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 Thought Leaders

Meaningful, meaningful use

Moving beyond implementation to strategy and analysis to improve clinical processes.

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   By Brandon Savage, M.D, March 2013

United States healthcare providers cited meaningful use as one of their primary areas of focus through 2014, according to HIMSS.1 In the same vein, IDC sees meaningful-use financial incentives as a primary motivator for small physician practices to adopt electronic health records (EHRs), projecting that 80 percent of them will do so by 2016, despite the associated challenges and costs.2

We should applaud the administration for putting in place the incentives and penalties that are accelerating the adoption and meaningful use of EHRs. Digitizing and exchanging data is critical to improving the quality, safety and cost of patient care. Without electronic data, the healthcare industry would never make significant progress at scale, as other industries achieved decades ago.

But in and of itself, an EHR won’t effect change. And even the meaningful use of EHRs won’t deliver the change we collectively seek. To drive the level of transformation in healthcare delivery that we urgently need, the industry must move beyond meaningful use (the digitization, exchange and reporting of data) and progress to meaningful, meaningful use (the strategic analysis of data to understand patients, populations, processes and performance) and utilize that insight to take the appropriate action. This understanding is the foundation for driving positive change, and ultimately, better outcomes.

Most organizations that are pursuing meaningful use are appropriately focused on Stage 1 of the process: data capture and sharing. But it is not too early to look to Stage 2: using EHRs to advance clinical processes. The decisions that organizations make now will lay the groundwork for a smooth progression from reporting quality measures to using these systems to analyze and advance performance.

Currently, organizations are being held accountable for the reporting of quality measures, but it will not be long until the quality measures themselves and the improvements achieved are the basis of accountability and reward or penalization. This means that meaningful use cannot just be the responsibility of the CIO; leaders across the organization need to come together to approach reporting and improvement strategically, because it’s going to affect them.

And all organizations would do well to take a strategic view, not just those with generous endowments or existing plans to rip and replace legacy systems. Smaller community hospitals with modest budgets, and organizations that are making incremental improvements to existing infrastructure, also have the capacity to take a strategic approach now. In fact, it’s more crucial for them to do so, to ensure the most efficient use of scarce resources now as well as in the future.

One organization that’s working to change outcomes through the strategic use of technology is Providence Health & Services. They have implemented a Modified Early Warning System (MEWS) that aggregates a wide range of near real-time patient data from multiple sources to create a patient score based on several factors, including heart rate, respiratory rate, blood pressure, urine output and other signs. The use of MEWS has helped them reduce code-blue events and escalations, reduced the number of patient transitions to the ICU and helped reduce the mortality rate at Providence St. Vincent Medical Center.

INTEGRIS Health, Oklahoma’s largest health system, is using data strategically as part of a system-wide approach to preventing avoidable 30-day patient readmissions to the hospital. Their new process allows them to identify patients at highest risk of readmission and target interventions appropriately. Even early on in the process, INTEGRIS is seeing a reduction in the number of preventable readmissions.

Only by committing to using data to measure and deeply understand the processes that constitute healthcare delivery can we innovate and evolve those processes to improve performance. Only when we begin to use data for meaningful collaboration across care settings can we more effectively manage the complex web of relationships involved in the care of individuals or populations as they transition from hospital to clinic to home. And only when we begin to share knowledge and best practices – also enabled by electronic data – can we optimize care at scale. HMT

About the Author:

Brandon Savage, M.D., is chief medical officer, Caradigm. For more on Caradigm: www.rsleads.com/303ht-212

 

  1. 2012 HIMSS Leadership Survey, Senior IT Executive Results. HIMSS. February 2012.
  2. IDC MarketScape: U.S. Ambulatory EMR/EHR for Small Practices 2012 Vendor Assessment. IDC Health Insights. May 2012.

Tags:  Thought Leaders