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Owning "Meaningful Use"

May 1, 2009
by Pam Arlotto
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HIMSS announced their recommendations for “meaningful use” this week with a suggested target of 51% and 85% use of CPOE by 2013 and 2015, respectively. AMDIS (the CMIO professional association) will launch the website www.meaningfuluse.org within the week. The hearings have started and the process for defining “meaningful use” will be announced shortly. We are well on our way to meeting the deadline for clarification around the term by December 31, 2009. Yet, defining the term tells us little about “the how” of “meaningful use”.

Early indications indicate that health care will be a very different place when we have “meaningful users”. The degree of change will be exponentially greater than the levels of incremental change we have accomplished to date.

Consider the exchange information electronically across the enterprise, with ambulatory providers and with community collaboratives. Consider the development of new processes for care coordination, closed loop medication administration and outcomes reporting. Consider the clinicial decision support, expanded use of protocols and true evidence based medicine.

Everett Rogers, recognized by many the “guru” of adoption/diffusion research suggest that each organization should design plans for progressive use of technology. Four levels of increased use include:

§ Adoption – Selection of a technology for use by an individual or organization

§ Diffusion – The stage in which the technology spreads to general use and application

§ Integration – Connotes a sense of acceptance and transparency within the user environment

§ Optimization – The technology provides value and return on investment is evident

The final requirements for “meaningful use” will be important for all of us to understand. Yet, in the meantime, given the level of change anticipated, I recommend that each organization develop its own definition of “meaningful use”—one that senior leadership owns and is accountable for. This definition should be accompanied by a plan to move the organization through the various stages of adoption, diffusion, integration and optimization. Knowing where you stand today, will make a hugh difference in identifying and closing the gaps between where you are and the final legislation.

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