By Grantham, Dennis
Behavioral Healthcare , Vol. 31, No. 4
Some 18 months ago, industry groups and providers far and wide were quick to point out the challenges they saw in the requirements to which they'd have to attest to earn the EHR "meaningful use" incentive funds provided in the HITECH section of ARRA, the American Recovery and Reinvestment Act.
More recently however, a growing number of providers have become more optimistic, says Amy Machtay, a HIMSS certified professional in health information management, or CPHIMS. A consultant with Boughton and Orn-dorf Consultants (Orange Beach, Fla.), Machtay visits behavioral health organizations to conduct "readiness assessments" that get them started on the path toward meeting meaningful use requirements.
For providers who still utilize paper-based systems--still a sizable number--Machtay's engagement often starts with an earlier step--fact-finding that helps an organization to evaluate and select a certified EHR. For those who already have and use EHRs (typically these are "non certified" and therefore in need of upgrade or replacement), she says that the readiness assessment can begin immediately.
Meaningful use measures "make sense"
"Every time I visit a provider, there are one or two individuals who've looked into the HITECH legislation who know something about it, as well as others who aren't at all familiar with the measures. But once we start walking through it, understanding the intent, the eligibility requirements, and the meaningful use measures, they begin to say, 'hey, this makes sense'," says Machtay. At a recent meeting, she says that a CMHC medical director spoke up and said, "Am I missing something? Aren't we already doing this for every patient? If we're not, then we should be."
While Machtay acknowledges that "there was early pushback about the [meaningful use] thresholds being high, the feedback I'm getting lately is that organizations find this very useful, very practical." This, she says, is a product of the process used to develop them. "Dr. Blumenthal [the recently retired head of ONC] and his team get very high marks. The acceptance of Meaningful Use measures reflects the wide participation of physicians, the medical industry, and other professionals who were involved."
"Many organizations say that once they go through the measures, and see their value, it's not about the incentives anymore. It becomes a valuable tool to improve quality. I hear that over and over again," she says. Then, she recalls a recent HIMSS meeting, when a CIO said, "The money is not the driver here. I didn't have kids just to get the tax deduction."
Assessments create a starting point
For any provider organization, the road to meaningful use begins with a benchmarking exercise that compares its current processes and outputs to those required for meaningful use attestation. The assessment process that she employs typically starts with a one-day meeting that reviews the purpose and intent of ARRA's HITECH provisions, the nature and qualification requirements for incentives, and the elements of Stage I meaningful use. This is the meeting "where the lights come on," as providers "recognize the practical value of the MU measures and see the alignment with their organization's care and quality objectives," she explains, noting that most elect to go forward with the next step--the readiness assessment.
The Boughton and Orndorf assessment begins with a simple question: Does the organization currently use any form of electronic records system? Machtay notes that "providers whose processes are more paper-based often ask for help in assessing EHR vendors. They know that they're not capturing data, and therefore wouldn't have meaningful benchmark assessment scores."
With providers like these, Machtay rakes a different approach. "I help them to align the accomplishment of meaningful use requirements with the implementation process for the EHR software that they select. …