Engaging Physicians in Meaningful Use

Amid the hubbub about meaningful use, AirStrip has stayed true to helping hospitals and physicians achieve their greater goals of clinical decision support:

1. Data access and data sharing – meaningful mobility with data transformation is a prerequisite to Stage 1
2. Understanding clinical practice - making the data available in a meaningful way for users, especially physicians in Stages 1 and 2
3. Guiding choices - incorporating concepts of evidence-based medicine in the offering in Stages 2 and 3
4. Knowledge-based prompting - providing views of data and rules that promote proactive, rather than reactive interventions to accompany Stage 3.

For hospitals to win at meaningful use, physicians MUST be engaged users - “use” being the definitive term.

We know that every hospital and physician needs useful EHR technology which provides clinical decision support in fulfillment of safe, effective, and more profitable patient care.  They've been struggling with this for 15 years, with fewer than 10% having achieved any level of success. The biggest challenges are interoperability, physician adoption, and change management. Congress hopes to use meaningful use financial incentives and penalties [1] to force hospitals and physicians to accomplish over the next 5 years what they have not been able to achieve in the previous 15 years. [2]

If hospitals want physicians to use the EMR (and LIKE it), then give them mobile (not remote) access. With AirStrip OB, obstetricians are interacting with hospital information systems an average of nearly five hours per physician per month beyond the time they are spending on CPOE or entering progress notes via a workstation. If you have 30-35 obstetricians delivering patients at your hospital or health system, that’s like adding one laborist FTE – without the cost. We are learning that other specialists are engaging at even more staggering levels with our cardiology and patient monitoring products. We need only look to the role of the physician to understand why.

Physicians perform two kinds of tasks: cognitive and procedural. Cognitive tasks include things like “triaging admissions, deciding whether a white cell count of 24,000 × 109/L with a 38.4°C temperature warrants antibiotics, whether surgery is indicated, etc. Procedural tasks include things like performing surgery, intubating a patient, placing a central line, etc. A subset of procedural tasks is administrative (e.g. prescribing orders, documentation, scheduling imaging studies)”. [3] Mobility solutions can effectively support multiple physician job functions.

Meaningful mobility transforms data into knowledge and, in turn, delivers that intelligence in a way that supports the improved performance of the cognitive tasks by physicians (diagnosis, triage, and clinical management), while mitigating the time management challenges of procedural tasks (physical assessment, interventional treatments, and prescribing). Meaningful mobility is vital to physician engagement and alignment with HIT.

References
[1] Section 1848 (a)(7) of the HITECH Act provides that beginning in Calendar Year 2015, eligible professionals who do not demonstrate that they are meaningful users of certified EHR technology will receive an adjustment to their fee schedule for their professional services of 99 percent for 2015, 98 percent for 2016, and 97 percent for 2017 and subsequent years. 

[2] Sections 1848(a)(2)(A) and 1886 (n)(3)(A) of the HITECH Act includes Congress’ identification of the broad goal of expanding the use of EHRs through the term meaningful use.

[3] Fackler, J., Watts, C., Grome, A., Miller, T., Crandall, B., Pronovost, P. (2009). Critical care physician cognitive task analysis: an exploratory study. Critical Care. 2009; 13(2): R33.