Have you heard your information technology (IT) staff talking a lot about “meaningful use”? It’s possible that pharmacists at your health system have been involved with meeting certain stages of meaningful use, especially in regard to computerized physician order entry (CPOE). Meaningful use has probably not caused too much insomnia for pharmacists, but it has for the Chief Information Officer and IT staff.
Meaningful use of health information technology (HIT) is a catchall phrase for the rules and regulations that hospitals and physicians must meet to qualify for federal incentive funding under the American Recovery and Reinvestment Act of 2009 (ARRA). CMS is authorized through this act to provide reimbursement incentives for eligible professionals and hospitals that meet certain milestones. Many hospitals have met certain stages of meaningful use and have started to receive incentive payments from CMS.
Meaningful use encompasses several goals, including one on improving quality, safety, and efficiency of patient care that pharmacists can affect. Although a lot of effort has been placed on the technology surrounding the electronic health record (EHR), quality metrics are central to meeting meaningful use. To accomplish this objective, hospitals must look at the quality of patient care and determine ways that the EHR can assist in not only measuring quality indicators, but also identifying ways to help improve these indicators. There are many technology systems that are available to provide reports, but a major issue is how those reports can be best used. Pharmacists are beneficial members of the team that develops and implements these reports.
If we look at the individual care goals that are part of the overall “improve quality, safety, and efficiency of patient care” goal, it becomes clear how this positively affects patient care. The care goals include the following:
Integrating care goals with HIT is an important factor when it comes to meeting meaningful use requirements. As medication experts, pharmacists can play a key role in using HIT to improve the quality, safety, and efficiency of patient care. For example, the measurement and reporting of whether or not patients admitted for an acute myocardial infarction (AMI) are prescribed an aspirin at discharge is a quality indicator that has been in place for some time. By incorporating standardized evidence-based order sets for AMI patients into the CPOE systems, the provider can be prompted to prescribe aspirin at discharge or to document a contraindication to that therapy. This very real scenario meets several of the care goals. Pharmacists understand the importance of quality measurement and understand that evidence-based guidelines can help to streamline the order set for efficiency.
Another example of pharmacy and HIT working together would be developing a more robust way of identifying patients that have been readmitted within 30 days and the reasons for that readmission. Knowing those patients who could be at high risk for readmission could help target interventions to improve their care. Depending on the target readmission, pharmacists could be the key health care provider for those additional interventions to help keep an “at risk” patient from being readmitted.
Meaningful use is a huge undertaking for a health system. To help reduce some of the insomnia associated with this endeavor, pharmacists should work hand in hand with HIT to meet meaningful-use targets.