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Working Together on Meaningful Use

April 7, 2010
by Mark Hagland
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A nationwide healthcare collaborative brings CIOs together on HITECH.

In March 2009, shortly after the passage of the ARRA-HITECH (American Recovery and Reinvestment Act of 2009/Health Information Technology for Economic and Clinical Health Act) legislation by the U.S. Congress, leaders at the Charlotte, N.C.-based Premier Inc., a nationwide healthcare alliance, formed what they called the Premier HIT Collaborative to develop a cooperative approach to responding to the HITECH Act on the part of the CIOs of Premier member organizations.

CIOs from more than 160 Premier member hospitals have been working together since then to develop collaborative strategies around HITECH. Among other deliverables, the Premier HIT Collaborative recently completed a meaningful use EHR [electronic health record] implementation best practices library.

Among other areas, CIOs in this collaborative are working on a policy response to such issues as the definition of hospital-based physicians under HITECH’s meaningful use guidelines — a definition some Premier member organization executives are concerned could lead to a possible shortchanging of funding under the Act. More broadly, the CIOs involved are enthusiastic about the opportunity to work together under the alliance’s aegis. Recently, William Spooner, senior vice president and CIO of the San Diego, Calif.-based Sharp HealthCare system, spoke with Healthcare Informatics Editor-in-Chief Mark Hagland regarding the activities of the Premier HIT Collaborative, of which Spooner is chairman.

Healthcare Informatics: What got you involved in this collaborative?

William Spooner: Premier suggested that we create this CIO collaborative to help each other identify the best road map for meaningful use, and to try to identify some best practices as far as HIT, with a special focus on CPOE [computerized physician order entry], for Premier’s member hospitals. They’ve been very active on the quality front, and in terms of pay for performance, and are proud that of some of the things they’ve done in the past. And I was impressed that they wanted to do this. So I’m chairing this.

We formed this almost a year ago, not long after the HITECH Act was passed; we identified some of our concerns with the draft documents back last spring. And a team of about eight of us including myself went to Washington, D.C., and met with Dr. Blumenthal [David Blumenthal, M.D., national coordinator for health information technology], and with someone from the office of Nancy Pelosi [Rep. Nancy Pelosi, D-Calif., Speaker of the House of Representatives], as well as with someone from CMS [the federal Centers for Medicare and Medicaid Services]. So we’ve done quite a bit of work along those lines. We also spun off the work involved in creating the best-practices database. And we’ve been conducting informational webinars along the way.

HCI: Where do you personally see the biggest gaps right now for CIOs around meaningful use?

Spooner: Among my top concerns is the fact that we don’t even have a certification process in place today in terms of the vendors. And until you get freeze the specifications, as with any IT issue, you can’t move forward. My number-two issue is that the way that the proposed final rule came out in December, you would either qualify or not. Now, there’s a recommendation by the HIT Policy Committee to ONC [the Office of the National Coordinator for Health Information Technology] that you could, for example, achieve 80 percent of the requirements for 2011. And the other thing is that the quality indicators are beyond the capabilities of today’s EMRs [electronic medical records]. I do have a concern that we may not be able to fulfill that requirement. But overall, I’m positive about the prospects.