HIT Happens

If you could change the meaningful use rules, what would you do?

We polled CIOs, vendors and clinical leaders -- with some compliance under their belts -- about how they'd tweak meaningful use if they could.

Editor's note: This is the first part of a two-part installment of "HIT Happens," a regular opinion column tackling health IT trends. The second part can be found here.

ORLANDO, Fla. -- At HIMSS 2014, what started as a project collecting ideas for our regular "Information Exchange" quotes page for our Pulse e-zine, quickly expanded into an all-star panel of health IT experts offering a wonderfully diverse collection of ideas in answer to one simple question: If you had the power to change one thing about the meaningful use rules, what would it be?

'Just enough healthcare' isn't good enough.

Rasu Shrestha, M.D.,
VP of Medical Information Technology, University of Pittsburgh Medical Center

The answers reflected each person's perspective -- be they a patient advocate, a software vendor, or clinicians and chief information officers struggling to bend workflows and data governance to stay qualified for federal incentives. But they also reflect thoughtful consideration of "meaningful use" as an idea: What, exactly, is "meaningful," besides a subjective term relative to one's own position in the healthcare world?

The problem is, our Pulse e-zine didn't offer nearly enough space to include everyone's ideas and the ones that did get published were by necessity distilled to their basics. Here's an expanded version that gives everyone a chance to express their opinions; we're all hoping ONC's advisory committees are listening as their bedrock discussions shape stage 3 and beyond:

Rasu Shrestha, M.D., University of Pittsburgh Medical Center vice president of Medical Information Technology: "I think 'just enough healthcare' isn't good enough. The approach that vendors embraced around meaningful use -- 'Let's look at numerators and denominators, let's game the system, such that we can meet the needs for their clients and get that carrot without getting the stick' -- is moving in the right direction, but it needs more teeth. I think it needs to be a lot more specific to really drive and transform healthcare."

Regina Holliday, patient advocate: "[Mandate] real-time access to medical records for patients and caregivers."

Russell Branzell, CEO of the College of Healthcare Information Management Executives (CHIME): "We have not been big proponents of using the terms 'extension' or 'delay.' We need flexibility at the beginning of stage 2 so if an organization says 'I really can't get to this until well after ICD-10,' there's no penalty."

Pamela Arora, vice president and chief information officer of Children's Medical Center of Dallas: "Giving all other institutions the time to jump on board...Our challenge is that you can have all the tools in place [such as health information exchange systems] but they're only useful if you're using them. Cultural adjustments take time."

Let us know what you think about the story; email Don Fluckinger, news director, or contact @DonFluckinger on Twitter.

This was first published in March 2014

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