Meaningful Use – Final Rule

The final rule for meaningful use is here, finally! The good news? Number of measures have gone down. The bad news? It is more complex to collect and report. Take for example the following stage 1 measure as defined in the final rule :

“More than 30% of unique patients with at least one medication in their medication list seen by the EP or admitted to the eligible hospital’s or CAH’s inpatient or emergency department

(POS 21 or 23) have at least one medication order entered using CPOE”.
Huh? Think about it. What would the measure for this look like? Let’s say the measure looks like this: “% of patients seen by EP (Eligible Professional) in Emergency Department or Inpatient with at least one medication order entered using CPOE”.
Easy enough? Not so fast, my computer savvy analyst ( yes, you know who you are…usually known as the “data queen” in your organization). Think about the data elements you have to collect.
Let’s break down the measure into chunks to better understand it:
1. Number of patients who was seen by an EP (Eligible Professional) – Who are eligible professionals? (We won’t go into the definition here, but if you are so inclined, you can read page 358 of the meaningful use rule to find out.) Bottom line for you to make this measure work, you will have to find out the “type of provider”. This information is stored where now? In your HR database, I presume?
2. Seen in an Emergency Department or Inpatient facility: Ok, so what happens if a patient was seen both by your ER and then admitted to your Inpatient facility? No matter, we can work around it, by looking at whether the patient was treated by an ER doc before she was sent to inpatient, right? Where is the data for this? Well, the EMR guys should have this info for sure, right?
3. Medications that are on the medication list ordered by CPOE. Well, the EMR guys should have this data too, correct? Great. It’s 2 for EMR, one for HR!
4. Hmmmm….what is the fourth element? Do we have all we need? Not yet, data queen. To calculate this measure, you also need to know the total number of patients who were seen and who were ordered medications “without” the use of CPOE. Where is the data for that?!!! Your appointment scheduling system? Maybe your claims system? Doctors’ notes?
Final score? Measure – 1. DQ – 0. The point, I am making, is invest in a really good Informatics platform. The measures are not going away and they are getting more complex. Once in place, you, my dear DQ, will be able to pull this data at the click of a button, or better still, program it to run automatically and send a PDF to your boss as an email attachment!
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