HITPC: CIOs share insight on MU Stage 2 attestation

Two CIOs at healthcare organizations shared experiences and insight on Meaningful Use (MU) Stage 2 attestation at the Health IT Policy Committee meeting on July 8.  

Pa.-based DuBois Regional Medical Center, the first hospital to attest to Stage 2 MU, already had developed a solid foundation to build out its systems, Tom Johnson, CIO, told the committee.

“In Stage 1, we really went all in. We had strived to do 100 percent of all measures,” he said. “It really did transform our organization. We had integrated Meaningful Use into every process. We were well-positioned for Stage 2.” Physicians were required to participate, and the hospital worked very closely with its vendor, he said.

Also, DuBois Regional collaborated with the state of Pennsylvania on three population health measures, adding to its readiness.

But two major hurdles did stand out in its pursuit of attestation: patient engagement and health information exchange (HIE).

To meet the patient engagement requirements, including view, transmit and download, Johnson said the system hired a full time licensed practical nurse who worked with each family to encourage them to log into the patient portal. The hospital only managed 7 percent enrollment in the patient portal. But “the people who have signed up for it are happy to see the labs.”

The HIE requirement was “difficult” and “didn’t add a lot of value to us,” he said. As it is rural, DeBois Regional already was part of a well-connected community that lacks population transience. “We had to get creative with platforms."

“My recommendation is do not lower standards, but give me time and flexibility,” he said. “I’m worried [about] backsliding.”

Paul Merrywell, vice president and CIO of Tenn.-based Mountain States Health Alliance, said the organization has struggled with the pace of MU. The provider is planning to attest to MU Stage 2 in the next couple of days.

In particular, he described “just-in-time” MU software that vendors rushed to develop. “It’s a rat race we’re in to manage the moving parts.” Both Mountain States and vendors are struggling with a true lack of readiness, he said.

“We have strong promotional activity that promotes Meaningful Use baked into our processes. We have 450 physicianss, including some who are superstar early adopters, but we have some on the opposite end of the spectrum who feel that me and the federal government are victimizing them in some way,” he said. In the meantime, he said it’s increasingly difficult to gain executive buy-in on capital expenses when the ROI isn’t clear.

In other comments, he said that there is too much focus on EMR technology at the expense of more downstream technologies, which are constrained by proprietary interests. “It creates problems for everyone who has interoperability as a vision for healthcare.”

Also, Merrywell questioned whether multiple federal agencies work at “cross purposes.”

“It’s really important at the federal level that there is alignment in policy. We’re working on that,” said National Coordinator for Health IT Karen DeSalvo, MD, MPH, MSc, in comments following the presentations. She stressed the importance of creating an infrastructure that supports different types of data, such as genomic data, patient-reported outcomes, quantified self-data and community data. “Stay engaged, and we’ll work with you on all of that as we go forward.”