EHR ROI: Meaningful Use and Leveraging Your Electronic Health Record

Shira Hauschen leads Dorsey Health Strategies LLC, a consulting firm serving the health industry affiliated with Dorsey & Whitney LLP. This article originally appeared in the Minnesota Hospital Association’s May 2015 issue of “Health Care Leader.”

Meaningful Use (MU) is again at the forefront of many hospital leaders’ minds, as the Centers for Medicare and Medicaid Services (CMS) released a proposed rule in early April that aligns Stage 1 and Stage 2 incentives and sets out guidelines for the third and final stage of the MU program. The Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009 established significant financial incentives for eligible hospitals and providers to use a certified electronic health record (EHR) in a “meaningful” way. Many Minnesota hospitals and health care providers were already ahead of the game as they worked to comply with state legislation enacted two years prior (Minn. Stat. §62J.495) that required implementing an interoperable EHR by Jan. 1, 2015. Spurred by both this statutory requirement and federal MU incentives, EHRs now prevail in Minnesota hospitals and health care provider settings. The question becomes: how to leverage those EHRs to meet meaningful use objectives?

Whether you are planning for Stage 1 or Stage 3, the following tactics may help ensure success:

• As you launch your MU program and throughout implementation, frame — and continually re-frame — your discussions about meaningful use within the broader context of improving patient care. If you focus solely on measuring MU objectives, you may miss opportunities to implement strategic change. For example, while creating a dashboard that monitors only MU-related objectives is important in and of itself, the dashboard design process can also prompt discussion about additional helpful metrics or other ways of delivering care. Too much scope creep will stymy your MU planning process, but do allow for some breathing room in MU discussions to imagine new possibilities.
• Muster and equip an integrated team for best results. Too often, MU data report design and collection is helmed by a team of IT and EHR technical experts, with a few clinicians sprinkled in. Designate a hospital leader from your strategy and/or business development units as a team member, potentially as the lead. Include a physician champion and nurse champion at the outset.
• It will be critical to mirror clinicians’ workflows in designing the MU dashboard and data reporting tools. Aligning your MU tools with clinicians’ mental maps — when and where they input each data element — is critical for success. You likely mapped clinical workflows when you were designing your EHR; dig those maps out and check where providers document each MU objective data element (e.g., where do they add a medication or allergy?). If you design with those answers in mind, you will create a set of MU tools that clinicians actually use.
• To promote buy-in, communicate less about the strategic importance of MU and more about exactly who should be inputting what. If this sounds less than inspirational, consider that most clinicians will quickly grasp and support your organization’s desire to achieve MU incentive payments. Clinicians’ time is limited and most wish to help, so their well-intentioned response is, “Just tell me what to do and where to click.” Communicating specifically and often about where to click will cause your Meaningful Use adherence to skyrocket.
• Address underlying cultural change issues. Providers’ belief in the power of data is now fairly widespread, however, daily use of it is not — yet. Engage your providers face-to-face, whether in town hall meetings or via roadshows visiting multiple sites. Be sure to share and provide access to the MU dashboard early, even in beta form, to encourage feedback, fine-tuning, and early adoption.
• Leverage MU-specific resources unabashedly. Convene your EHR vendor’s technical support together with your MU team and identify tools or minor coding modifications that might ease your data collection efforts. Meet with other providers who are in a similar place in their MU programs to share ideas or even the costs of technical solutions (particularly if you have the same EHR software).

Contact Shira Hauschen at Dorsey Health Strategies at 612-492-6418 for more information.