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Meaningful use can drive deeper change for physicians, MGMA says

Addressing meaningful use right away will show that the mandate is about quality, not technology, consultants with the Medical Group Management Association suggest.

Physicians and hospitals are delving deeper into the meaningful use criteria to determine what they're prepared for already and which areas of health IT they must adopt.

"There are a lot of practices out there that are, quite frankly, intimidated by the technology," said Derek Kosiorek, consultant with the Medical Group Management Association's Health Care Consulting Group, during a recent MGMA webinar on the meaningful use final rule. If doctors focus on the "I" in health IT, they'll begin to see that meaningful use is about quality, not technology, he added. "We have to be able to let the computer use the information."

Portal technology and the areas of clinical decision support and clinical summaries for patients will have a big impact on doctors because of their potential to change practices, according to the MGMA consultants. Providers have to demonstrate they are incorporating clinical decision support tools in their work for the first stage of the meaningful use program. In addition, they must provide summaries of visits to patients who request the documents.

Such things as standard messages, real-time dashboards and better interfaces with labs would help doctors meet the decision support requirement, and it would benefit their practices by making clinical work more efficient, according to Rosemarie Nelson, principal consultant for MGMA's health care group. "This would be the perfect time for a vendor to come out really hard and fast" with new clinical decision support technologies. "We're going to see great operational gains in this process," she said.

One other criterion that potentially could have a big impact on physician practices is creating lists of patients by specific conditions. Doctors do not have to follow this requirement in the core set of criteria, but they can choose it under the second menu option in the meaningful use program. Creating lists of specific conditions manually is costly and time-consuming, Kosiorek said. "This is one of the areas where we're seeing a solid, measurable benefit of EHRs [electronic health records]."

There is no reason to panic. You have time to learn how to be a meaningful user.

David Blumenthal, national coordinator for health IT

Another benefit for patients is the clinical summaries, which document what treatments were ordered and what the doctor did during a visit, Kosiorek said. "I look at this as sort of a receipt for the visit. As a patient, this is a really nice thing to have."

The voluntary federal EHR Incentive Program, through which providers can demonstrate they are meaningful users of health IT to qualify for payments, requires doctors to implement EHR systems that follow certain criteria. The program was established in the Health Information Technology for Economic and Clinical Health (HITECH) Act of the 2009 stimulus law in an effort to boost IT adoption rates among health care providers.

The first year a provider participates, the program will be able to manually prove they have met the meaningful use criteria for the 90-day period. Starting in the second year, providers will have to submit reports electronically, with data collected directly from the EHR system. MGMA consultants suggest that doctors look for EHR systems that have portal capabilities now, rather than wait. "You want to evaluate how vendors collect and report data," Nelson said.

There are still some holes in the process. Vendors continue to wait on a final rule that will explain the certification of EHR software through a required federal process. And while the meaningful use requirements are set to begin Jan. 1, 2011, providers are still unsure about how to submit their EHR use to the Centers for Medicare & Medicaid Services (CMS) to receive incentive payments. That process is being made final by the CMS in conjunction with the Office of the National Coordinator for Health Information Technology, or ONC.

While industry stakeholders have been focused on the timelines for the meaningful use rollout, the recommendation from the top is to take time and focus on the goal of improving care. "There is no reason to panic," said David Blumenthal, national coordinator for health IT, speaking during the MGMA presentation. "You have time to learn how to be a meaningful user."

Let us know what you think about the story; email Jean DerGurahian, News Writer.

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