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A more meaningful meaningful use

By Brandon Savage, M.D., chief medical officer, GE Healthcare IT

Striving to improve the quality of the U.S. healthcare system, the government will invest about $30 billion in healthcare IT over the next decade, including financial incentives for healthcare providers who adopt electronic health records and demonstrate meaningful use. The bar set for meeting the first stage of meaningful use, which starts in 2011, ensures an effective start for the program, with expectations to increase rigor every two years. This will enable a shift from a structured data capture and exchange focus to one that addresses improved healthcare outcomes and advanced care processes. In the next year, healthcare leaders will begin to look beyond just meeting the initial requirements and drive toward making meaningful use meaningful for their organizations. An increasing number of CIOs will realize that they need to generate long-term value from meeting initial and subsequent meaningful-use measures

and prepare for the future. They’ll participate in emerging models, such as value-based payment, patient-centered medical homes and accountable care organizations. There has also been a growing and

appropriate systemic shift toward patient financial accountability as well as provider/ patient engagement. Providers know patients, in turn, will demand more transparency and choice as they bear a higher proportion of

healthcare costs and have access to more information on their care. Meanwhile, government and private payer value-based payment standards are forcing more financial and quality benchmarking, and although some CIOs will undoubtedly remain focused on meeting just the initial bare minimum, this groundswell will force an unmistakable tipping point. Meaningful meaningful use will pull away from ordinary meaningful use and benefit the smart healthcare systems employing it. These are the organizations that will drive better optimization of cost, quality and access and leverage the ARRA reimbursement’s once-in-a-lifetime opportunity for many lifetimes to come.

EHRs: Finding new approaches to integration

By Alan Portela, president, CliniComp With the passage of the HITECH Act and rules

regarding meaningful use, the federal government has taken a leading role in creating urgency in the adoption of electronic health records (EHRs). During the past decade, healthcare organizations have invested billions of dollars in failed attempts to adopt comprehensive EHRs (less than 10 percent adoption). Today’s biggest challenge is the lack of automation in inpatient, mission-critical clinical areas (such as EDs, ICUs, ORs), as well as the integration of systems to address key strategic initiatives (i.e., medication error reduction that requires CPOE, eMAR, bar coding, pharmacy, dispensing). The need to reach 100 percent adoption during the next

fi ve years is prompting healthcare organizations to seek a new approach optimizing the existing infrastructure and the automation of functional care-setting suites (FCSS) covering existing operational and clinical gaps, rather than

replacing the entire infrastructure with a solution from one vendor the way it was done over the past decade. The recommended approach is “best of suite,” covering functional care-setting suites and combining fully integrated “best-of-breed” applications, meeting the needs of caregivers while improving clinical workfl ow and matching the organization’s strategic initiatives. We should start with meaningful-use compliance as the top

strategic initiative, which requires two key components: meaningful data (mission-critical areas) and meaningful use (clinician adoption).

The need for developing a transitional strategy without disrupting the current workflow is crucial to EHR modernization. Systems must be able to support open standards as well as effectively communicate information without requiring extensive tailoring of the core infrastructure.

The challenge for large healthcare institutions while upgrading their clinical applications is the scale of migration and integration with existing infrastructure while meeting operational and clinical needs.



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