So far, only 10 hospitals have attested to Stage 2 of meaningful use, but on Tuesday, July 8, the Health IT Policy Committee heard from the CIO of one of them and from another about to go through the process.
Tom Johnson, CIO of DuBois Regional Medical Center, a 200-bed community hospital in rural western Pennsylvania, told the committee he believes his hospital was the very first to attest to Stage 2.
He said the positioning for that success began with Stage 1. “We decided to go all in and exceed every measure,” he said. His team did not ask providers to meet 5 or 10 percent thresholds, but to meet them with 100 percent of patients and included all menu items. “We integrated meaningful use into everything we did,” he said. They worked to transform workflows, and participation was not optional for providers. “So our positioning for Stage 2 began with Stage 1,” Johnson said. DuBois’ strong relationship with its vendor Cerner was key in getting it where it is today, he added.
The two major hurdles he noted involved patient engagement and health information exchange requirements. To engage patients in care, DuBois hired a full-time LPN who went to every patient admitted and worked with them to encourage them to sign up for the portal so they could see their lab work online. “We only got 7 percent of patients enrolled. They are happy to see their labs, so view and download is happening, but I am not sure about the transmit part,” he said.
DuBois already has remote connections to nursing homes and clinics, so there wasn’t much of a business case for creating new health information exchange arrangements, he said. “We had to get creative, and develop interfaces to overcome that measure. It didn't add a lot of value for us,” he admitted. “It was a regulatory challenge, and to navigate the language, we leaned on Cerner to get over that hurdle.”
Paul Merrywell, CIO at 14-hospital Mountain States Health Alliance based in Johnson City, Tenn., said his organization has struggled with the rate of change meaningful use poses. Working with Siemens on its Soarian implementation, Mountain States just finished collection of data for a few of its hospitals June 30, and will begin attestation for the rest in October.
“The pace is a problem for us,” Merrywell said. Both his organization and the vendor community have limited resources, he said. His organization has 90 clinics with 450 physicians. Some are superstar adopters, he said. “But there is another group who believe that the federal government and I are victimizing them in some way,” he said. Merryman said he was encouraged by the ONC’s recently published vision for interoperability, although he is discouraged that the estimate is it would take 10 years to get there.
He also noted that the multiple government agencies involved in health IT do not appear to be on the same page and may be working at cross purposes,
National Coordinator Karen DeSalvo, M.D., thanked the two CIOs for their comments, and in response to Merrywell’s comment about alignment, she noted that a reworking of the federal health IT strategic plan is under way, involving 36 departments and agencies and aligning reporting structures is one of its goals.