Among the first CIOs in the country to complete the attestation process on April 18, the first day in which attestation of the fulfillment of the Stage 1 requirements for meaningful use under the Health Information Technology for Economic and Clinical Health (HITECH) Act was possible, was Michael Sauk, vice president and CIO of the 468-bed University of Wisconsin Hospitals & Clinics in Madison, Wis.
Sauk spoke with HCI Editor-in-Chief Mark Hagland late last week, as the finishing touches were being put on his organization’s attestation, and then confirmed with him that the attestation was completed on April 18. He and his colleagues at UW Hospitals & Clinics credit their early attestation to a number of factors, including the fact that they chose a few years ago to implement the comprehensive suite of solutions from the Verona, Wis.-based Epic Systems Corporation.
A related element, Sauk says, is the fact that his organization moved quickly to implement all the necessary clinical information systems in order to be designated a “stage 7” hospital organization, according to the development schematic used by HIMSS Analytics, a division of the Chicago-based Health Information and Management Systems Society (HIMSS). He also credits his dynamic 192-person IT team. Below are excerpts from the interview.
How do you feel about having completed your attestation so early?
Excellent. It’s nice to be a leader; and you don’t get to be a leader without putting in a lot of work. Clinically, operationally, and from an IT perspective, it’s huge, and people are exhausted. I am so happy, though, to be on this side of the river. We started installing Epic in earnest in January 2007. We had had Siemens, but it was only a clinical data repository; we didn’t have order entry or clinical documentation.
How did you get this far this fast?
We were declared and awarded a stage 7 in January 2010. That’s the highest level; we were the first academic medical center in the United States to reach that level. And the primary thing it says is that you can exchange data with other hospitals, or physician practices; that you have a Web portal for your patients; and some other requirements. And those are also things you need for meaningful use. So once Epic got its software certified, we were basically ready. And Epic wrote all the scripts and programming necessary to generate the data for data reporting under MU. What’s more, we helped Epic work out a lot of the bugs in that area, actually. And from a compliance perspective, we were exceeding all the minimum levels of all the core measures. For example, with regard to smoking cessation reporting, you have to be at 50 percent of your patients; we’re at 89 percent. In terms of maintaining an active problem list, you have to be at 80 percent of your patients; we’re at 99 percent. And in terms of CPOE [computerized physician order entry], you have to be at 30 percent, and we’re at 99 percent. So we were basically ready a year ago. You can’t achieve stage 7 without having done all these things. And we didn’t even know what the meaningful use measures would be at the time we began our installation; we simply installed the system with all its functionality. And by doing that with Epic, you’re pretty much ready. And by installing Epic’s anesthesia solution—we were the second site up on it—we were ready. So in other words, if you’ve fully installed all of the solutions from Epic, you’re pretty much at stage 7.
Have there been any areas of struggle?
The quality measures: if you read them, they’re super-complex clinically. So it took us a while to make sure we were capturing the right data and the right workflows, in order to meet the requirements for the 19 quality measures. We had a team, mainly our reporting team, and key operational leads, that worked for about six or seven months to get us to that point of readiness. We were done by the first week of March. We were ready to enter the data on April 1, into PECOS, the CMS (Centers for Medicare and Medicaid Services) system, but they changed that date to April 18, the first date a hospital can enter their data and apply.
So many organizations are struggling when it comes to meaningful use. What’s most important, in terms of prioritization?
I think you shouldn’t even read about stage 7 or meaningful use—just focus on getting an electronic health record fully installed and utilized, and then on stepping back and asking, are we doing everything we need to meet meaningful use...
What would you say with regard to the monies you’re expecting in return for your progress on meaningful use?
Like most any large academic medical center, we’ve spent tens of millions of dollars installing and implementing a complete clinical information system. The several million dollars we might receive from CMS for achieving meaningful use will represent only a small percentage of the funds we’ve spent to get to where we are now. You shouldn’t be doing this just to get the money anyway. Hopefully you’ve done it for all the right patient safety, care quality, and effectiveness reasons, because, all of a sudden, when a patient enters a unit, you don’t have to hunt down their medical record.