It looks like the steep climb to meaningful use Stage 2 could be rocky, fraught with big and small stumbling blocks.
There’s no shortage of things to worry about: EHR certification, lagging interoperability, clunky EHRs. Then, there are the seemingly unanswerable questions: “Will the vendors be ready on time? Will patients like our portal? Will they engage? Will we be able to attest to it? How can I get the right quality measures reported the right way? What’s wrong with my EHR? What does any of this mean to specialists?
There are many questions, but few clear answers. Confusion seems to be spreading.
In a recent blog titled “Time for a new optimism,” standards guru John Halamka, MD, CIO of Beth Israel Deaconess Medical Center in Boston, considers the lay of land, worries about meaningful use fatigue and advocates for a shift in approach.
As Halamka discusses in his blog, one of the most difficult challenges for most healthcare organizations is juggling the competing demands and deadlines of federal government initiatives.
The work of transforming healthcare can seem daunting or even impossible at times. But many are facing the complexities head on, and finding new ways to get things done.
Recently, Michele Mills, director of the ITS Program Management Office at University of Utah Health Care urged us to talk with Anita Willoughby, senior project manager, who heads the ICD-9-to-ICD-10 medical coding conversion at the health system. Lest we forget, the deadline for ICD-10 compliance is October 1 – this year.
[See also: As 2014 begins, ICD-10 deadline looms.]
UUHC is in the midst of rolling out an Epic EHR system across the enterprise even as Willoughby is working to meet the ICD-10 deadline.
That might be overwhelming to some, prompting concerns about their own project being sidelined. Willoughby was concerned, she admitted, but she found a way to make it work – even better than it might have without the competing EHR project.
[See also: Stage 2 meaningful use off to slow start.]
Because executives decided to put the EHR rollout ahead of the ICD-10 deadline, “it allowed us to minimize the number of systems we had to remediate,” Willoughby told us. “So that was a real plus for the ICD-10 project. And, of course, it minimized the number of interfaces that we had to handle for ICD-10. So that was a real plus as well.”
One Chart is what UUHC calls its EHR system. Willoughby is part of the One Chart team, which gives her insight into the synergies she can tap to benefit the ICD-10 project.
She is piggybacking ICD-10 testing on the testing being done for the EHR rollout, using the same test scripts. And, she is working in training for ICD-10 as physicians are getting trained on the new EHR system.
Both Mills and Willoughby credit UUHC CIO Jim Turnbull for providing unwavering leadership during stressful times.
We talked to Turnbull around this time a year ago, when CHIME and HIMSS named him 2012 CIO of the Year. We asked him how he viewed his mission as CIO.
“When I think of a single word for it, I think of enablement or enabling,” he said. “First and foremost is enabling the organization to fulfill its mission and achieve its long-term vision. So that's a big piece. The second piece is to enable my own staff to fulfill their roles and to do that without too many roadblocks – sort of taking the reins off them and removing the barriers so we can really execute to the maximum of their abilities.”
That kind of leadership, not just from the top, but also throughout the organization, engenders trust, respect and collaboration. It’s the kind of approach that leads to innovative ways of getting things done, as Willoughby seems to be finding at every turn.
The stories may be different at hospitals X, Y and Z, but innovation is not limited to Salt Lake City. Nor is it exclusive to academic medical centers. There are similar illustrations of stick-to-itiveness and out-of-the-box thinking at small and large, rural and urban organizations all across the country.
So meaningful use Stage 2 may mean a big leap for some, a slog across rugged terrain for others, but what if what appear to be stumbling blocks today turn out to be stepping stones – perhaps to the new approach Halamka is advocating in his call for “a new optimism.”
