10 Steps to Achieve “Meaningful Use”

For oncology to move forward, innovation is required. Science, technology, patient care, and communication are all components of this move toward significant improvement. With the advent of government incentives to encourage the uptake of oncologists’ use of technology in a meaningful way, the pressure is on vendors to adapt standards set by the government oversight body, the Office of the National Coordinator (ONC) for Health Information Technology (HIT).

This is development, but not necessarily innovation. True innovation comes when the enhanced technology is fully used and implemented in an oncologist’s office.

A well-run oncology office is a beautiful sight to behold, but one often gets the impression it is a tightrope walk every month. The balance of workload on human resources, finances, and patient health is the primary concern of any oncology practice. And technology, at its best, can help each of these areas significantly.

The Centers for Medicare & Medicaid Services (CMS) Electronic Health Record (EHR) Incentive Program requires HIT be at its best to allow physicians to achieve and successfully attest to “meaningful use,” defined as “ways that can be measured significantly in quality and in quantity.” As overwhelming as achieving meaningful use may seem, however, it can be done.

Implementation and Attestation
Northern Hematology Oncology is a community oncology practice in Thornton, CO, that implemented a 2011/2012 ONC-certified EHR system in March 2011 and successfully attested to meaningful use by the end of July, within approximately 120 days. To be clear, this group went from a paper medical chart environment to fully compliant meaningful use workflow in a paperless EHR system in less than 120 days.

Analysis of the successful attestations using this EHR indicates that the innovation was the practice’s adaptability and openness to change throughout the entire team.

Strong physician leadership clearly set expectations for the staff, and also led by example. These doctors, busy with learning a new EHR system, took the time to implement the new technology in a way that set up success for receiving CMS incentives. This impressive implementation— and resulting attestation and incentive payments-can be replicated in any oncology practice. The trainers and support staff of the EHR system offer the following 10-step guide to successful meaningful use implementation and attestation.

  1. Review all the required meaningful use criteria on the CMS website (www.cms.gov/EHRIncentivePrograms/30_Meaningful_Use.asp). You may choose from Medicare or Medicaid incentive programs.
  2. Register each of your eligible providers (physicians) at www.cms.gov/EHRIncentivePrograms/20_RegistrationandAttestation.asp. It is the eligible provider’s responsibility to understand and achieve the incentive requirements.
  3. If you are not yet using an EHR system, implement an ONC-certified complete EHR. The ONC provides a list of certified HIT products (http://onc-chpl.force.com/ehrcert).
  4. Meet with the entire staff to provide an overview of meaningful use and its requirements for 2011/ 2012, known as Stage 1. Include mention of the eventual penalties if a practice isn’t compliant by 2015.
  5. Review criteria for meaningful use and the separate clinical quality measures. Note: the meaningful use criteria are all pass or fail. Each provider must pass each measure for a minimum of 90 days for the first reporting year. Subsequent years require reporting for the entire year. If you fail one meaningful use item within the 90-day reporting period, you receive no prize. The good news is that clinical quality measures do not require a pass/fail threshold. Each physician is simply responsible for re porting numerators and de nom inators for each chosen quality measure.
  6. Evaluate the holes in your practice’s current workflow. If your group currently does not assess patient smoking status, indicate this as a gap. If you do not provide access to a patient portal, put this on the gap list. Do not entertain any aversion to change around these gaps that must be filled. Change can be difficult, but the processes your practice puts in place now for Stage 1 will make the subsequent 2 stages less overwhelming.
  7. Assign staff members responsibility for workflow changes required for meaningful use. If your practice’s chemotherapy nurses provide pa tient education, make each nurse responsible for providing patients with a documented patient education experience. If the medical assistants usually enter vitals for the patients they escort to the examination rooms, be sure they also include height, weight, and blood pressure in the chart.
  8. Monitor progress each week. Run a meaningful use report, if your EHR system includes this feature. Alternatively, create a worksheet to evaluate your progress for each meaningful use measure. Take action to remediate any shortcomings as your providers must pass all measures for a full, consecutive 90 days. Each physician may have a different 90-day reporting period if needed.
  9. Attest. The attestation is quick and easy. This must be done through CMS’s EHR Incentive Program Registration and Attestation System (https://ehrincentives.cms.gov/hitech/login.action). The website is well designed, and it is fairly easy to follow onscreen instructions. For attestation, you will need your meaningful use report printed and ready to reference, as well as your numerators and denominators for the clinical quality measures. Sign in and answer all the questions. Each physician will need to complete the attestation, because it requires a statement of attestation and electronic signature. Upon successful attestation, make a note of the attestation number, which is basically a tracking number to allow you to track payment.
  10. Last, but not least, receive money. Upon your successful attestation, the celebration of your healthcare innovation should be enjoyed by all. Share your story, and assist others in their quest to become meaningful.

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