Stories from the Front Lines: The Journey to Meaningful Use

Doctors Clinic of Spokane, WA Attests to Meaningful Use:
How They Got There

The Doctor’s Clinic recently navigated through the attestation process, and John Fisher, the clinic IT manager, was kind enough to share some insights on their process.  The Doctors Clinic is a mid-level practice that focuses on quality healthcare and professional excellence.

John’s clinic worked closely with the WIREC who audited their practice, and also worked closely with their vendor, HealthCo’s, support teams. The practice is also an active member of the Medical Quality Improvement Consortium (MQIC) from GE Healthcare.

John had this to say about his practice and their process in general:

“Overall, the process was not as daunting as we expected.  The WIREC audit helped us to focus on specific areas, but we have been preparing for a long time, so there weren’t any real negative surprises.  One pleasant surprise was our clinic actually met ten different quality measures, but we only had to report three.  Our WIREC consultant knew Centricity as well, so we felt like that was very beneficial for us. Both our WIREC consultant and HealthCo’s support team provided tremendous assistance when we had questions long the way. We attended countless webinars by WIREC, GE, HealthCo and almost anyone else we could find to be sure we were prepared.  These were extremely valuable for us.” 

When asked out the history of the clinic, John revealed some surprising information:  this was their second EMR.  “We implemented a different EMR several years back that failed.  One of our physicians recommended we move to Centricity and shortly after we made that decision, that physician left our practice, so we were left with a challenge to say the least!”

Here are John’s insights into specific processes:

WIREC: What changes have you had to make in your practice as a result of meaningful use?
John: Our biggest change had to be around the modification of workflows to be sure we were capturing the data we needed.  We utilized the orders and ePrescribing components to the percentages dictated by meaningful use, and made sure we were providing the appropriate handouts.
WIREC: What would you offer as guidance to your fellow doctors/clinics regarding EHRs and obtaining meaningful use status?
John: Know what the requirements are and pick the requirements that fit your clinic.
WIREC: Can you give us an overview of what the process has been like thus far?
John: Since we took the time we have to prepare, and utilized the assistance that was out there in WIREC and HealthCo, we were able to work as a team and point toward the same goals as a clinic.  Everyone took some extra time to understand our goals, and because of the buy-in from the providers and staff, it’s gone very smoothly.”
WIREC: How long have you been working towards MU?
John: Really since inception.  I would say diligently for six months or more, but tracking since it was announced.
WIREC: How much additional time is it taking to meet the criteria for attestation?
John: Depends on the person.  For the providers, it’s a little more time, nurses a bit more and the IT side, monitoring the capture of the data increases quite a bit, as much as thirty three percent.  But preparation allows for both meaningful use (MU) and physician quality reporting system (PQRS) capture.
WIREC: What steps did you take to ensure you were ready to attest?
John: We ran the MU reports almost daily to see where they sat on each measure.  The Medical Quality Improvement Consortium (MQIC) was also key as it helped our team focus on where they were behind, and seeing a good sixty-day window of data identified areas where we were lacking.
WIREC: What benefits are your patients seeing from your EHR?
John: Outcomes, all around.  We know quicker when diabetics need A1C, hypertension patients know when they need rechecks.
WIREC: What do you say to your fellow doctors and practices who are concerned about implementing an EHR in their practice? 
John: If you are going to implement an EHR anyway, you need to go for MU.  It’s a twofold win—first, the patient gets better healthcare, and second, the office wins for the incentive.
WIREC: What do you know now about attesting for meaningful use that you wish you knew prior to attesting?
John: It wasn’t as difficult as I thought it would be.  With the tools provided by HealthCo, GE, and WIREC the information is readily accessible and easy to retrieve so you have all of your back-up data in the event of an audit.  It really was fairly painless.  Once workflows were modified, the rest fell into place.
WIREC: What can you share with other physicians who are getting ready to attest in the next weeks and months?
John: Make sure you have signed up, get registration in advance.  Print out reports on a regular basis.  It allows immediate focus and if you print them in order, the questions come up the same way.  Make sure which is the numerator and denominator, because they (CMS) switch them on you near the end during attestation.
WIREC: Were there any unique challenges for your specialty in showing meaningful use?
John: Not really, we’re a Family Practice so we hit the elements anyway.
WIREC: What one thing would you point to as being most helpful about WIREC?
John: Our consultant, Helen Stroebel’s, in-depth personal knowledge of EHRs was one of the definitive factors; the onsite meaningful use assessment would be, if I had to point to only one, the most helpful of all.  The assessment demonstrated to us that we could achieve MU. We had the Certified EHR and now our focus was to ensure that we used it as it was meant to be used and that we documented the quality measures that we were already doing but just not documenting properly.  I stay in touch with Helen to for additional assistance on our workflow so that we will be able to continue to achieve MU and provide the best possible healthcare to our patients. After all, that is what it is all about: “Better patient outcomes”. 

Doctors Clinic successfully attested August 1, 2011 and received their first CMS incentive check on September 23, 2011.