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By Tamara Korbel
MIS Systems Administrator / Data Security Officer
Ridgeview Medical Center
Waconia, Minn.
The Right Path
Virtually everyone in healthcare these days is focused on the HITECH provisions of the American Recovery and Reinvestment Act (ARRA), which is driving the adoption of electronic health records (EHRs).
Our goal is to meet the 2015 deadline for deploying these solutions, and in the process, qualify for stimulus funding. While it might seem a long way off, we realized quickly that we must start the process now to be ready to meet the requirements for the meaningful use of EHRs.
Achieving meaningful use is complicated and sometimes unclear even to the informed observer. I believe the key to success is developing a systematic process that tells you both where you are and what you need to do next to achieve your goals.
The process should include:
 A project manager for your meaningful use initiative
A detailed assessment of stimulus readiness
The organization of teams to plan and execute specific projects
When I joined Ridgeview Medical Center, I became the point person for this initiative. I am responsible for ensuring that we meet the phased requirements leading up to the 2015 deadline and then qualify for all the reimbursements.
Designating one person to understand the changes needed in technology and work processes is Ridgeview's recognition that this process cannot be left to chance. Someone must tie it all together and drive the actions needed to meet the milestones set forth in each stage of the adoption of an EHR.
Evaluation of Current State
Start by discovering where you are right now. As a Paragon® HIS user, we enlisted McKesson to perform an on-site stimulus readiness assessment. The assessment revealed how our hospital information system can help us meet meaningful use requirements — what we already have in place and what else we need to do. It has become the roadmap for our journey.
A clear roadmap of everything that needs to be done led us to accelerate our implementation schedule for applications such as computerized physician order entry (CPOE) — a prime component of Stage 1 requirements. It also helped establish the level of funding needed for application purchases.
Leadership Support
An initiative this large and expensive demands the complete support of leadership. They must be willing to make achieving meaningful use a high priority, and that means allocating both human and financial resources to the process. Most of all, they must understand what is at stake for the institution, since failure to reach meaningful use carries its own penalties.
Ridgeview's commitment is reflected in the time we are allocating to mapping our progress toward meeting requirements. With the publication of the final rules, we are creating new flowcharts and conducting meetings to plan our approach to each stimulus-related project.
We see ongoing communication with leadership as essential to our success. For example, we update executives on our progress and plans for meaningful use in monthly steering committee meetings.
Teamwork
Teams shape the deployment of each component of the EHR. For the CPOE component, team members are interpreting the final meaningful use requirements. For example, the requirement for real-time alerts at the point of care for drug-to-allergy indicators sparked considerable debate within the team as to who should view those alerts.
Some physicians said "We don't want to see all those pop-ups. We want to leave it to the pharmacist to take care of that." Yet, the standards clearly indicate the physician should look at them in real-time at the point of order entry. Understanding and addressing workflow considerations up-front helps position us for success long-term.
Supporting Technology
Technology needs to support the care delivery process, not make it more difficult. Paragon enables our physicians to access patient charts, lab results and imaging studies through the Paragon WebStation for Physicians. Our physicians will use this same application to access CPOE — an important factor for ease of use. Physicians don't need another sign-on or entry point, so this streamlines the process, improves adoption and ensures greater compliance.
You also need to determine whether the software you're using meets certification standards.
As users of McKesson's Paragon HIS, we've carefully evaluated each projected release to ensure that it will support our efforts to meet the final requirements in 2015.
Reaching the Goal
While getting to meaningful use has in some way been an evolving process, it is clear that being proactive is vital. Creating a process that supports each requirement, organizing resources, monitoring and evaluating progress, and communicating with leadership will ensure that we achieve our goal.
Tamara Korbel is the MIS Systems Administrator/Data Security Officer at Ridgeview Medical Center. She serves on the Paragon Advisory Council and is a member of the Healthcare Information and Management Systems Society (HIMSS), and the InSight user group for McKesson Provider Technologies solutions. Previously, she worked at District One Hospital as Manager of Information Systems in Faribault, Minn.
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