EMR to meet the certified EHR and meaningful use requirements? How much did it cost for you to do that if you had to?

Yes, we upgraded to Centricity 9.5. We spent around $60,000 to upgrade our servers and laptops.

How long did it take you to select and implement your EHR? What criteria did you find most important in your selection of an EHR?

We went on the Practice Management software in September 2007, and then implemented the EMR in June 2008. It’s interesting that many of the components I purchased we did not fully implement until we went live on the EMR. The patient portal was one of those products, as well as the Indexing Client that facilitates the movement of scanned documents into the charts. Centricity has a wide spectrum of products that fully integrate and compliment the PM/EMR software.

How many hours of extra effort do you estimate it took for you and your staff to meet meaningful use criteria?

We began to actively prepare for attestation in the fall of 2010 when the CMS issued their final rule. Towards December, we were honing in on our workflows and consulting with our physicians to ensure that they were capturing all the necessary data within the EMR. In total, we estimate that 60 extra hours were spent on this project.

What were some of the changes you had to make to your practice style or documentation methods to meet meaningful use?

Ensuring that we were careful and precise with our documentation was certainly critical, since the Centers for Medicare and Medicaid Services (CMS) require specific tracking of criteria. For example, medication reconciliation is done in our practice at every office visit because we’re specialists. However, CMS views medication reconciliation only in the context of “transition of care,” so that’s how we have to document it – even when we are seeing the patient in a post-op visit. Our providers had to be trained to use a specific code to identify a post-op visit as a “transition of care” event in order to satisfy the medication reconciliation criteria.

Overall, the most important factor for us in meeting meaningful use requirements was understanding how certain data was being captured and recorded. We also made sure to match the new reporting requirements with our workflows, which naturally takes a little time.

Were there any surprises in the meaningful use attestation process?

I was very excited when we ran the first reports – our physicians were actually doing most of the processes that were required and at very high percentages. But the biggest surprise was that we would need to modify our workflows to prove some of the measures.

Who helped you through the process (your vendor, a consultant, your REC, etc.)?

We’re thrilled that we have a strong vendor partnership with GE Healthcare – they were extraordinarily supportive throughout the process of helping us prepare for attestation and run the necessary meaningful use reports.

I believe dependable vendor support is especially important for physician practices who do not have IT departments at their disposal to help troubleshoot the EMR and ensure that all the meaningful use reporting requirements are met.

Were there any unique challenges for cardiologists in showing meaningful use?

Actually, I feel cardiology is one specialty that easily meets meaningful use, barring the immunization requirements. We easily met the core measures and many of the quality measures as well. We have been participating in PQRI (now PQRS) and e-Prescribing with GE’s MQIC product. MQIC’s reporting tools keep us on track with many quality measures and protocols that we have instituted in our practice on our own.

Meaningful use Stage 1 has a relatively low bar. Are you concerned that stages 2 and 3 might be a much harder challenge?

I’m optimistic about meeting the requirements for stage 2, although I do have concerns about exchanging data between disparate providers. Given my knowledge of the Phoenix market, I don’t believe that level of data exchange has gained real traction yet in our region. We will have to work hard to encourage data exchange with our referring doctors.

What do you say to your fellow doctors who are concerned about implementing an EHR in their practice?

EHR is a necessity in today’s time. We have found a real scale of efficiency in using the Centricity product. It has improved communication within our practice. With the patient portal, we have improved communication with our patients as well. Our physicians love the ability to login to the system from anywhere and access patient data to facilitate communication with hospitals and other physicians in an instant!