Devore Culver, CEO for Maine HealthInfoNet -- the statewide health information exchange (HIE) -- serves health care providers on a spectrum from large hospitals down to solo physician practices, public health organizations and a host of other parties whose businesses involve patient data. Check with your state HIE to see what services are available and how they can help your meaningful use compliance program meet specific criteria.
What meaningful use criteria can I satisfy when joining an HIE?
Devore Culver: For Maine -- and I need to frame it in that context -- I support both physician practices and hospitals in a couple of key areas: connecting to the patient registry, and that can be a byproduct of their sending me communications, which I then add to the data set in the exchange … I become basically a broker.
The same thing is true with laboratory results that are required by states for things like mandated disease reporting. I run a service in Maine where we have automated that reporting.
Third, I can validate for them [physicians and hospitals] their patient clinical summary by having them send to me their [continuity of care document] CCD. I will take it in, run it against a NIST test to validate that it meets the standard, and I will give them a letter of validation that they can tuck in their folder to say, yes, they demonstrated their compliance requirement.
For when the EHR incentive program auditors come.
Those are the types of services for stage 1 that we are doing. The problem with meaningful use in general is that it's EMR-centric. It cares more about what the EMR does and less about the actual exchange of data. One of the key problems is that while we have a lovely standard called the CCD that is the wrapper [for the patient data], the data inside that wrapper is not standardized. Therefore, I think interoperability is more myth than fact ... [and] that means the value of the data is diminished. We're struggling, everyone's struggling, with that issue of how do you take that CCD, unpack the content, map it, dedupe it and make sure it gets into a dynamic form that can be used. That's a real slough. Meaningful use has not done us any favors on that.
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