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All Things HIT

Jun 14 2010   8:05AM GMT

Meaningful Use: One step at a time!



Posted by: AllinHIT
CPOE, EHR, Meaningful use

Like most of you, I have reviewed, discussed, and pondered issues, centered around Meaningful Use (MU).  I was under the impression that EHR Adoption, was ONC’s primary goal.  However, based upon the initial 25 requirements in Stage 1, I must of been mistaken!

If adoption was the goal, the ONC should of given the first year of incentives (18k), just for implementing the technology! Vendor selection, then implementation, is disruptive enough to operations!  ONC’s fast and “in a hurry”  MU steps, disallows the physician to adopt using what I call a step-wise approach. Implementing in modules, versus all modules, lessens the impact on operations, workflow, and resources!

Ok…lets say the other goal besides adoption, was ONC wanted some assurance that physicians were using the systems.  I agree that CPOE, is at the top of the list, in terms of benefits and its ranking in meaningful use of the system.  However, I suggest some CPOE requirement changes!

The first change is too allow for designated MA’s, PA’s, and other staff members to directly input CPOE orders.  Having the physician requirement of physically inputing these orders, to the tune of 80%, puts an unneccessary burden on the physician!  Second, CPOE should only apply to lab and pharmacy orders!  Radiology, physical therapy, and other services should be further down the road, giving the physician and the vendors time to develop interfaces and interface engines, where non exist now. For example, I recently talked with the CIO of a large radiology company, about their efforts to create a “RAD Hub”.  This Hub would make it easier for physicians to meet this requirement, when it “go live” in the next year.  EHR Lab interfaces are commonplace, and due to the CMS 2% e-prescribing incentive, ePre exists more and more into a physicians workflow.  It will be easy to take the stand -alone ePre systems, and convert the process in an EHR with an ePre module.  These changes will increase adoption, lessen the burden to the physician and the practice, and lastly, put us on the road to true meaningful use.

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