DENVER -- At the Institute for Health Technology Transformation's Health IT Summit in Denver last week, health care stakeholders shared experiences, advice and concerns about the meaningful use incentive program. The intimate 175-person summit allowed attendees to learn directly from their peers.
While the conference drew a diverse group of health care professionals from a variety of industries throughout the country, they overwhelmingly agreed on two things:
- Incentive payments alone should not be the driving force behind health IT adoption; and
- Meeting meaningful use requirements is not going to be easy.
Greg Veltri, CIO of Denver Health, said that "health care won't be able to exist without IT in 10 years." Still, he warned, "If all you're doing is implementing applications to get the money, you're going to end up harming patients."
Mark Blatt, worldwide director of global health care strategy at Intel, said that patient empowerment, not qualifying for incentive payments, should be health care providers' end goal.
Sharing Best Practices
Throughout the two-day summit, health care providers, vendors, and legal and privacy experts offered lessons they have learned in their quest to comply with meaningful use criteria.
Several speakers urged health care providers to consider a modular approach to electronic health record adoption, rather than buying one comprehensive system from a single vendor.
Steven Grant -- vice president of physician relations at the Detroit Medical Center -- said his facility is using a modular EHR approach because it is less expensive, easier to implement and less disruptive to clinician workflow.
Blatt noted that health care providers could meet Stage 1 meaningful use requirements by implementing only a registry application and an electronic prescribing system.
Steve Fowler -- director of the Colorado Benefits Management System and former interim enterprise architect for the Colorado Governor's Office for IT -- said that while Colorado still is in the early stages of health IT adoption, the state also is pursuing a modular approach.
Elizabeth Johnson -- vice president of applied clinical applications at Tenet Healthcare -- stressed the importance of vendor communication. She added that it is important in the contract phase to include everything you expect the vendor to deliver.
Justin Graham, chief medical informatics officer at NorthBay Healthcare, concurred, noting that it is important to include in contract agreements language that requires vendors to meet Stage 1 or 2 meaningful use certification deadlines.
Johnson said Tenet -- which includes 49 acute care hospitals in 11 states, as well as 84 outpatient centers -- plans to attest for meaningful use in 2012. She said that Tenet's vision goes beyond meaningful use incentives and is "to provide the right information when and where it's needed to improve the care and life of every person in the communities that we serve."
One of the key steps in Tenet's huge undertaking to implement health IT and comply with meaningful use requirements was to put together a meaningful use committee, as well as multiple advisory groups, that included representatives from legal, audit, compliance, finance, physicians and other clinical staff. Johnson explained that such task groups allowed for collaboration, engagement and improved communication.
In addition, Johnson recommended putting together a team dedicated to tracking and testing health IT applications. She also noted the importance of making health IT decisions with the future in mind, noting that stages 2 and 3 meaningful use requirements and final accountable care organization rules still are unknown.
Veltri urged health care providers to work to change care processes and eliminate waste as they seek to meet meaningful use requirements.
Keeping an Eye on the Challenges
Grant noted that "EHRs as they are now do not make your life easier in terms of time." He added that from a physician perspective, implementation requires "very heavy lifting."
Several health care providers noted that usability is lagging in many EHR systems.
Larry Wolf -- health IT strategist at Kindred Healthcare -- said that usability is essential for both EHR adoption and EHR safety.
Johnson -- who also is a member of the Health IT Standards Committee -- said that EHR usability criteria likely will be included in Stage 3 of the meaningful use program.
Jennifer Lyle -- CEO and founder of Software Testing Solutions -- said it is important for organizations to ensure that they are not implementing health IT just for the sake of it but rather to improve patient outcomes.
Graham said that there are concerns that Stage 1 is becoming more about checking boxes than the meaningful use of technology. He added that it is a challenge to keep the focus on improving care.
Conference attendees also raised concerns about the auditing process after health care providers and facilities have attested to meeting meaningful use.
Graham said that because a lot of the measures are "very open for interpretation" the prospect of audits "is a little terrifying." He added that for small practices, audits probably are not even on their radars.
Looking Forward
Stakeholders noted that the meaningful use program might create a new floor or community standard and that payers might avoid health care providers who are not meaningful users of health IT.
Still, Veltri said the HITECH Act is "not a provider-centric activity" but rather aims "to enable a productive interaction between patients and the health care system."
Johnson said that meaningful use is only the first step. She said health IT should really be about supporting the exchange of data, capturing use of data and getting to new care models.
Johnson said the meaningful use program "is a journey that has many side trips and distractions," but she urged health care providers to "never forget it is about patient care."