Posted by: Jenny Laurello
CFO, Chief Financial Officer, Computerized physician order entry, CPOE, EHR Adoption, EHR attestation, ICD-10 migration planning, Meaningful use, MU
Guest post by: Joseph DeLuca, Knowledge Architect, Fulcrum Methods
In my post last month, I covered some aspects of the meaningful use program and, in particular, pointed out the evolving role of the CFO as the likely attestation officer. Since then, this expanded fiduciary duty has become even more apparent as the 2012 budget cycle ended. Many health systems have now baked into the 2012 budget receipt of meaningful use incentives, and the CFO is becoming accountable to drive the organization to accomplish this.
I am also finding many CFOs to be balanced in wanting to get the dollars, but also to truly achieve positive cultural change as well as the patient care and service benefits the program authors intended. This requires a partnership approach with the organization’s clinical resources and in particular the CMIO. For more advanced electronic health record (EHR) users, this should reinforce the progress of the organization to achieve a new electronic standard of care.
“Our biggest challenge, and ultimately the benefit of meaningful use, was to prove that our implementation (of computerized physician order entry, or CPOE, and other clinical redesign efforts) was as good as we thought it was. The process forced us to accelerate our drug-drug and drug-allergy checks, make sure we were properly recording vitals, demographics, smoking status, etc. These were all important and ultimately made us a better organization,” noted the CMIO of a California hospital who attested as a meaningful user in FFY11.
“Meaningful use, to a large degree, is a clinical initiative affecting clinical workflows and established patient care practices. There is no need to wait for meaningful use certified technology to change the culture and evaluate current clinical practices and begin to implement clinical workflow changes where needed,” stated the CFO of a Texas based multi-hospital system with a controlled medical group.
In moving forward, allow me a moment to take a broader view on meaningful use, health care information systems and the move to accountable care.
Future meaningful use requirements converge with and support the new direction of health care nationally, and was already experienced in many highly competitive local markets with significant managed care penetration. Meaningful use stages 2 and 3 requirements to support a shared care clinical process, population health, and demonstrate improvements in process and outcome measures, are all cornerstones of accountability in care. The reimbursement technique — through an HMO, ACO, Medicare Shared Savings, pay-for-performance or other financial program — are market tactics over the longer term.
So accept and embrace this direction. Engage in an organization-wide information system planning effort within your organization, and include ICD-10 remediation requirements. How you say? This doesn’t need to be an extensive effort since many organizations use a structured workshop or two that includes clinical, revenue cycle, strategic planning, operations and information systems in a workshop at the same time. Map out a five year timeline with the forces of change facing you. Then overlay the high level of information system requirements, including the impact of stages 2 and 3 and ICD-10 requirements. Additionally, don’t forget the need for systems to support your local market version of accountable care. The result of this planning effort should create a road map for change and transformative to leadership.
For more information, please visit www.fulcrummethods.com.