December 10, 2015

Healthcare providers preparing for Stage 2 encountered considerable difficulty, according to various reports, which has resulted in some easing back by the CMS and ONC on the requirements for the third stage.

A survey of 2,000 physicians conducted by Medical Practice Insider found that more than half of providers said they wouldn’t attest to Stage 2 in 2015. The reasons included a lack of finances and resources for implementation, along with struggles getting elderly patients and others not comfortable with technology to use online engagement tools. An estimated 20 percent of providers dropped out of the MU incentive program in 2015.

Despite these numbers, other reports show progress. In 2014, data from the ONC showed that more than half of hospitals were enabled to offer patients the ability to securely message with providers, and roughly two-thirds of hospitals allowed patients to submit patient-generated data, such as blood glucose or weight.

Stage 3 is still two years away, yet preparing now can help avoid last-minute scrambling and also helps CIOs with budget and resource planning. Here are the major considerations:

Infrastructure Planning

Healthcare CIOs need to consider infrastructure issues, such as how to handle growing storage and compute needs for a significantly larger volume of patient data that will be collected and integrated into the EHR and other systems. Security and governance needs will naturally grow, with more sensitive data being exchanged between systems and providers and accessed by caregivers at the point of care.

Big Data Requirements

Real-time processing needs, such as to support the CDS and drug alerting requirements, will require powerhouse databases that can handle the load of high-volume data streams. Data management systems designed for storing both structured and unstructured data, such as Hadoop or Cloudera, may also be useful to cost-efficiently merge patient data from email, social media and wearables with transactional data from internal systems. All data formats will need to be structured for search and analysis. For example, screenshots of a lab test are no longer acceptable. The intent of integration is to tie data points together for quality management and reporting purposes, such as linking a lab order with a test result, and then connecting back to the clinical decision support application.

User Experience and Patient Engagement

A decades-old barrier to clinical systems adoption is the fact that caregivers often don’t like them. In some cases, EMRs create more work through data entry or navigation. With Stage 3, workflow changes again, with additional requirements for patient education, CPOE, and for incorporating new information into decisions, such as drug interaction alerts. Common struggles in Stage 2, for example, related to facilitating electronic transition of care to facilities outside of the healthcare system and motivating patients to use care portals. Finding out ahead of time what will be the potential barriers for users can help the CIO and team plan appropriately for training and change management.

emids latest white paper [INSERT LINK] breaks down how these and other factors will influence healthcare companies as MU3 requirements march closer.

Along with infrastructure planning, big data requirements, and user experience and patient engagement, what other considerations do you see making a big impact on the ability of healthcare companies to successfully prepare for Meaningful Use Stage 3? Tell us in the comments.

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