When I ask a room of 100 health plan leaders, “how many of you know what HL7 is,” and only a third raise their hands, I realize there had been a “Meaningful Use” for my recent travels through the healthcare provider system and its maze of regulatory and payer mandates. I navigated change management hell in order to inform my future endeavors. I came out on the other side of an attestation nightmare with the knowledge to educate others who are embarking on extensions of that journey. This “Eyes Wide Shut” series has come full-circle.
For those who have followed this series, a quick update on the fate of the IDN highlighted throughout earlier posts: they have not yet successfully attested to all Meaningful Use Stage 2 measures across all the inpatient facilities and ambulatory practices. However, the continuing changes to attestation criteria (specifically, the engagement measures that caused so much consternation) may allow them to squeak in under the wire in fiscal year 2016 before penalties kick in. Although I’m no longer directly involved in the IDN’s pursuit of multi-EMR integration excellence, I am a “beneficiary” of those encounter data normalization efforts, as I am back to working with payer clients who are leveraging this clinically-integrated network. And I’m still having to adjust for inconsistencies in identity management rules, coding practices, and clinical workflow differences across each of the offices (and departments within offices), as I integrate their information with the insurer’s data ecosystem.
I began this series on my (woefully neglected) personal blog, almost 2 years ago: Eyes Wide Shut: Seeing the Dark Side of Health IT Mandates and Meaningful Use. Coming from the health insurance world, I had no idea of the magnitude of healthcare provider process impacts resulting from regulatory and payer demands (nee, mandates). I was insensitive to the plight of the independent general practitioner, and the size of the budget required to implement a certified EMR, let alone populate it with any patient history or integrate it with existing scheduling or billing processes. I didn’t realize that my request for chart data to support HEDIS measures would involve more work than simply clicking an indicator in an EMR configuration screen to suddenly send me my heart’s desire of data elements. I would never have believed that certified software would not be tested for conformance to code-level specifications (only visual output tests).
To all my clinician and provider office-worker friends: I am sorry for all the ways in which this ignorance may have contributed to the new reality forced on practitioners of medicine to also be data-entry clerks/contract lawyers/IT experts. Personally, I want my doctor to be my doctor. So, I’m dedicating the next leg of my career journey aligning all healthcare system actors to what should always have been our higher purpose: contributing positively to the health and well-being of the individuals and populations we serve.
When I initially began writing this post, I thought I’d be using it to end the series.
Instead, I’m just embarking on a new chapter: the post-provider world of healthcare actor convergence.