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Healthcare Policy & Reform | Meaningful Use

Opening the Kimono on Meaningful Use


jonathan bushWe’ve had a project here we’ve kept under wraps for the past few months. We call it “Open Kimono.”

The idea is pretty simple. We are providing, on our website, a dashboard view that shows exactly how all of the eligible providers on our network are doing on every Meaningful Use measure. You can view it here, and we’ll be updating it every two weeks so you can check back and keep track of our progress.

Why are we doing this? For athenahealth, this network-wide dashboard view is about providing real transparency on what it takes for physicians to achieve Meaningful Use of an EHR.

In our industry, transparency can be hard to come by, and lately there’s been a lot of talk on Meaningful Use that’s coming out both sides of the industry’s mouth. “Attestation” in this case, unfortunately, ends up substituting for reporting actual performance data. So we have decided to talk out of just one side of our mouth and encourage others in the industry to do the same.

At athenahealth, we advocate for both simplicity and a financial upside for doctors–we try to be the “best in world at getting docs PAID for doing the right thing.” Admittedly, when Meaningful Use first came out we were not huge fans of the program. But since it has become law, we have been going the distance for our clients to get them paid for it.

In the spirit of going the distance and delivering on our Medicare incentive guarantee, starting today we’re releasing the status of how providers in our Meaningful Use program are performing against all the CMS requirements.

If 68.5% are behind on, say, giving their patients written clinical summaries at the end of their visits – one of the toughest measures for providers to achieve – you will know it. In fact, they are – so now you know it! That’s real work for us to do.

As you can see in core measure #7–querying patients on race, ethnicity, and preferred language–4 percent aren’t doing it yet. More work for us to get them over the hump.

Being cloud-based, we not only know where providers are having a hard time, but why they are having a hard time and what we and they can do about it. And, we’re happy to talk to anyone about what we’ve learned. We think this type of real-time learning informed by real-time transparency will help our providers get over the Meaningful Use finish line, not to mention all the other finish lines that are coming up fast behind MU, from Stage 2 to ICD-10, etc.

And what if these gaps are not closed in time? Well, three things will happen:

  • Those clients won’t attest…
  • If we screwed up, we’d have to meet our Meaningful Use Guarantees…
  • And you will know the whole story.

Will other companies take the same responsibility?

Will others follow this example? Without the benefit of having every client on a single cloud-based network, software vendors are going to find this difficult, so maybe they won’t…

And maybe we’ll take all the heat for being honest and showing that Meaningful Use is hard. We’ll see. No turning back now.


All Things EMR | Healthcare Policy & Reform

EHR & HIT News Round-Up


  • There might be four, or is it three, employees of athenahealth who are not in some way working to ensure our eligible physicians achieve Meaningful Use of our EHR. And now that physicians are starting to attest and get paid, Meaningful Use is getting more attention in the press and other outlets. NEJM weighed in on the meaning of it all with a piece that casts doubt on the eventual benefits and CIO extraordinaire John Halamka, MD, points to the cloud, saying “I believe the only way to rapidly implement electronic health records is via the cloud.”  We are hearing a lot of good feedback from our doctors–and some complaints–but also that non-athena doctors are having a devil of a time with Meaningful Use. What have you heard?  
  • Every now and then, an article zooms through email accounts here at athenahealth and this piece on cloud-computing by Vivek Kundra was the latest. The reasons for going to the cloud are plentiful. Here’s one example, “Like a large office building, cloud data centers are efficient: many different tenants occupy the same space, sharing the same critical infrastructure, yet each tenant still has its own secure, customizable space.” Kundra provided tight budgets as yet another cause. We know that small medical practices with thin margins and even hospital systems that don’t want a heavy balance sheet commitment go to the cloud for the same reasons.
  • Two Harvard economists have expressed caution about the cost-saving effectiveness of ACO.
  • The onslaught of Hurricane/Tropical Storm Irene along the East Coast raised the question again of the medical record security. This came up a few months ago when a tornado hit Joplin, Mo. The main hospital there got hammered but they’d converted from paper to EHR so while the charts were blown into the next county, they’d been backed up.  We were also interested to see this advisory. How do you take your servers with you?? Do you rent a van? And then where do you go? What if the van sinks in the flood? Read like an advertisement for the cloud as far as we could tell!
  • There is also a storm gathering in the form of ANSI 5010. Maybe you’ve noticed the warnings from our federal government. You will hear more about this from us soon. There are a lot of people here doing a lot of work to make sure our doctors do not suffer from anything more painful than a hangover on Jan. 1, 2012.
  • If physicians are not prepared for the conversion, it seems many will plunge deeper into what’s been described as the “digital divide” that ONC has noted and wants to hear more about.
  • Finally, food. There was the news this week that half of Americans drink a “sugary” beverage of some kind very often, which is good news for dentists and corn farmers. Projections of an obese nation are grim. And while a widespread need for large trousers may hurt our chances at the Olympics, it also costs a lot of money to have a fat population. One financial forecast reported in Bloomberg put the price at $66 billion a year in 2030.

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