Meaningful Use can cost millions, even after EHR purchase

How much does Meaningful Use cost a healthcare system, beyond the initial price of electronic health record hardware and software? The CIOs of three systems gave answers to that question in a wide-ranging discussion at CHIME's Fall CIO Forum in San Antonio.

Karen Thomas, vice president and CIO of Mainline Health, said her system--which includes four acute-care hospitals and 400 physicians eligible for government EHR incentives--has spent between $3 million and $4 million on its Meaningful Use effort across inpatient and ambulatory care. That's less than the Philadelphia-area healthcare system expects to receive in Stage 1 Meaningful Use rewards, she said. But the incentives will be less than the total amount invested in the EHR system, she added.

Linda Reed, vice president of information systems and CIO of Atlantic Health System in northern New Jersey, said her organization probably will spend about the same as Mainline on Stage 1 of Meaningful Use. Atlantic is a three-hospital system with 1,300 beds and about 300 employed physicians.

Mike Mistretta, CIO of MedCentral Health System, which includes two hospitals in Mansfield and Shelby, Ohio, said his organization had spent just $100,000 on a software upgrade to help it qualify for Meaningful Use. MedCentral did not hire any additional staff for the initiative, he noted.

MedCentral was the first hospital in the U.S. to attest to Meaningful Use, Mistretta said, and has already received its incentive payment for Stage 1. Mainline and Atlantic don't plan to attest until 2012 because of internal issues and organizational priorities, respectively.

Reed said that one of the biggest issues in moving a healthcare organization to Meaningful Use is keeping the key players involved. "For the C-suite, Meaningful Use is yesterday's news," she pointed out. "You have to keep it in front of everybody's face every day, or it won't get done."

She also cited staff burnout as a key problem because of all the upgrades and implementations that must be done across the healthcare system.

Both Reed and Mistretta emphasized that Meaningful Use goes way beyond health IT. "It's not an IT project," said Mistretta. "Ninety percent of what you have to do is clinical-based."

In response to a question about who owns Meaningful Use, the CIOs said that they alone were not being held responsible for the success of the Meaningful Use effort. Thomas noted that the clinical leaders in her organization had bought into the EHR effort and that the whole team understood their role in adoption.

Similarly, Mistretta observed that MedCentral had allocated responsibility for Meaningful Use initiatives to several different executives, including the chief nursing officer, who had taken ownership of nursing tasks.

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