Meaningful use (MU) is mainly a primary-care program whose design had physicians providing primary care and their patients in mind. However, we beg to divert from this premise and consider what MU could do for specialists, especially given Stage 2 MU whose focus is on interoperability.
If electronic health records systems (EHR) vendors would build on the foundation established by meaningful use, they would be able to offer physicians more than just a reliable channel for retrieval of patient information – they could provide a useful scheme through which such information can be reconciled and incorporated into their charts.
MU Stage to impact on primary and specialist physicians
Presently, the amount of discontinuous clinical data transmitted among physicians in increasing. The MU Stage 2 requirements introduce additional stipulations to the dataset provided by Stage 1. This means that most physicians will find themselves affected by a substantial level of disruption to their workflows before all the data has meaningfully incorporated on patients’’ charts.
The impact of the workflow disruption is much more pronounced the first time a physician consults with a new patient. Specialist physicians, for whom new patients make up 25-25% of all patients seen, would therefore be more intensely impacted than primary-care physicians, who probably see just a handful of new patients in any week.
This in turn introduces a new challenge: How shall the data be fed into patients’ charts, and from where should it be sourced? Patients themselves are a useful source of demographic data, but if the specialist wants a definitive and trustworthy record of a patient’s medical history, the primary-care physician is the only sensible choice.
Using meaningful use stage 2 consultants, the stage 2 MU provides for standards that enable transportation of medical data from primary care physicians to specialists. This is through ‘Direct’ messaging protocol, which is like a secure email exchange channel. Sending of the data uses a standardized format known as the Consolidated Clinical Document Architecture (CCDA).
Once sent, the buck falls with the recipient, who should find the data and incorporate it into the patient’s electronic chart. Where the process has not automated, this can be a time-consuming process, which is the major cause of disruption in the recipient’s workflow.
Automated tools to increase process efficiency
It will therefore be important for physicians to implement tools that will enable accomplishment of these tasks in an efficacious and productive way if the stage 2 MU system becomes a real game-changer. You can find more information about this on http://mesusolutions.com.
It is not enough to have EHRs that display information provided by primary-care physicians. Instead, vendors have the greater task of providing useful tools for reconciling data received and inserting distinct clinical data elements into patient charts in an automated scheme. HER vendors should therefore meet the expectation that users have by exceeding the requirements provided by MU.
This is the only way the meaningful use stage 2 standards will make sense for specialists, and result in more efficient systems all round.
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