Meaningful Use can trigger high-performance culture
I believe it is a short sighted approach to consider Meaningful Use a 'reporting compliance' initiative to become eligible for incentives. The core objectives of MU are improving patient care and reducing healthcare costs by:
• Improving patient safety and care coordination
• Reducing health disparities
• Engaging patients and their families in management of their health
• Improving population and public health
Hence, the primary purpose of MU is to act as a catalyst for improving clinical, operational and subsequently financial performance of the providers. The measures to be reported on for MU compliance will become increasingly outcomes oriented from Stage 1 to Stage 3 criteria. Organizations that are approaching Meaningful Use from 'Reporting' perspective are likely to struggle trying to catch up with compliance requirements for next stage MU measures. At the least, missing MU compliance for the single year means losing out on incentives for that payment year. Long term implications would be being at competitive disadvantage compared to other providers who have taken MU as a stepping stone for promoting higher performance within their organization.
For improving clinical outcomes and operational efficiency, the focus should extend beyond MU measures to encompass next set of clinical and operational KPIs that directly or indirectly impact MU measures. For eg- the extended set of KPIs associated with MU measure for use of CPOE for medication order could be number of prescription errors, number of drug-drug, drug-condition interactions, number of delayed/missed prescription refills, percentage use of generic alternatives etc. These additional measures not only influence MU measure but also impact clinical outcomes and cost of care. By proactively measuring, monitoring and managing these extended set of KPIs, providers will experience higher performance levels and greater benefits realization from MU.
To achieve greater organization-wide efficacy for MU and higher performance, a strong metrics governance structure needs to be set up. Each person in the organization must be made accountable for metrics associated with their job function with senior managers taking responsibility of aggregated performance measures of their area of command. Metrics governance hierarchy results in greater accountability and ownership of performance measures at all levels. There should also be well defined processes for periodic review of performance measures, problem analysis of under-performing KPIs, revising benchmarks for consistently high performing KPIs and informed strategic decision-making to achieve higher performance levels.
