Childs Medical Clinic in Samson, Ala., successfully attested for meaningful use of electronic health records on April 19 and a month later was one of the first practices in the nation to receive an incentive payment from Medicare. Practice administrator Jule Childs has several tips for peer organizations, most importantly, "It's worthwhile."

The one physician, one nurse practitioner clinic spent three months working on collecting the data to attest. Several EHR vendors offer a dashboard application that tracks progress toward meeting meaningful use objectives and Childs found the dashboard with her EHR from Greenway Medical Technologies Inc. to be invaluable. The dashboard, for instance, pinpointed patients seen each day but not added to the numerator for applicable meaningful use measures.

Everyone in the office has to be involved in achieving meaningful use, Childs counsels. Each level of staff has different assignments and each had specific changes to their workflow that were minor but critical to meeting the measures.

Intake personnel, for instance, had to get used to asking each patient for their ethnicity and preferred method of communication. And prominent notifications had to be placed on face sheets to make sure that a tobacco assessment was taken of all patients 13 years of age and older because non-smokers weren't being counted.

The problem list for patients with no problems had to be documented as "non-relevant" or "no current problems" because the dashboard didn't capture N/A notations. A big surprise while reaching meaningful use was finding that while the clinic was meeting a measure to provide clinical summaries to patients, most did not want it. "They'd say "I don't want to leave a list of medications and visits lying around, you keep track of it," Childs recalls.

Childs Medical Clinic also gave everyone ownership of meaningful use. "I told everyone, when we get this incentive payment everyone will get a bonus," Childs says.

After paying the bonuses, most of the meaningful use incentive money will fund a new floor in the clinic, she adds. "Any expenditure in a small office is big for us."

--Joseph Goedert


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