HIMSS Webinar: 10 Steps to achieving Stage 1 of meaningful use

Aurora Health Care, a Milwaukee-based nonprofit healthcare system serving eastern Wisconsin, is engaged in a three-year process to qualify its 15 hospitals, 1,200 eligible providers and 120 physical locations for Stage 1 meaningful use of EHRs. According to Judith A. Murphy, RN, vice president of IT at Aurora, this effort has been roughly “75 percent clinical and 25 percent IT.”

During the Nov. 3 HIMSS Virtual Conference opening keynote, “Achieving and Measuring Meaningful Use: A View from the Field,” Murphy outlined 10 steps for creating a road map for meaningful use:

1. Understand ARRA [American Recovery and Reinvestment Act] goals and meaningful use criteria. “This has not been the easiest thing,” she said. In addition to understanding the final rules, it’s important to revisit the frequently asked questions on the Centers for Medicare & Medicaid Services' and the Office of the National Coordinator for Health IT's websites, because clarification is ongoing. One way to stay current with the FAQs is to “get updates pushed out to your email,” she said.

2. Understand your incentive opportunity. If implementing an EHR is seen as a value proposition, and that will include spending money, “you want to understand what your opportunity actually is,” Murphy said. Based on a phased process, with hospitals going live in 2011, 2012 and 2013, Aurora estimated its incentive amount based on 2009 Medicare cost report data. Its total: $102 million, if all possible incentives are achieved. “If you wait too long, your opportunity is decreased,” she said.

3. Understand your current state. What applications are already implemented, and which ones are not? This includes looking at the actual adoption of applications as well. “This is where the measurement starts to come in. It’s extremely important to know [not only] what functions are turned on, but what your level of adoption is.”

4. Identify gaps between final criteria and your current state. Where do you need to focus your efforts? To get an accurate assessment, list the meaningful use criteria with high change or technology impact. Murphy recommended looking at meaningful use criteria in terms of:

• Technology: Do you have needed software installed?
• Adoption: Do you have required adoption?
• Measurement: Do you have the tools to measure everything needed?

 
5. Create an implementation and adoption plan. Based on the information gathered in steps one to four, plan your deployment.

6. Build rigor. Test and re-test processes, applications, infrastructure, organizational structure and the playbook. “Change what you need to change and keep core principles in the plan,” she said.

7. Get ready. This step involves “making sure you’ve got the culture change to [realize] your opportunity,” Murphy said. An organization will need adequate sponsorship, communication, learning and support to complete this step.

8. Complete your rollout. Consider security criteria—are changes needed? Will additional clinics or physicians be included? Does the organization plan to connect to an health information exchange?

9. Demonstrate and measure to get results. Do you have measurement tools for quality measures, care outcomes, performance, compliance and benefits? “Having an interactive dashboard has been particularly helpful," said Murphy. Aurora uses a dashboard tool that shows Stage 1 objectives, Stage 1 measures and the system’s actual measures.

10. Celebrate. It’s easy to overlook the progress an organization has made, but it’s very important to recognize everyone's efforts, she said.