January 10, 2011

Ed Korba

Collaboration Is Key to Hospitals Meeting Meaningful Use

After reading the article, “Optimism about meeting the meaningful use fades for hospitals.” I could  not help but sit back and think about the current state of healthcare in the United States. reported, “The biggest hurdle is overcoming (Physician) resistance to computerized physician order systems.” The physicians are slow to change because they have little to gain financially.
It seems there is a feeling that if physicians have to go through an effort to use technology rather than just record it on a clipboard, then it’s taking up too much of their time.  And their time is their money.
Is the problem of meeting the meaningful use rule, 30% of all unique patients with at least one medicine on the list need to be ordered electronically that hard to do?  I asked Caroline Samuels, MD, our resident physician on our DrFirst Hospital Services Team, “Is this true?”
She said,” The decline in percentage of CIOs expecting to meet Meaningful Use requirements this year is understandable, and could have been anticipated.   The Objectives of ONC (Office of the National Coordinator) read just like the strategic goals of just about any hospital.  Any CIO will agree with the goal of improved patient safety. However, when the details of the Meaningful Use criteria are reviewed in detail, the height of the “bar” being set is much clearer, as is the velocity with which the bar is expected to rise over the years of the program. It may be convenient to blame physicians for not using CPOE,  but the anticipated reporting requirements, the actual use of emerging IT standards and the interoperability requirements are every bit as challenging as CPOE.  It is clear from examples of system implementations, that physicians will use well-designed systems that they have helped to customize.  Blaming physicians for the lack of progress towards meeting Meaningful Use is a red herring.”
This seems to be a case of group-serving bias where one group or another attributes its failure to the situational factors beyond its control.   I’m sure Hippocrates, for whom the physician Hippocratic Oath was named, didn’t say, “Just do it.” but if he were living today that actually might be his sentiments. The bottom line is that CIOs, physicians, and CPOE vendors all have to work together towards the goal of meaningful use.  CIOs who need to reach a goal should ask for help from physicians.  If workflow needs to be adjusted, ask for help from your system vendor.   If all parties communicate and collaborate, an awful lot can be accomplished in short time by “just doing it.”