When it comes to meeting meaningful use requirements, there's no single "correct" approach that works for all physician practices. Like the patients they care for, practices have their own qualities and limitations.
Nonethess, as PhysBizTech discovered after talking to three practices that have passed through the initial gauntlet of meaningful use (MU) attestation, there are some common threads among those who have achieved success.
In each case, meeting meaningful use meant putting in extra hours for physicians and staff, but they all agreed their EMR was “set up" to get them working in the right direction.
Drilling down for true understanding
Danielle Sink, MD, a physician at Acacia Internal Medicine Specialists, a three-physician practice based in Phoenix, took the lead on meeting meaningful use (MU) for her practice. She credits the early adoption of their EMR in 2006 with helping to set up the practice for meeting MU requirements. More important, Sink said the practice was already on the right track due to their involvement in quality initiative programs, such as the Patient-Centered Medical Home (PCMH).
“For me the biggest hurdle was understanding what we needed to do, understanding what the requirements were. It is kind if like doing your taxes,” she said. “The rule is not always what you would think logically by the government's description” added Sink. “So we had to be very careful to examine the rule, and some things we determined wrong.” That's where the practice's local Regional Extension Center (REC) came in.
Another aid was their EMR's “meaningful use wizard” which highlighted in green what needed to be done for MU.
When the MU incentive money came in, some of it went to upgrading the practice's server and security upgrades, but it also went toward reimbursing Sink for the hours she put in – about an hour a week – for almost a year and a half. The rest of the money was set aside for doing something the practice had always wanted to do – offer Tai Chi classes.
A fast start pays off
“I am a tech junky. I always have been,” said Amit Tailor, MD, a solo physician practicing in Rutherford, N.J. Tailor opened up his practice in his hometown, six months after the local doctor passed away. It was 2005, and with no capital, he invested $1,000 in an EMR. It served him well. He jumped into meeting MU early and has already attested for both year one and two. “The earlier you got in the easier it was,” explained Tailor. Between his EMR software, which he says, “was set up for meaningful use,” and help from his local REC, it took Tailor just three months to attest for year one in 2011, and a year to attest to year two in 2012. “All of these things, we really already do as primary care doctors,” said Tailor. “It is proving that we do them that is a little bit harder.”
As Tailor looks toward the future, he is considering how his current EMR software will hold up. “There is all of this buzz around meaningful use because that is where the money is,” he commented. And “meaningful use is great,” he added. “It is helping providers to manage the data.” But, he pointed out, it is “not the way of the future.” Tailor believes that lies in programs like the PCMH and accountable care organizations (ACOs). And if providers think meeting meaningful use is difficult, Tailor noted that quality programs are much more involved. Those programs are asking for reporting on a lot more detailed data, he said. “ As a solo practitioner I have to be on top of all this,” continued Tailor, and that means preparing for a future beyond meaningful use.
An investment of time
Nisha Chellam, MD, a solo physician practicing in Novi, Mich., said it took her three years to meet year one meaningful use requirements. She too considers herself an early adopter, and has been using an EMR since 2000 when she worked for the VA system.
In 2008 she started her own practice – one that aims at patient-centered care. Chellam said although meeting meaningful use was very time-consuming – taking up to four hours to run some reports and over an hour to finish patient documentation – she still considers the process to have been an easy one.
Like Sink and Tailor she said her EMR was “set up” for meaningful use. However, she is concerned that meaningful use right now is more about the “financial implications than patient care.”
“True patient care is about an equal partnership between physician and patient,” noted Chellam.