In my last message, the first five measures that provide critical proof of using an Electronic Health Record (EHR) were explored from a different angle, the practical implications for professionals and consumers. There are fifteen of these measures, and we’ll tackle a few more today.
Incentives from Medicaid are over $63,000 per prescriber, and that contributes greatly to offsetting purchase price and ongoing expense of the EHR. Mental Health clinics and Substance Abuse Treatment organizations were left out of the original definition of who could qualify for Meaningful Use incentives, and the solution to that oversight is to use prescribers to qualify, at least for now. Checking the progress of the bill that’s intended to add these healthcare providers to the equation, it’s rocketing through House of Representative committees at the speed of government…a tedious process that requires a lot of lobbying to keep it on the radar.
Here are a few tidbits about measures six through ten:
6. Medication Allergy List: The functionality for this relates back measure 2, Drug Interactions and Allergy Checks. In order for an alert to pop up on the CPOE (Computerized Physician Order Entry), it has to come from somewhere in the software, usually another list (doctors seem to like lists). As with other related measures, professionals and consumers really like avoiding an interaction or allergic symptoms invading a consumer’s day because of an interaction with the medication. Additionally, I remember somewhere in the dim past that medication / allergy interactions can occasionally be fatal. It’s lifesaving technology, and the professionals’ inputting a consumer’s allergies is a fairly simple matter. In most software. Some products I have seen have been more work than it’s worth to use. If you’re shopping for an EHR, check the CPOE out thoroughly to assure it’s easy for the prescribers to use.
7. Record Demographics: Who is this consumer? Where does he live? When was he born? Addressing these questions is a no-brainer; professionals need to know who they’re working with. It’s a pretty inoffensive process to gather the required demographics, and they’re needed in order to bill, and consumers are used to this delay. It goes with the territory, so the software needs to work within the professionals’ process to be effective.
8. Record Vital Signs: Blood pressure, and Body Mass Index (BMI) help the professional recognize and monitor conditions like a weight problem. In Mental Health, it’s probably a casual notation to most professionals, however to the consumer, something like that BMI can be an indication of a body-image problem, and a professional may want to discuss this sort of thing.
9. Record Smoking Status: If the consumer is twelve years old, don’t worry about recording this. For those of us over age 13, however this is a terribly important notation. I have heart disease…how much of that condition was aggravated by my smoking, even though I quit over 17 years ago? I have a pal battling bladder cancer every day; his doctors say that’s a direct result of smoking. OK. That’s enough of me on my soap box. The fact is that smoking is an addiction, and that’s of concern to professionals in this business.
10. Clinical Quality Measures: Is treatment working? In my mind, this is one of the most important things we can do in this field because peoples’ lives improve when treatment is successful. There are a ton of assessments intended to measure treatment outcomes. They’re pretty painless, using radio buttons and check boxes to speed the process and enable improvement tracking on a report. Many of these assessments are intended to be administered multiple times, providing a graph of progress toward a treatment goal. In our field, suicide and other assessments deliver measurements of outcomes. In other areas of healthcare, there are different measurements. (http://www.cms.gov/QualityMeasures/03_ElectronicSpecifications.asp#TopOfPage)
If you’re a professional who wants to take advantage of Meaningful Use incentives, remember that your EHR needs to be certified. A couple of companies have been identified as approved in this effort by the government. (http://www.ihealthbeat.org/features/2010/onc-names-temporary-certification-bodies-for-meaningful-use-program.aspx) Not all EHR vendors have sought and received certification, and usually professionals and the organizations they work for are relying on these vendors to secure certification of their software…so ask them if you don’t know and want to collect Meaningful Use incentives.
I’ll share my take on the final five measures in the very near future.
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