The situation is especially problematic for rural and community hospitals, as well as small hospitals in a multi-hospital system. Unlike large hospitals of more than 500 beds, smaller hospitals of 100 to 150 beds are often short on resources. Although eager to tackle MU requirements, they are still challenged to invest time and resources to re-engineer clinical and administrative processes and revamp the routines of end users.
Technology experience also influences a hospital’s approach to MU. Hospitals with more than five years of experience in electronic medical record (EMR) implementation are likely to adopt a comprehensive, process-oriented approach to MU because they have the resources required to support the extensive training, planning and longevity of the implementation. In comparison, CIOs of hospitals with unmodified, 10-year-old systems may feel overwhelmed and challenged by the massive process overhaul required by MU.
Regardless of size and technology prowess, hospitals and healthcare organizations can prepare for emerging MU challenges by considering these steps:
- Anticipate the impact of MU requirements on clinical, financial and operational performance. Stage 3, for example, will likely require providers to track individual healthcare goals; facilitate reconciliation of medications, problem lists, goals and care plans; and allow viewing by care-team members, caregivers and patients, according to ONC’s Health IT Policy Committee work group. Consider consultant-facilitated small-group, task-force and retreat sessions to discuss the breadth, scope and ramifications of Stage 2 and 3 MU requirements.
- Focus on end-user work routines and roles. Resist the temptation to make MU just an “IT project.” Instead, carefully evaluate how MU requirements will transform a broad spectrum of user roles, functions and tasks, as well as the activities of varied departments and divisions. Consider variables, such as rapid, easy access and navigation within and between systems, as well as tapping data and information retrieval for clinical and business decision making.
- Develop multiple multidisciplinary teams. Involving clinicians, managers, executives and staff in an authentic interdisciplinary discussion will minimize confusion, anxiety and resistance. But a single multidisciplinary group may prove too cumbersome. The best approach is to focus on a specific MU requirement, identify affected departments and invite leaders and potential champions to serve as members of committees and task forces.
- Bring in appropriate expertise for product/solution design. For example, designing order sets for clinical decision support requires that the MU task force reach beyond IT to incorporate input from those with the expertise and skill to identify potential risks, pitfalls and opportunities. While IT is an enabler, the ideal scenario is for external consultants, IT and clinicians to join forces and develop documentation templates, alerts, data displays and other tools. The result: speedier clinician buy-in and less time expended in MU solution design.
- Avoid the battle cry of “Show me the money.” All too often, healthcare organizations choose to fulfill MU requirements at the most basic level to quickly secure much-needed incentives. They mistakenly think that once MU requirements are fulfilled, they can tweak systems to enhance functionality and meet users’ needs. Few MU assumptions are more misguided.
- Build an MU-focused culture. Do everything possible to make MU part of the HCO’s mission, vision and strategic agenda. After securing buy-in and full support from top management, make sure that clinical, operational and financial leaders communicate a cohesive, unified message on the importance, process and impact of MU implementation. By creating a series of multidisciplinary teams and keeping team managers informed and engaged through collaborative project management software, HCOs can quickly transfer MU ownership and generate MU champions.
- Stay briefed on MU. Among the sites that offer MU resources are those sponsored by ONC and the Health Information Management Systems Society (HIMSS).
Sheri Stoltenberg is founder and CEO of Stoltenberg Consulting. For more on Stoltenberg Consulting: click here.
