With the Meaningful Use Stage 2 (MU2) Eligible Hospital (EH) attestation deadline rapidly approaching, many organizations are working hard to button up their scorecards with incentive ready numbers. There have been a few bumps in the road, including a late option to report Stage 2 using Stage 1 measures, and this can leave hospitals wondering if they should zig or zag. Add the challenge of EMR vendors keeping up with the changing tides and it’s easy to see why there’s so much challenge around this topic.
I was fortunate to have had the opportunity to work with an Illinois-based health system over the past year as their MU2 Project Manager and helped them navigate the waters of language, rules and governance with success, although not without a little fear! I’m pleased to report that our client is attestation ready with remarkable numbers and I wanted to share some tips and guidance for other health systems currently walking through the fun house known as MU2!
Interpret the Rules – For anyone looking for a clear cut interpretation of the measures please let me know when you find one. CMS does a good job at leaving much room for individual interpretation. Your best bet is to get your knowledge experts together to hash out the interpretation and document it. The CPOE Medications Measure for MU2 was a good example of this with questions like, “who can prescribe?” “Can you include Nursing in this measure?” “If you decide you can, why?” Make sure that you can justify your interpretation decisions if an audit were to take place.
Build Reports Early and Keep Them Updated – It’s great to identify measures that the organization feels they already excel at. It’s even better to know you are excelling. Build your MU reports early, and start measuring yourselves to ensure there are no “gotchas!” It’s also important to keep your reports updated with the latest vendor packages. Monthly fixes are typical and important to ensure reports remain on track.
Plan Early – While we’re a little late for MU2, it’s a good tip for pre-planning for MU Stage 3 (MU3). It’s key to understand the measures, interpret the rules, and identify new solutions and workflow changes as swiftly as possible. For almost every measure that most hospitals currently excel at, there is another that is new and will require workflow changes, vendor engagement, and implementation. The earlier you identify what the organization does well, not so well, and what’s brand new, the more success you’ll have within your timeline.
Reach Out to Vendors – Engage in vendor conversation around new initiatives. Have them assist with identifying pitfalls of clients who have gone before you, upcoming upgrades to functionality, and timelines for new implementations. No budget available? Most vendors have a Wiki or user group available that are a great source of information for little to no cost.
Set Your Project Timelines – Once you have interpreted the rules and have your plan of what works now, what needs work, and what’s brand new – map it out. Line up timelines to be sure you have the most impactful projects front loaded. Resources are most likely tight, so take that into account when planning how the dominoes should fall.
Engage End Users Early – It’s always smoother sailing when everyone is in the boat before it leaves the dock. Talk up initiatives early. Engage Clinical Informatics to deliver information at staff meetings. Develop scorecards sharing what is working well; celebration of good work will go a long way to entice staff to step up in the areas that need attention. Provide regular staff updates on progress and upcoming implementations. If you keep everyone engaged, you’ll reap the benefits of a team effort.
Documentation – Last, but definitely not least, document everything! If you made a specific interpretation to a rule, document your justification. As you implement new workflows and functionality, document your decision and design process. Develop a Meaningful Use Binder that can be provided if an audit were to occur. For each measure be sure to have screenshots, decision making strategies, and interpretation justification. You can never have too much documentation.
Meaningful Use at any stage is a unique challenge as well as an opportunity to embrace optimization, celebrate current successes, and implement new and exciting solutions. While there will certainly be moments of confusion – preplanning, engagement and focused communication will go a long way toward success.
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