Optimistic on Meaningful Use? Some CIOs Are

Members of the Ann Arbor, Mich.-based College of Healthcare Information Management Executives (CHIME) who responded to a recent membership survey expressed relative optimism regarding their organizations’ potential for fulfilling the requirements of Stage 1 meaningful use under the federal American Reinvestment and Recovery Act/Health Information Technology for Economic and Clinical Health (ARRA-HITECH) Act, and therefore, regarding their chance to obtain HITECH funding.

Of the 152 CHIME member CIOs who responded to the survey, executed during August, 28 percent said they expected to qualify for stimulus funding in the first six months of fiscal year 2011, which begins on Oct. 1, 2010; while an additional 62 percent reported that they expect to qualify between Apr. 1, 2011 and Sep. 30, 2012, the date on which qualification for Stage 1 funding ends under the incentive program.

Not surprisingly, there was a contrast in responses between CIOs at smaller and mid-sized community hospitals, and those at larger hospital organizations. For example, only two-thirds of CIOs from hospitals with 100-199 beds believe they will get funding within the first two fiscal years that the Stage 1 criteria are in effect, while nearly all respondents from facilities with 600-999 beds expected to qualify during the first two years of the program.

Meanwhile, though 40 percent of respondents said they were well-positioned to achieve meaningful use with their current IT strategy and existing applications, slightly more than half are accelerating their EHR and HIT implementation plans.
HCI Editor-in-Chief Mark Hagland spoke with Rich Correll, CHIME’s president and CIO, shortly after the September 10 release of the survey results, to learn his perspectives on those findings.

Healthcare Informatics: Were you surprised at all by the results of your new poll?

Rich Correll: Yes, because in the run-up to the finalization of the final rule, there was lots of ‘woe is me’ out there. So my impression was that unless they [leaders at the federal Office of the National Coordinator for Health Information Technology, or ONC] greatly relaxed some of the requirements, there was going to be a lot of pessimism among some of the members about being able to make it. But ironically, even though there was relaxation of the rules, not that many members said that they thought it made much difference in their chances to get the dollars. So I don’t know if it was that they didn’t understand the regulations in the run-up to the finalization, or they just sort of redoubled their determination? I’m sure this is reflecting a can-do attitude, which I greatly admire. That’s the CHIME members for you; they’re going to go for it, and they’re optimistic that they’ll make it, in spite of very significant challenges. There are a lot of unknowns. As Pam McNutt [Pamela McNutt, senior vice president and CIO of Methodist Health System, Dallas, and chair of CHIME’s Policy Steering Committee] has said, the vendor certification issue is still very blurry. And where these folks stand in terms of having their applications upgraded to meet certification is still not certain yet for lots of folks.

HCI: Do you think anyone is being overly optimistic, in terms of issues like CPOE [computerized physician order entry] implementation?

Correll: I don’t know why they would be. I mean, they know what that requirement’s about. They know what CPOE is and isn’t. It was close behind product certification as a major challenge. But I think, probably, let’s face it, there’s a lot of forces in play with this. It’s more than just the money. John Glaser [John Glaser, Ph.D., formerly senior vice president and CIO, Partners HealthCare, Boston] was eloquent in one of the columns he did for us in saying, look, you can think about it all you want in terms of whether you should go for the money or not, but there are a lot of reasons to do it. If you don’t, you may be the only hospital in town not doing it, and how’s that going to look? And the payers might strike favorable deals with your competitors over that issue, and how’s that going to feel? So, there are a number of factors in play here around moving forward on CPOE, not just the funding-related ones. And we’ve had some discussions with CEOs. And we’ve provided webinars for our members on how to coach their CEOs. We did a handbook with the AHA [the Chicago-based American Hospital Association] on how to work with their CEOs. As some have said, this is not an IT strategy; this has got to be a major organization-wide mission. So if that kind of perspective can be achieved about this, things can happen faster than they otherwise would.

HCI: What are your members most concerned about right now?

Correll: Product certification is the concern I hear about the most. There’s a lot of concern there; they’re waiting for answers from their vendors on where they stand in line to be upgraded. But among the board members of CHIME, whom I do talk with frequently—and of course, these are prominent CIOs—I would say that’s the dominant issue, the certification-related requirements.

HCI: Your organization should be pretty well-placed to help its members get up to speed on these issues, because you’re at the center of the swirl here, right?

Correll: Selfishly speaking, this kind of activity is good for the kinds of education we provide. And we’ve done some webinars to get interpretations out as quickly as we could, and so forth. And we’re about to pose questions to CMS that have filtered up through the members, and whose answers we’ll publicize to the members. Webinars are becoming our major educational vehicle du jour, because this stuff moves so fast; as soon as we can latch onto some new information, we can quickly strike up a session. So, we’re scaling up our webinar platforms for more seats, and so forth, because we anticipate that that’s going to be a regular vehicle for us.

HCI: How do you see the next couple of years for CIOs?

Correll: Well, the hospitals will do what’s in front of them. The additional excitement, which has already been bootstrapped and is up and going, is the HIE movement. CHIME has put together our StateNet, which has really become active. We’ve got a CHIME member CIO in every state who’s become a coordinator within their state to marshal the collective efforts of CIOs in their state and in neighboring states. And Russ Branzell is the chair of StateNet. And we’ve had discussions with ONC about working closely with the regional extension centers. And the CIOs need to be engaged with them. So to me, the real excitement is when these hospitals really do start connecting data, and we poor consumers won’t have to fill out those terrible paper forms every time; and if I drop in Dubuque, hopefully, they won’t inject me with something that will kill me! But talk about obstacles and challenges—there are concerns over competition, and so on. So it’s certainly got its challenges; but if you take Russ in Colorado, those folks have put a stake in the ground, saying, we’re going to do it. And they’ve even committed to a common patient identifier.

HCI: So you feel optimistic in general?

Correll: Well, I’m optimistic because the members are optimistic. I applaud their optimism. I love a we-can-do-it attitude, and that attitude is obviously being reflected in the results in this poll. Now, if we suffer some disillusionment along the way, our members will have to buck up and find ways to overcome it. Everyone will have to come together, including the vendors. And I look forward to a healthy discussion in Phoenix [where CHIME’s annual Fall Forum will be held in October] around the topic of everyone having to pitch in together. The vendors will say, look, if we can respond quickly, can the hospital be ready for CPOE, or whatever, can they get ready in time? So it’s a two-way street.