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Many practices struggle to sustain the changes they made in Stage One. Here's how not to be one of them.
More than two-thirds of physician practices have made the move to adopt EHRs, and made the move to a new work flow and way of life. But not as many are sustaining the changes they made to achieve Stage 1 of CMS’ “meaningful use” requirements, the cornerstone of the EHR incentive program.
“A lot of providers did their 90 days, got their $18,000 and are sitting back,” said Jeff Loughlin, executive director, Regional Extension Center of New Hampshire, who conducted the “Making Meaningful Use Meaningful and Sustainable” session on Tuesday at the MGMA12 conference in San Antonio. “If you’re not vigilant, some of the work flow models will revert back to the old paper days.”
Fortunately, Loughlin had a few ideas for practices to keep their post-EHR way of life
for the long haul.
The first: Think of meaningful use in the context of how Stage One interventions can help patients long-term. Loughlin used the example of a diabetic, 67-year-old patient coming in for a three-month checkup. Physicians committed to meaningful use could use diabetic templates created in an EHR to better keep track of disease-management interventions (such as smoking cessation counseling) on follow-up visits, as well as the patient’s progress. The practice could then analyze the outcomes to see how well certain best practices work.
When it comes to Stage 2, Loughlin advised practices not to get overwhelmed by the task of achieving MU objectives. In fact, some objectives aren’t actually too difficult to achieve. For example, if you routinely generate reminder letters for visits to a target diagnosis population, you’ve already met the objective of “generating a list of patients by specific conditions to use for quality improvement, reduction of disparities, research or outreach.”
Also, documenting a list of easy interventions such as recommending smoking apps (“MyQuit Coach,” etc.) will help your practice to meet - and demonstrate that it has met - Stage 2 objectives.
Another factor correlated with meaningful use sustainability is EHR familiarity - or lack thereof.
“We are seeing that many people are just using out of the box tools” such as alerts without customization, said Loughlin. When providers don’t know how to customize such alerts and turn off irrelevant ones (such as a mammogram-reminder alert in an orthopedic practice), they get fatigued and frustrated. To prevent this, make sure your practice’s clinical and administrative staff get enough training up front, and on an ongoing basis.
Most of all, sustaining EHR use means changing behavior and work flow patterns around to produce meaningful results on an ongoing basis.
“It’s more about the change management,” said Loughlin. “Do you change behavior because you believe in it, or chase it to meet the requirement?”