Are we there yet?
If you are like me (and have been hanging around the HIT space for many years – more than I like to admit) it feels like we are on a really long family vacation. You know, like the one you took with your parents, siblings and the family dog. The one where you spent hours upon driving endless interstates sitting in the backseat. Yes, that is the meaningful use trip! And, no we are not there yet.
The meaningful use regulations came into effect in 2010. Since that time, the regulations have largely dictated how the HIT industry has progressed. Healthcare organizations, both large and small, have attacked their HIT implementations to meet the staged deadlines. Vendors have had to modify their software roadmaps in order to be compliant with all the stages. And, most importantly, the financial implications to both hospitals and vendors are scrutinized continually.
Given all of that, you would think that everyone involved with an HIT implementation would know exactly where they stand. Be able to recite stage, objectives and quality measures that have been achieved. Also, they would easily tell you where and when they will complete the next stage. Yeah, you would think that, but not so much.
Don’t make me stop this car!
Over the last couple of years, as I have had many conversations with informaticists, consultants, and HIT managers, it has become evident that the topic of meaningful use varies widely among the industry. The elite few hospitals that have attested and achieved stage 2 have done it only with a keen focus on the matters at hand.
Contrary to those few hospitals, is the rest of the industry. According to CMS, 94% of hospitals enrolled in the Meaningful Use program in order to receive the financial "carrots" offered for implementation. 92% of enrolled hospitals have actually received some payment towards their implementation. These precious dollars were meant to offset the huge cost of an EMR implementation and increase early adoption. Many small or critical access hospitals could not afford the technology any other way.
In spite of all that background information, it is estimated that only 50% of hospitals have even made attempts to work through Stage 2. As of September 2014, only 143 hospitals nationwide had attested (achieved) Stage 2.
Are we lost? Do we need a GPS?
So, with the dismal performance in 2014, how will the industry catch up? CMS has eased up on a few pieces of criteria and has offered new "pathways" to achieve Stage 2. But, the mandates for 2015 are solid and it is evident that hospitals will need to modify their existing approach to maintain compliance.
So, what is the answer? More staff? Maybe. More support from EMR vendors? Maybe. A new emphasis on the project at hand? Definitely. Hospitals should take a moment and realize that what they have been doing is not going to get them to the final destination. A fresh look at project plans, budgets, available subject matter experts and executive support is needed to get back on track. Only with revised milestones and superb project management will the vast majority of hospitals produce the mandated results.
The long and winding road…
What we do know, is that like every long road trip, we will eventually get to the end of the journey. We will likely have a car full of junk food wrappers, empty Red Bull cans and an empty gas tank. But, that is okay – the clean up (or optimization) can start later on. Oh, that sounds like another project. " ROAD TRIP!!"