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Finding the Core of Meaning in Meaningful Use

May 24, 2010
by Mark Hagland, Editor in Chief
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Mark Hagland
Mark Hagland

During my recent travels, I had the distinct privilege of meeting with executives and clinicians at the Traverse Health Clinic in Traverse City, Michigan. Touring the clinic, which occupies two humble, low-rise buildings in a non-descript neighborhood in that town of about 14,000 people (though with a broadly defined metro population of nearly 10 times that size), was a real experience.

While the Traverse Health Clinic (THC) is a community-based, non-profit, 501(c) 3 organization that serves more than 2,300 medically needy patients a month, either through on-site care or through a broad network of volunteer clinicians in the community, it is not a federally qualified health center (FQHC) under the formal federal definition, and thus falls awkwardly into a gray area between some key funding categories. As a result, THC is not positioned to benefit from the provisions in the comprehensive healthcare reform legislation passed in late March that will channel $11 billion to FQHCs nationwide via a new program. Consequently, the good people at THC will have to continue to struggle forward to provide medical, behavioral, and dental care to thousands of medically needy residents in their community, particularly since the recent economic downturn has triggered a tsunami of need there.

While at THC, I heard many stories about the impact that the clinic has had on the lives of local residents who comprise the working poor-those not poor enough to qualify for Medicaid, but who currently lack health insurance coverage, and are unable to pay for the healthcare they often desperately need. THC staff and volunteers go to heroic efforts every day to provide a range of medical, behavioral, and dental services-as well as day-to-day medical supplies-to those area residents.

In the midst of this, it was particularly interesting to speak with a couple of the nurse practitioners who provide the organization's onsite medical services. One friendly, sincere nurse practitioner whom I'll call “Wendy” (not her real name), shared with me some of her learnings (and a few frustrations) with the clinic's recently implemented EMR, which includes CPOE (in this case, computerized provider order entry, since the lead clinicians within the clinic are all nurse practitioners).

Here's the crux of the matter: given the perpetually challenging circumstances the clinic will always face (with shortages of people, money, and supplies), Wendy and her fellow clinicians will always have to work hard to optimize their workflow; they have no choice. So what IT professionals do for and with people like Wendy makes a huge difference literally in terms of how many medically indigent people she and her colleagues can see each day.

So when you have moments in which you wonder why you're doing everything you're doing to achieve meaningful use, or just to get your day-to-day job done, think of Wendy. It's clinicians like her who gain from IT-facilitated workflow optimization; and it's patients like hers who reap the ultimate benefit.

Visiting the Traverse Health Clinic reinforced for me yet once again what I believe is most important in what you do in your work, and in what we as a publication do to help you, and to encourage excellence. In the end, it's all about the patients, all about your communities. When the moments of frustration with process and problems inevitably come, it can be good-and even restorative-to keep that simple truth in mind.

Mark Hagland, Editor in Chief Healthcare Informatics 2010 June;27(6):6