AAMI: Meaningful use rewards early interoperability adopters
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Despite the lack of a clear and specific meaningful use (MU) definition of “interoperability,” Moorman said the expected American Reinvestment and Recovery Act's (ARRA) Stage 1 date for device interoperability is 2011. Identified in the legislation, hospitals must be able to electronically chart three vital signs, Moorman said: blood pressure, height and weight. Interestingly, the law does not specify that information must be integrated electronically. Therefore, it could even be typed into a computer, she said.
While there is money tied to the MU legislation, she noted that the vague wording may be with regard to definitions and standards.
“Stage 1 incentivizes clinicians to purchase EMRs,” she said. “Even though there was a lot of background work to create the MU requirements, they, unfortunately, did not specify data standards. While you’re not required to have a fully electronic organization under those standards, MU might present an opportunity to begin your device integration journey.”
In 2007, the Congressional Budget Office estimated EMR costs of $14,500 per bed, plus $2,700 per bed for operations and maintenance. Those figures did not include medical device connectivity. Three years later, in 2010, McKinsey Quarterly estimated costs of $80,000 to $100,000 per bed, Moorman said.
“So you’ve got quite a range there,” she said.
Moorman estimated device connectivity costs—based on network infrastructure, costs of cabling, device integration in terms of software, labor and management—to be within the range of $6,700 to $10,000 per bed.
ARRA rewards organizations for early implementation of EMRs, by decreasing funding as years progress, eventually penalizing organizations that don’t transition, she said. In a slide presentation to attendees at Saturday’s lecture, Moorman presented the “ARRA reality.”
In 2011/2012 ARRA awards $44,000 per eligible professional (EP); in 2013 ARRA awards $39,000 per EP; in 2014 ARRA awards $24,000 per EP; and in 2015 ARRA doesn’t award anything. “Then, after that, they penalize you if you don’t have certifiable EMRs,” Moorman said.
Among the numerous facets of interoperability, hospitals should evaluate their networks, devices, drivers, data, age of equipment and other complicating features of their systems. Whether a network is wired, wireless or uses BlueTooth, ZigBee or other features is only one aspect of interoperability, she noted.
“You should probably do this before you embark upon your integration strategies,” she said. “But you can probably track it along the way as well."
Moorman worked with four hospitals in their efforts at implementing EMRs and device interoperability, she said. During that time, she uncovered that unanticipated costs include device replacement, third-party integration and network connections.
“If you haven’t started this odyssey,” she said. “truly start tracking your devices so you know where you are.”