Meeting Stage 1 Meaningful Use: A View from a Healthcare System

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Meeting Stage 1 Meaningful Use A View from a
Healthcare System

• Pamela McNutt
• Sr. VP CIO
• Methodist Health System
• Chair, College of Health Information Management
  Executives Policy Advisory Committee
• Member, AHA IT Advisory Committee

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Methodist Health System Overview

• Acute Care Hospitals
• Methodist Dallas Medical Center 515 beds
• Methodist Charlton Medical Center 254 beds
• Methodist Mansfield Medical Center 106 bed
• Methodist Richardson Medical Center - 209 beds
• Methodist McKinney 14 bed specialty physician JV
  
• Methodist Hospital for Surgery 44 bed specialty
  physician JV (opens 11/2010)
• 15 Satellite Family Practice Care Centers and
  Teaching Clinics
• Midlothian Imaging Center
• Methodist Rehabilitation Hospital
• 1,120 active physicians
• Graduate Medical Educational Programs
• Ob-Gyn
• Surgery
• Medicine
• Internal Medicine
• Family Practice/Sports Medicine Physicians

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Methodist Health SystemElectronic Medical
RecordApril 2010
Enterprise Index Demographics, allergies and
medication profile
Linking of patients across visits and site of
service
Ambulatory Care
Image Repository
Acute Care Single Vendor
-Visit Data - Patient Portal
-Histories - Interface to
acute -Problem List care
system -Medications -ePrescribing
-Xray -Ultrasound -CT -MRI -Nuclear
Medicine -Cath Lab -ECHO -Mammography (digital
only)
-Physician dictated reports -Nurse
documentation -Admission assessment -Medication
Administration -Bedside Medication
Verification -Care Plans -ED Physicians
record -Cath reports -ECHO reports -GI
reports -EKG reports -Lab reports reference
labs blood gases point of care
testing -Perioperative charting -Radiology
reports -Physician Notes -CPOE -Flowsheet -Monito
r Data -Patient Portal -Scanning and Archiving
Hosted major vendor offering
Product tightly integrated to acute care vendor
Completely Filmless

• Pavilion Practice Management offering
• to MedHealth clinics and managed practices
• (78 physicians)
• Private Physicians
• 10/2010 -gt
• (75 planned)

• Teaching Clinics
• Fall 2008 2011
• (90 physicians and
• residents)
• Private Physicians
• 2011 -gt

-Prenatal Data -Prenatal Chart -Labor and
delivery record -Fetal monitor data
Fetal Monitor Charting Archive System
Legend In Production Planned
2012-2013 Planned 2010/2011 In Progress
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Changes in/or Affirmations of Strategic Direction

• Delayed some initiatives
• ED order entry
• Monitor interfaces
• Nursing documentation in outpatient and specialty
  areas
• Short case surgical documentation
• Accelerated some initiatives
• Patient portals
• CPOE in acute care
• Affirmation of initiatives
• ED system replacement
• Developing an interface between our acute care
  and physician office system
• Scanning and archiving to capture loose paper
  records

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Methodists Expectation for Obtaining Stimulus
Funds

• 450,000 for physicians in the teaching clinics
• Medicare - 10.4 million for 4 acute care
  hospitals
• Like amount for Medicaid
• Late 2011/early 2012 with relief on the all
  or nothing meaningful use approach
• 2013, at best, if the meaningful use and quality
  metric reporting remain as is
• Believe we will only get 2 years of funding,
  Stage 2 and 3 are out of reach

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Challenges with HITECH/Stimulus Requirements

• Manual calculations needed for meaningful use
  measures
• Requirement for structured data sets
• Quality metrics that must be calculated by the
  electronic record rather than allowing for other
  data compilation tools
• Timing of new certification process, upgrades may
  be needed
• Lack of functional Health Information Exchanges
• Vendors pricing on data upload/down load routines
• Concurrent 5010 billing and ICD-10
  implementations
• Shortage and cost of clinical informatics
  resources
• HIPAA change treating the use of EHRs for
  Treatment, Payment and Operations as a reportable
  disclosure