Healthcare executive and blogger John D. Halamka, MD, says meaningful use will focus on quality and efficiency, and it will require the electronic exchange of quality measures including process and outcome metrics. Halamka, CIO of the Harvard Medical School, says it will require coordination of care through the transmission of clinical summaries, and decision-support-driven medication management with a comprehensive e-prescribing system that includes eligibility, formulary, history, drug interaction, routing, and refills.
The definition of meaningful use will be expanded each year, requiring more features and more data exchange, he says. Initially, the interoperability criteria needed for meaningful use "will include submission of quality datasets, e-prescribing, and clinical summary exchange at a minimum," Halamka says. In the short run, meaningful use could be a combination of products or an EHR lite, Halamka says, adding that a comprehensive EHR will be the best foundation for meaningful use.
How are hospitals preparing?
Eastern Maine has one of its hospitals live on CPOE, with the second coming online later this year. The health system plans to roll out CPOE to its entire organization at a rate of one hospital per year based on its available resources, says Bruno. "But if for some reason there were millions of dollars at stake, we could staff up or hire consultants to help us move more quickly," she says.
Lutheran HealthCare is deploying a computerized physician ordering system for medications, consultations, and documents. The hospital is also implementing a bar-code medication administration system and should have its system up and running by the end of this year. Art concedes he's taking a bit of a gamble on the new system as Lutheran HealthCare works toward meaningful use status. "We as an organization made the decision that these are the features and functions that we need to take care of the patient properly," says Art. "My fear now is that the system that I bought—and these systems are not cheap—won't be certified. And if it's not certified, do I miss out on all the money the government was willing to give me?"