Spotlight: Achieving "Meaningful Use" of Technology Through IMPACT 

 

Through IMPACT, our hospital is using technology to improve care. The federal government has allocated funds to assist hospitals and other health providers in their computerization efforts through the American Recovery and Reinvestment Act (ARRA). To qualify for funding we have to do more than just implement computer systems, however. We must show "meaningful use" of technology by: 

  

4  Using a federally "certified EHR,"  

4  Sharing information with other health providers, 

4  Reporting patient quality measures. 

Hospitals who meet "meaningful use" criteria will receive funding in the form of increased Medicare and Medicaid payments for patient services. Hospitals that do not computerize, or that implement systems in a manner that does not meet "meaningful use" criteria, will have their Medicare and Medicaid payments reduced. ARRA incentives are initially paid in stages through 2015. This allows hospitals to implement clinical functions in phases, so that staff and physicians can adjust to the major changes that an electronic environment brings.    

  

The IMPACT program is designed to meet "meaningful use" so that our hospital will be in compliance with ARRA regulation. 

·         We have selected a certified EHR (Cerner). 

·         We have built in ARRA standards, such as data exchange, security, medical terminology, coding.  

·         We have incorporated required patient safety alerts and rules and implementing evidence-based orders for physicians to use upon order entry. 

·         We are implementing IMPACT systems in phases to match ARRA payment schedules. 

  

"Meaningful use" requires standardization. We need standardization so we can share patient data with other health providers and compare patient outcomes. It is a federal requirement, and it is the right thing to do to improve patient care in our country. 

  

Who determines how IMPACT standards are implemented at Tenet hospitals?  You do.  Every hospital is invited to participate on many of the clinical advisory teams (nursing, pharmacy, lab, radiology, therapy, ED, and surgery) to make decisions on how to implement federal and state mandated standards and automate effective practices. A physician advisory council (PAC) addresses physician standard order sets and practices. The chairs of these Advisory Teams comprise the Clinical Leadership Council which oversees standards that affect multiple disciplines. Check with your hospital IMPACT leaders (listed below) for more information on how these councils work. 

 

WHAT is changing with IMPACT? 

After our hospital goes live on IMPACT, the way we perform our daily functions will be quite different. 

·         All medications will be bar-coded. 

·         Medications will be administered only after cross-checking the bar-coded label on the drug with the bar-coded wrist band on the patient's arm. 

·         Clinicians will document directly into the computer as care is delivered (not on sticky notes, worksheets or kardexes). 

·         Nurses will give shift reports by looking at the information that was documented directly into the computer. 

·         Bedside monitors will continue to automatically feed patient vital signs into the patient's electronic chart. 

·         Physicians will look up patient information in the electronic chart from any wireless-enabled location (within the hospital or from their office, home, or remote location). 

·         Orders will be entered electronically for immediate action by all departments.  With CPOE, physicians will enter their own orders to ensure that all the rules, alerts, contraindications, drug interactions, and other clinical decision support are acted upon at the time of order entry. 

Information we enter into the computer will be reported to the U.S. Department of Health and Human Services to show we are "meaningful users" of technology and eligible for ARRA incentive payments. 

  

HOW will hospital staff and physicians prepare? Our hospital is already beginning to prepare for the changes that will occur with IMPACT. 

·         Process.   Leaders and department representatives have been meeting with members of the IMPACT team to identify areas of process, workflow, policy, and procedure changes we must address. Through the Clinical Process Improvement Committee (CPIC), hospital departments will be defining new processes, workflow, policies, and procedures that describe how we will perform our jobs in the future. 

·         Standards. Physicians and other clinicians can review standard order sets and alerts that will be built into the CPOE system. Also, each hospital has representatives on various clinical advisory teams (nursing, pharmacy, lab, radiology, therapy, ED, and surgery) that sets standards and ensures compliance with federal and state regulations. 

·         Trainers and Super Users. In a few months each department will select individuals who are committed to be highly skilled in our new technology and processes. These people will provide testing, training, and go-live support, and are critical to ensuring a smooth implementation. 

·         Training. Staff and physicians will receive training for both rounds of IMPACT implementations. The amount of time and content of training will be determined for each specific job role, and you will be notified closer to training of the requirements for your role and how training will be delivered.  

To find out more about ARRA, visit the IMPACT Program website (on eTenet under Tenet Initiatives).