First Practices Achieve Meaningful Use on Louisiana Medical News

First Practices Achieve Meaningful Use

By: TED GRIGGS

Posted: Friday, October 21, 2011 11:27 am

First Practices Achieve Meaningful Use | Centers for Medicare & Medicaid Services, Louisiana Health Information Technology Resource Center, Health Information Technology for Economic and Clinical Health Act

A handful of Louisiana’s primary care practices and at least one hospital have already met Medicare’s requirements for meaningful use of electronic health records.

Those providers have qualified for federal funds through the Medicare EHR Incentive Program, and the Louisiana Health Information Technology Resource Center expects hundreds more of its clients to qualify within the next year or so.

For more information about LHIT Resource Center support as well as the benefits of EHRs for providers, patients and the medical community, please visit www.lhcqf.org or e-mail rec@lhcqf.org.

Program manager Nadine Robin said LHIT is working with 991 priority primary care providers and 19 critical access hospitals, all under 50 beds in rural areas.

LHIT, which serves as the Regional Extension Center for Louisiana, is also working with more than 100 specialists to help them achieve the meaningful use standard, she said. LHIT can’t use its Health Information Technology for Economic and Clinical Health Act grant money for those clients.

Parish Internal Medicine Associates of Destrehan was the first Louisiana practice working with the Resource Center to attest to meaningful use. However, Robin said LHIT expects everyone it is working with to eventually meet the standard.

The center’s services include helping providers find an EHR vendor, redesigning practices and workflows, and managing the projects. The center also helps providers work through the meaningful use attestation process.

“There were all these questions about when the final rule was going to come out and which version would be used,” Robin said. “Everyone and their cousin, brother, what have you did a webinar that touched on this information.”

But situations always arise in practices that can’t be solved through a webinar or a list of online tips, Robin said.

Because of its well-established relationships with the Centers for Medicare & Medicaid Services, LHIT can advocate for providers, Robin said. The resource center can get providers the answers to their questions, down to the smallest detail, and make sure the providers do everything accurately to meet the requirements.

The center has also launched a message board where providers can network with other providers using the same EHR system, she said. The first provider can ask the second how that practice solved a problem.

“We can bring together everything that’s happening all over the state and pool all that knowledge,” Robin said.

Under the HITECH Act, CMS can provide reimbursement incentives to physicians and hospitals that demonstrate meaningful use of certified EHR technology. Medicare incentives can provide up to $44,000 per provider over five years, and Medicaid incentives up to $63,750 per provider over six years.

Linda Holyfield, president and chief executive officer of P&S Surgical Hospital in Monroe, said the procedural hospital began implementing its new EHR system in 2009.

The hospital, a 50-50 venture between physicians and St. Francis Medical Center in Monroe, budgeted $1.75 million for implementing the EHR system, Holyfield said. But that amount doesn’t include the hundreds, if not thousands, of man-hours spent implementing and refining the processes needed for meaningful use.

Holyfield said the hospital expects to get around $1 million back this year from CMS as a result of meeting meaningful use level one standards.

While that’s wonderful, the most important thing about EHRs isn’t collecting a bonus or avoiding penalties, Holyfield said.

“If it can be customized to really enhance the care patients are getting, I think it’s a win-win,” she said. “But if you design it so all the nurses are doing is working the computer and not seeing the patients, then you’ve not done a good job.”

Justin Bennett, nurse practitioner at Riverside Family Medical in Maurepas, said the clinic opened in November 2006 with an electronic health record system so the move to meaningful use was fairly smooth.

Riverside’s system could capture the kind of detail needed to meet meaningful use, he said. But doing so requires attention to detail.

For example, Bennett said, providers automatically assess the patient, mentally noting details like his posture and how he is walking.

But providers don’t always remember to document that in the electronic medical record, and that type of information must be included to meet meaningful use standards, Bennett said.

Dr. Ronald Hubbard, a Monroe physician, has had electronic medical records for around 15 years, backing them up with paper charts before going paperless around four or five years ago.

Despite his familiarity with EHRs, Hubbard said meeting the meaningful use standard required a lot of small procedural changes.

For example, one of the key things is documenting tobacco use, Hubbard said. While that information was routinely recorded, the data wasn’t recorded in the format that CMS wanted, Hubbard said. And Hubbard said it was difficult to estimate how much time his practice spent making those changes.

It probably took several hundred hours over a six-month period to train his seven-person staff, which was already experienced, and to tweak the system, he said.

And without LHIT’s help, the process wouldn’t have gone that quickly, he said. The most interesting part, determining how much the EHR improves the quality of patient care, is still to be determined.