Expert Panel Discussion: Health Care Reform:
How Community Hospitals Thrive in an Environment of Rapid Change
The strategic planning process includes health information technology elements that strengthen the organization's infrastructure and ability to provide real-time data that will equip providers with decisionmaking tools and rules and create better clinical quality while reducing risk. A significant portion of the capital budget has been earmarked to meaningful use over the next several years.
In an earlier post I mentioned that our recently updated strategic plan contains goals for achieving meaningful use during our fiscal year 2011 (July 1, 2010 to June 30, 2011). This will be necessary to maximize our ability to capture stimulus dollars to help reimburse our cost of implementing our IS solutions. In our strategic plan and budget, we have allowed for the necessary resources--financial and workforce--to meet these goals.
There were some beneficial changes made in the recent final rules for meaningful use, but there are definitely still concerns. For critical access hospitals, our biggest concern is the unreasonable time frame in which to implement the systems to meet the criteria for meaningful use. If critical access facilities cannot prove meaningful use as soon as they are eligible, according to regulations, they begin to lose potential costs as their reimbursement through stimulus funds are based on depreciation on these costs to obtain meaningful use. For a critical access hospital that does not have a game plan already in motion, the stimulus fund benefit will very likely be limited.
Our strategic plan did not address meaningful use. As a result, at our July board meeting, I laid the foundation for updating the current strategic plan to include a roadmap for achieving meaningful use as well as developing a Technology Pillar for goals and benchmarks. Along with the strategic technical plan and pillar, I plan to add a comprehensive, fully tested disaster recovery plan.
I believe that critical access hospitals need a strong voice when regulations are modified and finalized for meaningful use. CAHs have to comply with regulations without the guarantee of stimulus just to see a penalty in cost reimbursement cuts. But CAHs have fewer resources in terms of staff, finances, and time.
The main reason I have extensive knowledge about meaningful use is due to a survey I had to file with Iowa's Department of Human Services in January. DHS wanted Marengo Memorial to be part of roundtable discussions regarding Medicare and Medicaid incentive payments. I asked if I could be part of the group as an IT manager. I saw an opportunity to be a voice in the process. The State of Iowa, in the face of budgetary constraints, is focused on keeping providers aware of important deadlines, final regulations, and providing guidance to help meet the regulatory requirements. The roundtable keeps me organized and helps prioritize objectives, and gives me confidence that our organization will be able to resolve the large challenges we face in Stage 1.
I have read many articles on larger health systems struggling to know where to start to achieve meaningful use and heard that some may not even try, given that reimbursement penalties may never outweigh the cost of the integration and support of a complex information system. The State of Iowa has been very supportive in our efforts to achieve meaningful use, giving us a fighting chance to qualify for the stimulus and incentives, and minimizing the impact of cost reimbursement penalties.
Based on what I'm hearing from our hospital customers, I can't emphasize enough the importance of starting each technology roadmap and strategic plan with a detailed stimulus readiness assessment. We conduct these with our hospital customers and they reveal a great deal about how technology can best be leveraged to speed each organization's path to meaningful use. As for the final rules, they're what we expected and we're pleased with the results. We like that eligible hospitals now have the flexibility to achieve meaningful use by taking different paths to implementing an EHR based on their individual needs and priorities. In addition, the achievement levels of many of the objectives have been reduced. We think the final rule positions more providers to be able to participate in the program in a timely manner.
Since passage of health care reform, we have been very involved with learning as much as possible. We have worked very closely with our Paragon and Practice Partner account executives to make sure our strategic plan is on the right track for achieving the requirements for meeting meaningful use as soon as possible.
At Twin County Regional Hospital, we have created a comprehensive ARRA timeline showing what McKesson modules need to be installed and when to meet the requirements. We have also started our capital budgeting process and we are showing all Stage 1 and 2 modules that we need to acquire in the next budget year and listing availability dates.
The hospital has reacted in a very positive way. We wanted to implement most of these modules, anyway, so we are essentially on an accelerated schedule.