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A Provider's Perspective on Meaningful Use

April 9, 2010
by Joe Bormel, M.D.
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Senior Director of Information Systems at Johns Hopkins, Steven F. Mandell delivered Grand Rounds at Hopkins today. The title of the talk, "Meaningful Use: Implications for Johns Hopkins, the Region, and the Nation."

It was broadcast over the web, accessible through this link: Link: http://webcast.jhu.edu/mediasite/Viewer/?peid=f9aa84017c2040edb3097dd2906dcdf4
These presentations are available on demand; I highly recommend CIOs at senior execs attend the grand rounds literally over a convenient lunch hour.

In this presentation, Steve candidly discusses the realities and challenges of Meaningful Use, and raises the key issues to his usual balanced style. There aren't a lot of world-class institutions, like Hopkins, that are stepping up to the public discussion in video, as professionally as the Hopkins team (Stephanie Reel, Andy Frake, Peter Greene, Harold Lehmann, and the other well-known international leaders at Hopkins). I'd love to see other comparably tiered organizations, like Mayo, Cleveland Clinic and Geissinger join in the dialogue in such a smart and highly available manner.

The substance of the presentation is first class; the video quality is exemplary as well:

There is a substantial improvement using MicroSoft's Silverlight technology, as compared to the Real Video technology used at Hopkins in prior years.
Regardless of the technology, what do you think of the content? That's the bottom line.
 

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Comments

Joe,
Thanks for sharing the CSC link. The attitude of the piece and its basic facts feel right to me. I am very favorably impressed with their key messages: get started now view this as a major process improvement/cultural shift/sea change don't let IT run the program don't look at it as a series of IT projects empower your physicians and nurses who are the keys to your success learn from others and resist reinventing the wheel.

One thing that does stand out and strike me as "funny" is the recommendation to begin in the ED. May or may not make sense, but for me it wouldn't have a whole lot of universal appeal. ED is only tangential to hospital meaningful use for stage 1, no disrespect to EDs intended.

Also, I am left with the feeling that CSC has really glossed over the magnitude of the challenges. They clearly state that this will be very, very difficult, but most of their language says "you can do it." But despite that occasional candor, I walked away from the article with a "Pollyanna" aftertaste.

Girish Pathria, Thanks for your comment.

Like most performance improvement initiatives, working at maintaining a positive and realistic attitude is distinct work. As you and Steve have noted, and EHR vendors have observed as well, the combinatorial impact of the Meaningful User criteria creates a higher hurdle requirement than is obvious when looking at the individual pieces.

I've received private email on this post, asking roughly this question:  Is this primarily of Hopkins challenge, or, "if a Hopkins cannot achieve Meaningful Use in a timely manner, are the rest of us less likely?"
 
I think that the Top Ten Challenges in Meaningful Use For Hospitals, a free CSC report from Jane Metzger, Erica Drazen and Beverly Bell helps elaborate the challenge very nicely. It's available here:

http://www.csc.com/health_services/insights/34489-meaningful_use_for_hospitals_the_top_ten_challenges





Great information.

If JHM entities find meeting MU criteria a challenge, imagine the plight of providers such as those in rural areas who are at the early stages of EHR implementation. What is the likelihood that such providers will meet criteria especially those pertaining to quality reporting and subsequently receive incentives? I know, I am asking a rhetorical question.

Joe Bormel

Healthcare IT Consutant

Joe Bormel

@jbormel

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