Blumenthal: Meaningful use must result in quality improvement, more time at bedside, less duplication

I know of a hospital who has already implemented a top tier EHR costing millions. This organization ‘gets it’. They are currently building a work-plan to see what additional work they must do to meet Meaningful use in time to qualify for 100% of the ARRA money. First blush—it will take tremendous amount of work for them to do it, but they will get there—if they choose to do so. They have a choice and the fact that they know that is their trump card.

If a hospital hasn't even begun the EHR process, as more than 80% have not, coupled with the more than fifty percent failure rates, I'd estimate their chances their chances of making the deadline at less than 1/3.

So, what to do? Stop and think. Ask the right questions. You have a choice of two strategies. Let ARRA money drive your decision, possibly implement it wrong, and probably miss the deadline. Then what do you have? Not much. Strategy number two; define your requirements, figure out what business problems you need the EHR to help solve, and buy the best one for you. Confused? Map out two work-plans for yourself. One work-plan that shows what you would have to do and what you would have to spend to meet the ARRA requirements. Draft a second work-plan that shows what you would have to do to implement what you really want. Compare the two plans and determine your deltas, your gaps.

Are you going to chase this for ARRA money? Because someone in Washington thinks you should do this?

Answer this question first. Is every hospital the same? Are you as good as the best, better than the worst? The EHR vendors think the answer is yes. Keep you processes the same, skip change management, and the implementation will be a breeze. We make every hospital look and operate the same. When did the EHR vendors become the best practice savants? The government thinks the answer is yes—that is why they are holding everyone to the same Meaningful Use standard.

One standard does not fit all hospitals—nor should it. Set your own standards and decide for yourself if you fit your version of Meaningful Use. ARRA money will end—then what? You’re stuck with your EHR. Get one you need.