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Written by: Bob Habasevich, PT on Thursday, August 30, 2012 Posted in: Inpatient Rehab

Meaningful use had its first birthday earlier this year and celebrated with announced success and ambitious goals to get another 100,000 healthcare providers paid under the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs by the end of 2012.  “Meaningful use” means providers need to show they are using certified EHR technology in ways that improve care.  So, where is the meaningful use for post acute rehabilitation providers?  This is an unfair question at the moment because there isn’t an answer.

Providers in the post acute care sector, including IRFs, are not eligible for financial incentives from the government to achieve the meaningful use of electronic health records (EHRs). However, that does not provide them a pass on the expectations to improve coordination; quality, safety and efficiency of care delivery, or to demonstrate the active participation of patients and families in managing their care.

Year two of meaningful use will see a greater emphasis on shared information, or the actual exchange of patient data and health information with all providers, including those in post acute healthcare. It is reasonable to assume that multi-directional sharing of information will be a requirement for all post acute healthcare providers.

In an article for Health Management Technology, Brad Savage writes how one post acute care provider isn’t waiting for the government to set in motion the incentive to advance meaningful use.  He suggests to focus instead on developing meaningful users and with meaningful analysis. In his article From meaningful use to meaningful analysis,“ he writes, “it’s not just the exchange of data but the aggregation of data – and not just the meaningful usebut the meaningful analysis of that data – that’s critical to transforming care. The key to meaningful analysis is enabling a single, patient centric view of information, whether in a post acute or acute care setting.”  Consistent with the intent to make information available across providers must be the use of patient centric data available for near real-time analysis for users at the point of care to be meaningful.

Achieving meaningful use is not an IT project, but rather a business challenge for the provider. Purchasing and implementing technology is far easier than ensuring the culture and behavior of clinical practice adopts technology and adjusts workflow. Old habits must change. A significant effort lies ahead for the post acute healthcare sector to be compliant and interoperable.

The post acute healthcare sector is waiting for more clarity on meaningful use, and potential funding.  In the meantime, getting an EHR operational and meeting internal meaningful use should be an immediate priority.

Every post acute healthcare provider will ultimately address these questions:

  • What is the business strategy for implementing an EHR solution?
  • Has it been selected? Has it been piloted? Does it meet the post acute care requirements?
  • Is there a multi-year budget plan for the investment in infrastructure, software, integration and training?
  • How will the EHR solution be interoperable with disparate hospital systems, doctors and other post acute healthcare providers?
  • What information do you expect to receive from other providers?
  • What information do you expect to contribute to other providers?
  • Will you build interfaces to each provider with whom you will exchange information?
  • Do you expect your application vendor to provide this capability? If so, who will fund the cost?
  • Will you allow other providers to access your data and information? If so, how will you handle security authorization and access?
  • Will you use healthcare information exchange gateways? If so, which ones and how will they interface with your EHR solution?
  • In all of this, how will you ensure your information is HIPAA compliant?
  • And, if you can’t answer these questions, what are you going to do in order to be able to answer them?

Until CMS finalizes the definition of meaningful use for post acute healthcare, many issues will remain unanswered, some can be answered now.  It should be clear that your business will depend upon your ability to electronically communicate with other providers, but first, meaningful use must be demonstrated internally one patient at a time.