This is the latest in an occasional series of meaningful use stage 2 attestation success stories. This installment features a healthcare system that uses Siemens, Wellsoft and MedTracker products.
When IT executives at New Jersey's CentraState Healthcare System embarked on proving to the Centers for Medicaid and Medicare Services that they had started to use electronic health records in earnest, they at first sputtered to a false start.
It was January, and the gates had been thrown open for hospitals and individual providers to start attesting to stage 2 of meaningful use.
But CentraState, like many other big healthcare systems, has multiple EHR platforms: Siemens AG's Soarian -- since acquired by Cerner Corp. -- as its main clinical system; First Data's MedsTracker for medication management; and Wellsoft in the emergency department. The EHRs cover a 284-bed hospital, a 171,000-square-foot outpatient center, and numerous satellite facilities, including three senior living communities.
Carrie Ivler, CentraState's director of applications, who managed the stage 2 attestation process, said that she, her staff and the three vendors were much more prepared to coordinate the 90-day attestation sprint by summer.
Now final records of their work have been prepared, including screen shots, and an electronic audit book documenting the trail of tests and trials to meet the 20 stage 2 attestation measures are ready. The healthcare system is now poised to send the results to CMS; it has been a success.
"At this point, I’d say we're done," Ivler said.
Overcome the challenges
In what is emerging as a distinct pattern across the country in stage 2 attestation efforts, the most difficult stage 2 criteria involved establishing and getting patient buy-ins to the patient portal, as well as documenting electronic capability in managing transitions of care, or referrals.
Hospital employees were enlisted to convince patients to sign up for the portal. Pamphlets were printed and distributed. Doctors mentioned it during bedside conversations.
As has been the case elsewhere, getting many older patients involved halted the progress. Many don't even own a computer, let alone understand how to use the portal.
As for electronic referrals -- to places such as long-term care centers and specialists, "One of the biggest challenges we had was sending the information," Ivler said.
To accomplish the electronic transmissions, Ivler and her staff used the direct messaging protocol with outside partners that had been provisioned with addresses for secure, healthcare-specific data exchange.
Peg Kauth, CentraState's assistant vice president of information systems, estimated that more than 1,000 hours of employee time – including long stretches of manual data input - was spent on a process that could eventually return up to $2 million in federal incentive payments. "It’s a calculation," she said.
The relatively easy tasks involved jobs such as electronically collecting and charting demographic and smoking-status data, as well as advance directives.
Return on Investment
Even so, meaningful use attestation "was a real time crunch," Ivler said.
Yet Ivler and Kauth both maintained that they support the concept of meaningful use. Without the government prodding the medical industry, they said that the pace of technology adoption would be considerably slower.
"I definitely understand what’s behind it," Ivler said. "Over time, it's a good thing. There's no other driver."
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