The Kiss of Death for Meaningful Use Efforts

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The kiss of death to an electronic health records meaningful use effort is boiling down the criteria to a checklist of to-do items for physicians. That’s the word from Jeff Loughlin, project manager at the Massachusetts eHealth Collaborative and executive director of the Regional Extension Center of New Hampshire.

“Physicians hate lists and once you think of meaningful use as a list, you are doomed to failure,” Loughlin said at the MGMA Conference in San Antonio. The program does provide qualification criteria in list format, he acknowledged, but the way to streamline adoption of meaningful use is to describe the criteria not as discrete tasks, but rather as steps that are part of any practice’s given workflow.

Loughlin then proceeded to assign each Stage 2 meaningful use measure to broad workflow categories, beginning with the pre-visit and ending with post-visit follow-up. In between are such steps as registration, intake, visit, and check-out. At each step, various MU measures--such as capturing patient demographics--can be done at check-in. Only a handful of the measures require hands-on work by physicians, he noted, such as reviewing lab results and creating the problem list.

Loughlin warned of several common industry practices that threaten to undermine the purpose of meaningful use to improve patient care. Some practices are merely taking paper-based processes and applying them to the computer. One practice he visited continues to document on paper and just transfers the minimum necessary data into its EHR to qualify.  That approach won’t work in later stages of MU, which put emphasis on sharing data outside the organization and with patients.

Other practices rely too heavily on “out of the box” software, implementing alerts and decision support tools without modifying them for their own practice, Loughlin contended. That can lead to an abundance of needless alerts, which are not only a nuisance but miss the program’s intent of using clinical decision support tools.

Physician documentation at the point of care is another common missing ingredient, he noted. If physicians document their visit after the patient has left the office, they miss on opportunities to view medication alerts in real time and sell the benefits of using a patient portal. “Meaningful use should not be viewed as a checklist, but as part of providing exceptional care.”

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