One example is the 722-licensed-bed University of Mississippi Medical Center in Jackson, Miss., which on June 1, went live with an implementation of the EpicCare EMR from Verona, Wis.–based Epic. In true 21st-century fashion, UMMC tweeted and issued posts to a public Facebook page before, during, and after go-live. Moving to meaningful use engaged the entire institution, says John Showalter, MD, MSIS, the CMIO at UMMC. "We have more than 900 people who signed up to be super-users on our training," Showalter says. "All those people had to be released from their regular clinical duties or administrative duties or lab duties to come and take extra training, and at go-live they were pulled out of their regular jobs just to be support staff."
Institutions take a financial and operational hit during the transition to meaningful use. UMMC has a $90 million implementation budget spread over five years, Showalter says. Because it is a state institution, the money came from a state-backed bond. "We whittled away a considerable portion of our cash while we were waiting for the bond to get through and get the money back from the bond. The bond has gone through and the money is coming in."
Other numbers tell their own story. In the past two and a half years, UMMC deployed more than 7,000 devices, counting barcode scanners and printers. In the end, UMMC brought up 15 applications in five hospitals and more than 20 clinic locations in a single day.
Staff had to pass a proficiency test or did not get access to the system. IT staff were able to learn valuable lessons by attending a similar go-live previously at Ochsner Medical Center in New Orleans, La., Showalter says.
Because approximately 35% of the UMMC patient population is eligible for Medicaid, the health system has already attested in 2012 and will receive more than $9 million in meaningful use reimbursement through the Medicaid Adopt program, Showalter says.
Those who attested in 2011 are breathing a sigh of relief over CMS' decision to allow them an extra year to achieve the Stage 2 thresholds.
"Common sense told us they were going to have to relax and push it out a year, so that was good news and I'm glad they did," says Ed Ricks, vice president of information systems and CIO at Beaufort (S.C.) Memorial Hospital. "We would have had to have been at Stage 2 by October 1 of this year, and now it's October 1, 2013. We can do that."
The American Hospital Association and the AMA came to at least one agreement on meaningful use. Commenting on the Notice of Proposed Rulemaking for Stage 2, they say the spirit of the law shouldn't allow CMS to peek back at 2012 data in order to get a full year's worth of data in each meaningful use attestation.
"It deprives providers of desperately needed time to comply," says the AMA's Stack.
As of this writing, it was unclear whether appeals for a 90-day recordkeeping period in 2013 would be substituted in the final rule for the 2014 edition of meaningful use.