My Continuing Journey Toward Meaningful Use Attestation

July 15, 2011
J. Scott Litton, Jr, MD

For the most part, I have found the reporting process to be very easily accomplished and have very few complaints or concerns at this point.

A few weeks ago I shared my first attempts with the attestation process for reporting my first stab at meaningful use reporting. My EHR of choice is a very robust software choice and without modifying any of our practice's work flow processes gave me almost an 80 percent score. Since this score was not high enough to successfully attest, I had a meeting with my office personnel and explained to them the reasoning behind modifying our current workflow.

Our demographics were solid and each patient was correctly updated as they came to our practice for follow-up visits. I found that the only modification necessary for satisfying the demographics reporting was to correctly state each patient's ethnic background. This was a very easy fix and within two weeks to three weeks I met the demographics reporting threshold.

Smoking status had also been updated at each visit, however my EHR had modified the health summary portion of the template and the meticulous documentation that had been previously entered was in need of a very simple update. This was also a very easy fix and within two weeks to three weeks I was able to meet that reporting threshold.

One aspect of our work flow that did require a significant change was to offer a visit summary to each patient during each encounter. At present, I have found that fewer than 20 percent of my patients would accept their visit summary. For those that did not want their visit summaries, I was left with three or four pages of paper waste for those encounters. However, the visit summary was printed and after a three-week to four-week period I was able to meet the requirement for providing visit summaries.

E-prescribing was essentially a no brainer, as 95 percent or more of the scripts I wrote were transmitted electronically. This requirement was easily met with essentially no change in our workflow process at all. I have been e-prescribing for almost three years now and the patients have found this service to be very much appreciated.

The portion that I am having difficulty with is the establishment of clinical reminders. For health maintenance, I use the rules manager portion of my EHR to allow my nurses to order mammograms, pap exams, bone density exams, etc. at the time of patient check in. The clinical reminder requires that patients be notified of the required testing by their preferred method of choice: mail, phone, e-mail, secure portal message, etc. I am presently working with my software vendor for the creation of these reminders and will hopefully have an update ready to pass along in the next few weeks.

For the most part, I have found the reporting process to be very easily accomplished and have very few complaints or concerns at this point. I am a little irritated with the amount of paper that I am wasting with patients who choose not to accept their visit summaries and wish the clinical reminder could be more easily satisfied with our present work flow, however this is the rule that has been established by our all-knowing politicians so I am left to play the game with the rules as is.

At this point, I feel that I have been using my EHR in a meaningful way from day one. The requirements for successfully proving to CMS that I am using my EHR in a meaningful way are not as time consuming as I had originally planned. My tentative reporting period started May 1 and I will hopefully be able to successfully attest by early- to mid-August. Now that the groundwork has been laid, I should be able to cruise through 2012 with very little additional efforts at all. Once I have successfully completed the attestation process, I will be happy to share my experiences with my colleagues and provide any additional advice or information as needed.

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