Don't Opt Out of Meaningful Use Just Yet

Talk to physicians about meaningful use and it’s likely to conjure up images of long hours and mountains of paperwork. But even while there is considerable talk of physicians electing to opt out of the program, despite the penalties, the reality is there are many benefits, both financial and clinical, of staying in.

The key, says Chris Tashjian, MD, president of Wisconsin-based River Falls, Ellsworth & Spring Valley Medical Clinics (RFMC), is to have a plan.

“When we looked at meaningful use, we asked, ‘What do we want to make it do?’” Tashjian recalls. “Then we looked at the meaningful use guidelines, and we could not find one guideline that didn’t include care. So, our basic philosophy was, if all these things are going to improve care, then why wouldn’t we [opt in].”

Determining your focus

Tashjian says that while many physicians and medical practices focused on meaningful use for how much money it would bring in, his clinic instead wondered how meaningful use was going to change the care the clinic provides, and how meaningful use could improve the care provided.

“That made it a much easier decision for us,” Tashjian says.

The other thing Tashjian understood was that medical practices regularly need to attract good, young talent, and without an electronic medical record, that was not going to happen. If RFMC was going to have an EMR, it had to be one that would provide the data needed to measurably improve care.

Not only did meaningful use money help fund the EMR, but the clinic was able to do simple things like put printers in every exam room. According to Tashjian, being able to print right in front of the patient enhanced the care they provided and delivered.

“The electronic age is calling,” he says. “You can only ignore it for so long. And meaningful use actually provides the framework and the guidelines on how to use it, so that you can practice better medicine.”

Benefits you can’t buy

Tashjian credits much of the success his clinic has had regarding meaningful use to establishing a positive working relationship with its regional extension center, the Wisconsin Health Information Technology Extension Center (WHITEC), which helped Tashjian and his colleagues develop their plan.

“They didn’t tell us what to do, but they asked questions like, ‘What do you expect to get out of your EMR?’” Tashjian says. “They guided us to choosing the right EMR. Because I’ll be honest with you: it’s a big enough investment that if we chose the wrong one it could put us under.”

RFMC chose the right one: an EMR that enabled the clinic to identify all its hypertensive, or heart disease, or diabetes patients who were not under control. That’s when the clinic was truly able to turn the corner.

“There’s no way medicine can be as good if you rely on paper or you rely on memory, or you don’t have a system in place,” says Tashjian. “If you choose to ignore this, then you’re going to choose to practice less than optimal medicine.”

Patients noticed the difference—a benefit that Tashjian says is priceless.

“Patients said, ‘Wow, my doctor actually called me up. He actually cares about my health,’” he recalls. “There’s no amount of meaningful use money that can make up for that.”

The bottom line

Tashjian says the clinic planned for a slowdown during the implementation of the EMR, including seeing fewer patients. But after two months they were back to seeing as many, if not more, patients than before the transition. And by the end of the year the clinic’s bottom line was up, not down.

“We’ve actually gained patients,” he says. “We’ve actually improved our revenue stream. And this is all alongside of meaningful use.”

The clinic has since invested in a patient portal, penetration for which is currently at 15%. Tashjian would like to see it reach 50% or 60%, and believes it’s just a matter of time and getting the word out to more patients.

“You can’t hide anymore,” Tashjian says. “The electronic record is here, and it’s here to stay. I think what most people forget is that when we learned paper, those of us who are old enough to remember those days, it was difficult. It wasn’t natural to us. Just like the people transitioning from paper to electronic: it’s not natural to them. But it is natural to all the people coming out of residency. And it will become natural if we make the effort to do it.”