ACC: Health IT to the rescue
 |
“What information tools are needed to help prevent heart attacks and strokes?” asked Mostashari. The answers, he opined, are quite simple.
Cardiologists need a way to measure basic inputs such as aspirin therapy, cholesterol and blood pressure controls and smoking cessation. This list conveniently corresponds to meaningful use measures and gets physicians 80 percent of the way to meaningful use.
When e-prescribing and a few other measures are added to the mix, meaningful use is possible. In fact, Mostashari pointed out that cardiologists record many measures in the PINNACLE registry. (The ONC-HIT has urged PINNACLE to obtain modular certification to enable cardiologists to leverage the program to meet part of their meaningful use reporting requirements. Mostashari suggested cardiologists express the same goal with PINNACLE.)
“Meaningful use is 100 percent aligned with what cardiologists need to do to thrive and survive as payment is tied more and more not to quantity but to quality.”
Looking ahead to Stage 2
Despite the value of Stage 1 measures, Mostashari noted that room for improvement remains. “Cardiologists need to be able to measure quality of care. They need registries and reminders, shared decision-making with patients and problem and medication lists.”
“Stage 2 will be ambitious and achievable. It will include more quality measures that are meaningful,” offered Mostashari. For example, Stage 2 measures won’t simply digitize chart measures, but will take advantage of longitudinal clinical data and provide data about questions such as how many patients with an A1C less than 7 improved, not how many patients there are with A1C less than 7.
Mostashari suggested cardiologists solicit assistance from the multiple sources of support: federal incentives, Regional Extension Centers (RECs), hospitals, accountable care organizations, vendors and professional societies.
The workflow challenge
James E. Tcheng, MD, professor of medicine at Duke University School of Medicine, deferred to Yogi Berra and stressed, “If you don’t know where you are going, chances are you will wind up somewhere else.”
Given the availability of incentives and the ultimate competitive pressures that physicians who don’t deploy health IT will face, Tcheng advised cardiologists to implement a certified EHR and use it on all patients, even though the regulation does not require 100 percent reporting.
He continued, “Cardiology practices have to start thinking differently and determine who will document measures. They need to analyze workflow so that most of the data are acquired through processes of care.
“This is the start of a journey. It does get progressively harder. Stage 2 requires greater use of CPOE and e-prescribing,” summed Tcheng.