Confidence in Meaningful Use Compliance is Dropping

Having spent time with numerous hospital executive teams over the past 6 months, it is no surprise to hear that confidence in “Meaningful Use” readiness is not what most people assumed. This article from Fiece Healthcare is worth reading for any of you with a stake in MU.

‘Meaningful Use’ readiness drops among hospital CIOs

Hospital CIOs are rapidly losing confidence in their organization’s ability to qualify early for federal subsidies for “meaningful use” of EMRs, according to an updated survey from the College of Healthcare Information Management Executives.

In a November survey, results of which were released last week, just 15 percent of the 191 CHIME members queried said they expected to qualify for the Medicare and Medicaid bonus payments in the first half of federal fiscal year 2011, which began Oct. 1. That is down nearly half from the 28 percent who expressed confidence in their ability to meet the standards early in a similar survey conducted in August.

“One potential reason for the drop in confidence may be due to the fact that CIOs are getting a clear view of the horizon, as many of their questions are being answered by federal agencies,” Chuck Christian, director of information systems and CIO at Good Samaritan Hospital in Vincennes, Ind., says in a CHIME press release. “Many of the clarifications are adding to the complexity of the task at hand.”

While just 10 percent of CIOs don’t believe their organizations will achieve meaningful use until Stage 2 of the program–fiscal years 2013-14, the same as in the August poll–concerns even among the most confident respondents have shifted. While more named EMR certification as their top concern three months earlier, this time a plurality of 29 percent view CPOE as the most problematic area of meaningful use. Some 22 percent said capturing and/or submitting quality data was their No. 1 concern, while 13 percent were most worried about vendor readiness.

More than six in 10 respondents expect to have some difficulty with CPOE requirements, particularly when it comes to convincing clinicians to enter enough orders electronically for the entire hospital to qualify for federal stimulus money.

“To really engage physicians, one must provide evidence that clearly shows the advantages of CPOE,” explains David Muntz, senior VP and CIO of Baylor Health Care System in Dallas. “Our experience has shown that once a physician begins using the technology, they will influence others. It is imperative that physician workflows are improved by the introduction of not only CPOE, but clinical documentation, and all other aspects of EHRs.”
A link to the CHIME reoprt is located below the article:  ‘Meaningful use’ readiness drops among hospital CIOs – FierceHealthIT

Meaningful Use 101

While Meaningful Use has been a hot topic over the past year, it will become even more important as we approach 2011 when actual incentive payments for qualified physicians and organizations can be received.

There still exists a lot of uncertainty about exactly what MU is and what it is not. I spoke with Robert Tumanic of C3 Partners ( about MU and their unique product, Meaningful Use Monitor (MUM ©) designed to help organizations and individuals actually meet the requirements. What follows is a loose transcript of our discussion. If you are a physician in a private practice or an administrator on the hook for ensuring your organization meets the MU requirements, C3 is a valuable group to be familiar with.

First, tell me about C3 Partners

We are a team of four individuals, all senior consultants with experience as partners from large firms. We are deeply entrenched in health care and Meaningful Use specifically; dating back to February 2009 we have been monitoring every aspect of the rules. We literally have over 8 man-years invested in the tool and we update it and our clients as the rules evolve. Remember, compliance isn’t a one time event….its ongoing annually and we make sure you don’t have to think about it because that’s what we do.

Additionally, we have aligned ourselves with nearly one hundred business partners who add MU and EHR consulting capability to our product. The partners, augmented by clinical professionals, have reviewed the final CMS rule and have provided their interpretations that are at the core of our MU tool.

Tell me about the Meaningful Use Monitor

The MUM tool was built to help with the process of getting reimbursements and avoiding eventual penalties associated with MU compliance. The HITECH Act, like HIPAA before it, is very complex, full of potholes, and somewhat open to interpretation. There are two components physicians and hospitals must address in order to qualify for the much talked about reimbursements:

Component 1 is that you must be using a “certified” EHR system. Component 2, and this is the one that is much more complex, is that you must use the EHR in a defined manner as per the rules posted by CMS; and this is the primary benefit we have built into the Meaningful Use Monitor. It enables the user to walk through all the aspects of the requirements and ensure they meet the specifications by modifying their clinical processes. In areas where there is a gap, it provides ways to get into compliance.

Can you give me an example of an area in which organizations might not be aware they have to be compliant under Component 2?

There is a requirement that a physician/hospital must offer a smoking cessation program to patient smokers and it needs to be entered into the EMR. What does this have to do with use of an EHR? It doesn’t matter…it’s a requirement to meet the MU requirements and thus, clinical processes must be altered so reflect the program was offered and this fact captured within the EHR.

Most of the buzz has been around the reimbursement physicians and organizations receive under MU… can you elaborate?

Individual physicians are eligible for $44K in reimbursements (in addition to Medicare or Medicaid bonuses) and hospitals may receive as much as $10M over the life of the program. Moreover, there are increased reimbursements for Medicare or Medicaid built in as well. These increased reimbursements will be applicable for the next 5 years. On the other hand, there will be penalties in the form of decreased reimbursements for those who do not meet the requirements.

When can physicians and groups begin to receive the reimbursements?

May 2011 is the first opportunity for reimbursement. For the first year, CMS requires that MU be demonstrated for only 90 days to meet the criterion for payment.

Who should be paying attention and resultantly, who might want to take advantage of the Meaningful Use Monitor?

The tool is designed for 4 audiences:

§  Health Systems/Hospitals

§  Large Groups

§  Small Groups/Solo practitioners

§  Public Sector – (Medicaid, RECs)

How can a user be certain their EHR is certified?

CCHIT lists EHRs that are certified (

Where do folks find the Meaningful Use Monitor?