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Meaningful Use: One Health System’s Journey

While most hospitals are focused on CMS’s release of the draft Stage 2 rules for Meaningful Use last week, now seems a good time to take a look back at how one health system managed to succeed with Stage 1. After all, more than half of all hospitals have yet to attest to Stage 1.

Summa Health System, where I work as lead quality and clinical analyst, is one of the largest integrated healthcare delivery systems in Ohio, serving more than 1 million patients each year in comprehensive acute, critical, emergency, outpatient and long-term/home-care settings. Summa includes eight hospitals, more than 1,500 physicians and 11,000 employees overall. Nationally renowned for excellence in patient care, Summa implemented the Sunrise Acute Care Electronic Health Record (EHR) from Allscripts in 2003.

(Editor’s Note: Steve Shaha, Ph.D. wrote last week about Summa’s success using Sunrise to drive significant improvements in stroke care).

When President Obama signed the HITECH Act in 2009, we began planning to attest to Meaningful Use under the law. In 2010 we upgraded to the Meaningful Use-certified version of Sunrise, which meets the requirements of HITECH including Computerized Provider Order Entry (CPOE). But HITECH also requires hospitals to calculate complex clinical quality measures as part of their Meaningful Use attestation to CMS.

So beginning in December 2010, Summa Akron City and St. Thomas Hospitals – our two largest facilities –  collaborated with Allscripts to identify workflow changes necessary to support attestation. In May 2011, we began implementing Sunrise Clinical Analytics, a business intelligence tool that extracts quality data from our EHR, and then calculates the measures as required by the CMS specifications.

Customization along the way

Because Summa captured home medication history by way of a Structured Note, our team had to build special rules into Sunrise Clinical Analytics to make stroke indicators extractable. Working with Allscripts, we added a mandatory field within the EHR to capture this data. A strength of Sunrise Clinical Analytics is that it can usually be configured to accurately calculate quality measures, even if needed data is not found in the default SCA components.

We completed the Sunrise Clinical Analytics implementation in just two months and began our 90-day Meaningful Use reporting period on June 28, 2011 almost immediately after the go-live.

Getting Sunrise Clinical Analytics installed and live, and the organization ready to report the clinical quality measures to CMS through attestation was quite a major undertaking. Fortunately Allscripts had the right resources from services, support, and development to support the implementation. We also attended a tremendous client workshop in June focused solely on quality measure configuration, so it was a great partnership and in the end we were successful.

On October 10, 2011, after finishing our 90-day attestation period, we completed the process using Sunrise Clinical Analytics to extract, analyze and submit Meaningful Use quality data from the EHR. We were certain that the attestation had gone well – a view that was confirmed when CMS delivered a check for $5.1 million that same month.

Future uses

While Sunrise Clinical Analytics fulfilled its promise with Summa’s Meaningful Use success, that was just the beginning. I’m excited that the solution aligns with Summa’s organizational initiatives on improving quality. It’s in its infancy stage now and we plan to use Sunrise Clinical Analytics far beyond Meaningful Use.  In fact, my team is already using the solution to analyze data, look for trends and improve care for delirium, diabetes, congestive heart failure and other problems.

The partnership between our organization and Allscripts is strong and getting stronger. Allscripts recognizes the importance of getting input from customers because we’re the ones using the application to care for patients. Working together, there’s no telling what creative ways we’ll find to use Sunrise Clinical Analytics in tandem with our EHR to improve the care we provide our patients.

Editor’s note: This post was authored by Linda Gleespen, RN, BSN, lead quality and clinical analyst for the Summa Health System of Akron, OH.

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