ACC: Meaningful use policy is helpful, but may not be feasible

ATLANTA--The government's plan for meaningful use with EHR implementations are helpful but might not be entirely feasible, said Michael J. Mirro, MD, of Fort Wayne Cardiology in Indiana, during a discussion of the pros and pitfalls of EHR adoption yesterday at the 59th annual American College of Cardiology (ACC) scientific session.

“The government has certainly played a major roll and we hope will play a positive roll,” said Mirro, adding that the new policy has provided standards for EHRs and health IT usage.

Under the American Recovery and Reinvestment Act (ARRA) of 2009, facilities must implement electronic records that exchange data in meaningful ways. In addition, the act calls for using healthcare information exchanges (HIEs) to enhance quality of care, and the use of EHRs to submit the quality data components of meaningful use.

Mirro said that although these “goals” are in the law, often they are “not really obtainable.”

Much of Mirro’s presentation focused on the purpose of implementing EHRs, which he said are a “critical tool” that can assist with cardiac care team coordination and improving the efficiency of a facility.

Facilities often adopt EHRs because they believe they are a valuable tool for building comprehensive patient charts and securing centralized data. EHRs can also reduce repetitive testing and allow medication and allergy lists  to be accessible from various locations, Mirro said.

Electronic records give physicians the ability to create patient alerts for appropriate testing and would notify patients when they are due for a certain exam.

In addition to benefiting patients, adopting an EHR can assist payers by improving documentation, enhancing clinical transparency and streamlining the billing, coding and reimbursement process at facilities, said Mirro.

“When you think about this from the 50,000-foot level,” he said, “what functions are important with health IT?” Mirro said that connectivity— including different providers and sources of health IT—can allow for clinical decision support. Adding connectivity to a facility can enable data mining, enhance quality of care and help to reduce errors, he said.

However, overall EHR adoption is still poor for several reasons, Mirro noted.

Often, a major barrier to implementing these systems is that they are designed by engineers who lack a clinical background. “Current information technology generally lacks cognitive support from clinicians in most systems and does not integrate with clinical workflow," Miro said. These systems often disregard human interaction and can lead to a poorly designed system.

Mirro cited other reasons for slow adoption, including:
  • Lack of money within private practice settings;
  • Inability to see an immediate return of investment (ROI);
  • Lack of system standardization; and
  • Limited interoperability for data exchange, caused by vendors that silo data within their own systems.

Facilities should “take an incremental approach” to adopting EHRs and other health IT systems, said Mirro. He also recommended performing an organizational change assessment, conducting a cultural evaluation on a facility's ability to work toward and accept change, assembling a “multi-stakeholder team” including all segments of staff, and making sure that vendors “are participating an the interoperability effort.”

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