The Achievement of Meaningful Use in the Community Hospital Setting
Tuesday, January 03, 2012
Jean Fernandez, Chief Information Officer, Milton Hospital
Photo: Jean Fernandez, Chief Information Officer, Milton Hospital
Q: What kinds of new technology did the hospital adopt in order to achieve meaningful use?
A: Milton Hospital needed to adopt certified electronic health record (EHR) technology and demonstrate to the federal government that we are ‘meaningful users’ of this technology. Our Meditech software received ARRA [American Recovery and Reinvestment Act of 2009] certification last year. A new data repository was created to gather information needed for quality measures. Updated encryption methods were installed to protect patient privacy. Software was purchased to enable data to be sent to the state’s public health agencies. And, our physicians adopted the use of computerized physician order entry (CPOE).
Q: Why has this been such a high priority for Milton Hospital?
A: Improving patient safety and quality of care has always been a high priority for Milton Hospital. Adopting the use of an EHR gives our providers and clinicians the information they need to not only provide the best possible care, but also to improve the quality of that care by measuring performance and outcomes.
Q: How does meaningful use affect patient care?
A: Meaningful use allows us to engage our patients and their families in their care. It empowers them to have a more active role in their health care. They are able to receive electronic copies of their discharge instructions, as well as their medical record. EHR also reduces the risk of errors and improves quality of care by facilitating better communication between caregivers.
Q: How does this impact physicians?
A: Physicians are able to easily access their patients’ health information, allowing them to diagnose health problems earlier and improve the outcomes of their patients. Interoperability of these records leads to a better coordination of care.
Q: As of this fall, only 6% of hospitals nationwide have achieved meaningful use thus far. How did Milton Hospital get so far ahead of the curve?
A: We started as soon as the legislation was announced. I began the task of interpreting the requirements and working with Meditech to determine how and when to install the required software. We began construction of new physician documentation areas and began training our hospitalists to use CPOE. As new hardware and software was installed, training would begin. It truly was a collaboration of efforts between the IT department and department managers.
Presentations were given to our leaders and our board members. ARRA meetings were held biweekly. Our Physician Advisory Committee was enlisted as our liaison between the IT department and our physician community.
Q: What were the biggest challenges in achieving this goal?
A: We were challenged with having to depend on many sources to get the job done. We depended on our hardware vendors to ship hardware in time; we depended on our software vendors to deliver software in time. We needed to be on top of a dozen projects all seeming to happen at the same time.
The IT department was very driven to meet this goal. Everyone had their job to do and got it done.
Q: As a small, independent community hospital, was it easier or more difficult to achieve meaningful use?
A: It was easier for us because we had a core group of managers who understood early on what was needed and what the impact would be to their staff, and they could set their own timelines for achieving their specific goals. It was also easier because I felt that administration trusted that we knew what we needed and when we needed it.
It was difficult because as a smaller institution, we did not have the resources that a larger organization would have to implement and train staff.
Staff in the IT department worked long and hard to keep pace with installation after installation.
Q: What types of new technology will Milton Hospital adopt next?
A: Our immediate goals will involve e-prescribing and establishing interoperability with physician offices.
Q: Can you give us an overview of your vision for Milton Hospital?
A: Milton Hospital will continue to pursue innovation solutions of information technology in our strategic planning. Over the last several years, we have proven to be leaders as early adopters of technology solutions ranging from Bedside Medication Verification to the dozens of successful implementations required for the completion of Stage 1 meaningful use requirements. My vision for Milton Hospital is to establish an EHR that will securely make data available — to our physicians, our caregivers and our patients — that will result in providing the best quality of care for our patients.
Q: What do you think is going to be the most important health care development that is on the horizon?
A: The most important development will be the health information exchange (HIE) business model. For those of us who have succeeded in attesting to meaningful use to the federal government for FY 2011, we have seen that we can capture data and keep it in our data repositories. Then, as standards are created, the task becomes exchanging this data among physician offices, hospitals and public health agencies.
Q: What is the key to being successful in the health care arena?
A: Milton Hospital has proven to be successful due to our early understanding of federal requirements. We have dedicated managers who have completed numerous projects presented to them with a finite time span for completion and have adjusted to changes along the way. The key to our success will be to keep on top of legislation, interpret the standards as they are released and continue to be early adopters of new technology.
MD News Future of Health Care 2011, Greater Boston