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Meaningful Use—It's a Gamble

October 25, 2009
by daphne
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They twisted my arm. Last week I went down to Atlantic City for the New Jersey-Delaware Valley HIMSS fall conference on meaningful use. First off, props to Rich Temple and the NJ chapter for such a well run and highly attended event—more than 400 attendees! Second, they really didn’t twist my arm — I wanted to see if there was a jackpot with my name on it.

Well, I didn’t hit the jackpot I expected. But I did, in a way, hit a different one. It was more like a can of worms, though. Let me explain.

The conference, “Stimulating HealthCare by Achieving Meaningful Use in Health IT” covered a lot of the usual ground, with real, practical advice for achieving meaningful use—thing like ROI, and barcoding with CPOE.

It wasn’t until Day 2 that Charlene Underwood, a HIMSS fellow and the Director of Government and Industry Affairs for Siemens pointed something out that could potentially be a real problem for hospitals if they don’t read carefully.

It’s in the final HIT Policy Recommendations for defining meaningful use matrix — the one from August.

Here it is, directly from the matrix: The 2011 OBJECTIVE for hospitals is for 10% of all orders (any type) to be directly entered by AUTHORIZING PROVIDER (e.g. MD, DO, RN PS, NP) through CPOE

So far so good. And I bet many hospitals thought they qualified — after all, that’s pretty broad and includes nursing documentation. In other words, it doesn’t have to be an order by a physician.

But here’s the kicker: The 2011 MEASURE is for % of orders (for medications, lab tests, radiology and referrals) BY PHYSICIANS through CPOE.

Are you following? The objective says that any caregiver entering orders qualifies for meaningful use. But the measurement to qualify only includes physicians.

I don’t know about you, but this looks like a mixed message to me. The thing is, most hospitals have already done the calculations to find out the dollars they expect to get from ARRA. Which calculation did you use? I wouldn’t be writing that money into any budget quite yet.

More and more, it seems like getting that HITECH money is a gamble. "Seeing Double"

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