Two Small Practices on Committing to Meaningful Use

White River Family Practice, an ambulatory, independent, primary-care practice in northern New England, has been attesting to meaningful use since 2011, the first year it was achievable. David Park, a family medicine doctor and partner of the practice, says a lot of the requirements were already being achieved through their regular practice work flow.

White River was a 2013 HIMSS Davies Ambulatory Award winner - recognized for outstanding achievement of health information technology to improve outcomes. Park credits White River's success in part to its selected EHR vendor, eClinicalWorks. "Any vendor worth their salt should make meaningful use easier - it's a natural selling point for them as a way to easily offset the initial cost of purchase."

Park says it is critical to elect a provider as a champion of meaningful use initiatives and to have buy-in from all staff members. "Having a provider be a part of the 'voice of change' can make buy-in easier for everyone," Park says. "I've heard from other practices whose meaningful use champion was an ancillary staff person, who really was challenged to make changes to the work flow - so necessary changes may be met with prickly resistance by providers who think their work flow is being unnecessarily changed by someone who doesn't understand fully how care is rendered."

For helpful meaningful-use resources, Park often turns to CMS' website and to his EHR vendor support e-mails and forums. "Sometimes, the easiest thing is to just go to the CMS.gov website and get information from the source," Park says. "The rules are there, however, the interpretation of them can be difficult at times. For that, I go to our EHR vendor's users' forum and can usually find answers there."

Fremont Family Care, a small primary-care practice in Fremont, Neb., is also several years into its own meaningful-use journey and has successfully attested to Stage 2. Shortly after the implementation of its EHR system in 2011, Fremont designated a super user and an EHR specialist who became familiar with meaningful use measures.

Beth Belmont, director of primary-care clinics at Fremont Health, says staying on top of the changes is difficult, but not impossible. "Our EHR system helps since we have a dashboard that shows the metrics and performance by physician," Belmont says. "Each year we also educate ourselves on meaningful use and any changes by reviewing information on the CMS website. The EHR implementation team then implements work flow changes as necessary.

Belmont says although Fremont has relied on the CMS website for continuous updates, they've also used their EHR vendor support extensively. "With the changes that occurred with meaningful use Stage 2, our practice paid for one-on-one education by our EHR support vendor," says Belmont. "This allowed us to better understand the metrics, how we could use our EHR to help us with the journey, and develop work flows for staff."

For practices that are still in the early stages of meaningful use, Belmont says it is critical to communicate expectations and optimize work flows. "As much as possible, collaborate with providers and staff to develop work flows that fit into their current routine, as to not disrupt the clinic flow," she says. "Constantly communicate with your staff and physicians about what they are doing well and what needs improvement to meet these metrics."