For Alicia Nesvacil at HealthPartners, the latest meaningful use requirements are more about conducting quality assurance than getting started.
The company’s meaningful use guru said that after reviewing the guidelines, she added a few checks and alerts to comply with new rules.
“Everything else was embedded in existing work processes — there was nothing new because of meaningful use,” she said.
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Nesvacil said the guidelines are helping the company measure ROI after 15 years of using an electronic health records system.
“We did a gap analysis of where we might have to do test files out to a public health agency,” she said. “Then we identified the gap and put a process into place to address it.”
For the company’s patients, the benefits of EHRs go well beyond scheduling appointments online, which was implemented in 2004. HealthPartners patients can:
- Receive test results electronically
- View medical records with a doctor in the examining room
- Better understand the risk and benefits of MRIs and CT scans
- Take home an after-visit summary
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Kevin Palattao, vice president of patient care systems, said that the first tangible sign of EHRs was when physicians started logging into the records and viewing them with patients in the exam room.
“It took a few years to get used to sharing the screen with people; now we don’t even think about it,” he said.
If a doctor orders a test during a visit, the results are delivered electronically and simultaneously to the patient and the doctor. HealthPartners has shared 16 million test results electronically since 2005.
“We think it’s a safer type of care to make sure things don’t fall through the cracks,” Palattao said. “The patients are in control; we are just the custodians of the information.”
Based in metro Minneapolis-St. Paul, the group has 425,000 patients and a network of medical and dental clinics, pharmacies, primary-care offices as well as 35 medical and surgical specialties.
Nesvacil, whose official title is senior consulting analyst, said the team focused on processes, the consumer experience and care team work flows when implementing EHRs.
At the beginning of the transition, Palattao said that the company had a lot of heart-to-heart conversations about who owns a medical record.
“We chose a particular path over time that allowed us to create empowering experiences for consumers,” he said. “People have to decide what’s best for them.”
One element of the EHR transition that has saved money for the healthcare company and patients is a new approach to CT scans and MRIs. The company changed its work-flow process to give doctors and patients access to the latest research about these scans in the exam room when the test is being ordered. The goal was to inform the decision-making process and allow the patient and doctor to decide together if the scan is necessary.
In a 2009 study, the company reported that since the program was implemented in February 2007:
- 92 percent of scans met guidelines
- 1 percent of orders were withdrawn
- 20,000 unnecessary tests were prevented
- $14 million in healthcare costs were avoided
Palattao said that people crave this kind of help in making expensive healthcare decisions.
“In our market, 30 percent-plus are enrolled in high deductible or health savings accounts, so the more info people have on options, the better they’ll be able to decide how to spend their money,” he said.
To make the meaningful use journey more productive than painful, Palattao suggests revisiting business and clinical strategy, instead of making the change about meaningful use.
“If you frame this as compliance or a way to avoid penalties, it will prohibit you from bringing your medical practice to a new level,” he said. “It’s table stakes at this point; you’ve got to have it. It’s just a matter of how far can you take it.”
[Photo from flickr user Septem Trionis]
