Rural Hospital Attests Four Times for Meaningful Use

When Frank Beaman came to Faith Community Hospital in Jacksboro, Texas in 2010, the electronic health records meaningful use program was not on the organization’s radar. Things changed in a hurry.

When Frank Beaman came to Faith Community Hospital in Jacksboro, Texas in 2010, the electronic health records meaningful use program was not on the organization’s radar. Things changed in a hurry.

The 41-bed facility attested for Stage 1 in 2011, 2012 and 2013, and then attested for Stage 2 in October 2014. The Stage 1 attestations netted a total of about $2.8 million and Stage 2 brought in another $300,000; a smaller amount than usual but the hospital had reached its cap of about $3 million in incentive payments.

When Beaman arrived, he quickly realized that the hospital had a culture of complacency in failing to recognize the importance of the meaningful use program and the federal law that spawned it. With money to be made and Medicare reimbursement penalties to be avoided, his message was: “This is not optional, it’s not a fad and it’s not something we’re going to change.” And he admits, “We had to have a little bit of housecleaning to make that happen.”

During Stage 1, staff had to manually calculate several measures because the EHR wasn’t capable of doing the calculations. But then, the hospital got audited and had to produce several hundred pages of documentation to prove they had properly calculated.

Faith Community achieved Stage 1 using the EHR of Prognosis Innovation Healthcare. However, the vendor—like many other companies—was struggling to get ready for Stage 2 and the hospital, running out of time to collect data by July 2014 to attest by October, switched to a cloud-based EHR from RazorInsights. The hospital considered Cerner but it became clear to Beamon that the vendor wasn’t geared to rural hospitals, and CPSI and Meditech could not meet its timeframe for attesting to Stage 2 in October.

The new EHR vendor impressed Beamon at go-live by having a team on site 24/7 for two weeks, which gave night staff access to training and help with troubleshooting. And, when Stage 2 attestation arrived, RazorInsights helped with screen reporting and screenshots to document compliance with measures.

The $2.8 million in incentive payments for three iterations of Stage 1 was worth the effort as it helped with software purchases that needed to be made and helped the bottom line, as well, Beaman says. But $300,000 for Stage 2 also was worth it—leaving money on the table would have been mismanagement, he notes, and facing reimbursement penalties for not finishing Stage 2 also was a reason to go forward.

The Stage 2 money wasn’t going to be enough to buy another EHR, but RazorInsights’ cloud-based system meant that Faith Community didn’t need the financial outlays for Stage 2 that it needed under Stage 1. And, the cloud appeals to Beaman because service and maintenance is easier, and all components are under one roof, rather than ancillary systems being interfaced with the EHR. “I also wanted one neck to choke if there were any problems,” he jokes.

While many stakeholders are finding attaining Stage 2 to be difficult, Joy Henry, chief nursing officer at Faith Community, thought it was easier than Stage 1. She lacked any knowledge of meaningful use when the hospital went into Stage 1, but soon realized the required measures for meaningful use were already being collected, so everything started to make sense. And, the same thing happened in Stage 2; the measures were expanded and some were new, but everyone knew what they were doing. “Joy set expectations for her staff,” Beaman says. “She let it be known that this was going to be successful.”

Stage 2 measures are more challenging, Beaman adds, but they should be to advance the meaningful use program and putting together resources to handle the measures is important to overall success. “Get ahead of this and don’t let it overtake you, or it will.”

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