IN THIS ISSUE: Travelers who begin a journey usually consult a roadmap or use a GPS. For achieving the meaningful use of health IT,
there is no GPS. But providers do have pathways they can follow that were blazed by their peers. This issue features organizations that
have reported successful attestation of Stage 1 requirements to receive stimulus funding under the American Reinvestment and Recovery
Act (ARRA). They share strategies that helped them be among the first providers in the nation to attest. The issue also features expert
perspectives from McKesson and the CEO of CHIME.
Beyond Meaningful Use: Centra Health Connects
the Continuum By Ben Clark
Vice president, CIO
Centra Health
Lynchburg, Va. Centra Health is a nonprofit system that provides a full continuum of health services in central Virginia. It includes two hospitals in Lynchburg with a total of 575 beds and an 80-bed hospital in Farmville, about 70 miles to the east. We’ve been connecting physician offices for more than 15 years, and today we reach nearly 200 employed and 450 non-employed physicians. Eight years ago, we installed a private Ethernet ring around the city. All medical traffic flows in and out of Centra’s data center through the ring. In addition, because we rely on hospitalists, many of our community physicians no longer round. So they can stay apprised of their patient’s status, we send an e-alert when the patient has been admitted and provide portal access that enables them to track the patient’s care while hospitalized. We began this practice long before the current concept of “menu item” was introduced.
Today the focus is on meaningful use and ICD-10, but the ultimate goal is a longitudinal record for each patient. Whether the driver is bundled payments, reduced preventable readmissions or patient-centered medical homes, health systems must figure out how to connect the full continuum.
High Support = High Adoption
We chose to attest for Stage 1 in FY2011 because we try to stay ahead of the industry in terms of IT, and we already had the supporting technology in place. Centra went live on McKesson’s Horizon Clinicals® in 2005 and has been live on CPOE house-wide since 2009. When we upgraded to the certified EHR release, we were already at 75% physician adoption of CPOE, and clinicians were accustomed to entering allergy, medication and other information as structured data, which lowered two major workflow hurdles.
Key to high adoption is high levels of support. We have clinical people on call 24/7, and we staff a physician technology center from 7 a.m. to 10 a.m., when doctors typically round. The doctors have learned that we’re available at that time and take advantage of it. Our support staff has made up to 180 visits a month to help. We even have some staff members who round and support clinicians full-time.
At first glance, meeting the technology adoption metrics may look like the bulk of the effort, but that’s not necessarily the case. For us, the clinical quality measures presented the greater challenge, which we heard others echo at industry forums. Because those measures have no threshold for Stage 1, we tended to put them on the back burner, but it’s worthwhile to nail down the complex data capture and reporting now.
“What Do I Need to Do to Hit My Number?”
Even before our software upgrade was complete, we created a scorecard and began tracking performance by objective. Each objective was assigned to a senior executive. The CNO had vital signs and advance directives, the CMO had CPOE, the CFO had preliminary cause of death, and so on. Knowing their scores would be displayed at the beginning of each meeting, they called our director of clinical informatics in advance to ask how their objective was doing. Just 45 days after our upgrade, we entered our 90-day reporting period.
On to ICD-10
Another reason we chose to attest early was so we could turn our attention to ICD-10. Health systems that try to tackle meaningful use and ICD-10 at the same time – not to mention various other mandates related to health reform -- are in for some real challenges. Each of these initiatives demands an organization’s full attention.
As with meaningful use, ICD-10 is not primarily an IT issue — it’s about clinical coding and financials. The IT department must be sure all applications are compliant by the deadline, but other departments have even more work to do in terms of identifying where the largest impact will be and mitigating it. Centra has a large, cross-functional committee assigned to make sure we’ll be ready for the October 2013 deadline.
The Real Key to Success is Your Workforce
It’s no secret that there’s a national shortage of experienced clinical IT people to do the yeoman’s work tied to health reform. Here in Lynchburg we are blessed with a stable workforce, and my team in particular is driven to do whatever it takes. It’s still important for leaders to acknowledge the long hours and show our appreciation. As much as we’ve accomplished, there’s so much more ahead.
Ben Clark has been at Centra Health in Lynchburg, Va., for 30 years, serving as CIO for the last 10. Centra has achieved Healthcare’s “Most Wired” and “Most Wireless” status, as well as awards for PACS implementation and several Virginia state grants for collaboration and intra-hospital data-sharing. In 2011, Centra partnered with the MedVirginia HIE for an ARRA Social Security demonstration project to secure online disability checking and approval. Ben Clark has a bachelor’s degree in engineering and technology from Virginia Tech and a Master of Science in information technology from the University of Maryland. He has completed a certificate in Federal Executive Competencies for CIOs and has been an active member of CHIME.
A survivor of Hurricane
Katrina, Memorial Gulfport
has tackled meaningful use
with executive buy-in,
clinician IT support, and
physician alignment.
OakBend met the meaningful
use challenge head-on as an
opportunity to improve its
organization’s performance —
from CMS core measure
scores to chart completion.
Despite obstacles commonly
associated with EHR
implementation in small, rural
hospitals, Renville County
Hospital forges ahead and
attests in 19 months.
CHIME’s CEO says that after
many years of preparation and
anticipation, it appears the
healthcare industry has
reached the tipping point for
digitizing health records.
McKesson’s Freed says with
so many mandates coming
down in rapid succession,
having a clear roadmap toward
a unified destination will
make the journey easier.
there is no GPS. But providers do have pathways they can follow that were blazed by their peers. This issue features organizations that
have reported successful attestation of Stage 1 requirements to receive stimulus funding under the American Reinvestment and Recovery
Act (ARRA). They share strategies that helped them be among the first providers in the nation to attest. The issue also features expert
perspectives from McKesson and the CEO of CHIME.