Tackling meaningful use: More insight, more questions

Mary Stevens, editor, CMIO magazine

With HIMSS 2011 and Orlando a distant warm memory now, one of the things that sticks with me is a question-and-answer session following a Physician IT Symposium panel discussion. The session had the deceptively simple title: “Tackling the Meaningful Use Requirements.” Panelists and audience members alike had questions, a few answers and a lot of insight into the challenges behind that title. Here are some highlights:

Physician adoption: “Technology in general is not understood by physicians unless it applies directly to their practice. They don’t see this as medicine,” said panel moderator William F. Bria, MD, CMIO at Shriners Hospital for Children. “Are we, with meaningful use, meaningfully bringing the practice of medicine into EMR/health IT use?”

Panelist Anthony F. Berliner, MD, associate medical director, CDS and IS support, at Allina Healthcare: Many colleagues view health IT as building a toy to deposit all of this information: “ ‘You’re making me sit at the computer when I could be spending time at the bedside.’ But if you implement a functional, integrated system then talk to the same people, you’ll find out they are using it as a real clinical tool.”

Early wins: Demonstrating quality and safety measures is a huge challenge, Berliner said. “We’re trying to gather that kind of data at least around safety (drug-drug, drug-allergy interactions), but we don’t have good metrics from before we started this.

Another thing we’re tracking is near-misses. Was this a case where the EMR allowed the clinician to see a problem before it did harm? We have a lot of quality data we get from our EMR, and we will get there, but we’re not there now,” he said.

Good catches are publicized, but that’s a two-edged sword, said Dean F. Sittig, PhD, of the University of Texas Memorial Hermann’s Center for Healthcare Quality and Safety. “It was nice we were having some good catches, but ... the measurements we’re making are causing us to ask a lot of questions."

Benjamin Kanter, MD, CMIO of Palomar Pomerado Health, summed up the discussion with a point that was made throughout the convention: “This is not about HIT as much as it is about the radical redesign of the way we practice medicine. An EHR is a tool: It touches a patient the same way a scalpel does. A scalpel, when used properly, can help—or it can maim,” he said.

“A rookie mistake is thinking this is an IT project.”

As you tackle meaningful use, what questions or answers would you add to the discussion? Let me know at mstevens@cmio.net.

Mary Stevens, editor