Embracing Proposed MU Revisions

Recently, the CMS and ONC announced a proposed rule that would provide additional flexibility to healthcare organizations and facilitate their continued participation in the Meaningful Use program in 2014. Before sharing our thoughts, let’s focus on what led to these proposed revisions.

In something of a domino effect, delays in the certification of EHR products to 2014 Edition CEHRT have delayed the installations and implementations of updated EHRs for provider organizations. Without the certification, organizations cannot successfully attest to meaningful use in 2014. So, the proposed changes announced by the CMS and ONC suggest providing healthcare organizations the option to participate in the Meaningful Use program by either utilizing the 2011 Edition CEHRT standards, if their EHR does not yet meet the 2014 Edition CEHRT standards, or using a combination of the standards. Come 2015, however, all reporting would still be required to use the 2014 Edition CEHRT.

Another component of the proposed rule is the extension of Stage 2 Meaningful Use through 2016 and the postponement of initiating Stage 3 to 2017, which was included in an effort to encourage the continued adoption of CEHRT by healthcare organizations.

Now, let’s take a step back to our HIMSS14 survey, where 70% of respondents indicated that their organizations had not yet maximized the full potential of Meaningful Use. Shane Pilcher, vice president here at Stoltenberg Consulting, has emphasized time and again that Meaningful Use is a marathon – not a sprint. The reason healthcare organizations that have achieved Meaningful Use are unable to see its full potential is the same reason other organizations struggle to successfully attest: everyone is in the “sprint” mentality.

The changes proposed by the CMS and ONC are not merely offering flexibility – they are giving providers a chance to run the marathon that is Meaningful Use. In the grand scheme of things, we have to look past rules, programs, successes and failures that tend to force healthcare providers into the “sprint” mentality of getting things done to meet requirements, receive incentives and avoid penalties. To push the industry forward as a whole, we have to refocus our perspective on the end goal, which is improving the healthcare system. And if we’d like to arrive at this objective, we need all healthcare organizations, in their varying stages of Meaningful Use, to build a momentum of progress in unison.

As the saying goes, progress is progress, no matter how small. The proposed revisions to Meaningful Use would support such sentiments by allowing all healthcare organizations to maintain their progress in deploying and optimizing their technologies. The successful adoption of EHRs will lay the bricks crucial to building a strong foundation for the improvement of healthcare, which is why a culture of encouragement must be fostered around it for all providers. Clinging to the rigidity of rules and agendas will lead to providers dropping out of the Meaningful Use program and leave them hindered in the journey to deliver better care.

So, the changes proposed by the CMS and ONC should be embraced and implemented – because how successful we are in improving healthcare cannot be measured in terms of those who meet the requirements of a program and those who don’t. It must be measured by the cumulative progress towards the greater goal, by all participants. And at the end of the day, that will be the biggest contributing factor in allowing healthcare organizations and professionals to deliver a new, improved healthcare system.

Overcoming Barriers to Meaningful Use Achievement

What are the barriers holding organizations back from achieving Meaningful Use? The majority of responses to our survey conducted at HIMSS14 indicated the biggest barrier as a lack of resources (50%) while other responses noted restricted timeframes (23%), lack of buy-in from the organization (15%) and competing IT projects (12%).


As we near the close of our HIMSS14 Industry Survey blog series, we ask, how do we address a lack of resources? While they can’t exactly grow a few money trees to solve their issues, organizations can take the following steps to better address the problem.

Planning & Strategy
Giving proper attention to both short-term and long-term planning behind implementations can enable organizations to strategically allocate existing resources in a manner that maximizes their efficiency, delivers results and minimizes the gaps created by a lack of resources. Placing significant planning and strategy towards the utilization of staff resources also helps prevent the burnout, and potential resignation, of current staff due to high levels of stress and exhaustion.

Building the Right Staff
Last year, the 2013 HIMSS Workforce Survey reported that nearly 80% of healthcare providers and IT vendors planned to hire additional staff but almost a third of organizations had to place IT initiatives on hold due to staffing shortages. Beyond that, 43% of the organizations and 56% of vendors blamed such shortages on the lack of a qualified talent pool. 

When you can’t find a qualified talent pool, work to create one. Organizations must invest in the hiring and training of their future workforce. They can do so by establishing partnerships, such as university programs, to educate, offer internships and eventually bring on the right candidates. Organizations can then develop internal training programs that utilize senior members to help new workers learn quickly and become highly competent HIT professionals. A great example of such a program is our own Junior Consultant Program. A proper focus on building a strong foundation for the next wave of HIT professionals via an emphasis on thorough training and HIT education is beneficial to healthcare as a whole.

As limited budgets and staffing issues cause their IT initiatives to suffer, organizations can utilize outsourced HIT services as a cost-effective and experienced solution for success. By identifying the areas and functions that would benefit most from the application of outsourced professionals and services, organizations can avoid overworking internal staff and exhausting already limited time and resources.

An example of how an outsourced service can greatly benefit an organization’s staff and resources can be indicated by the help desk function. Some areas critical to the success of a hospital or healthcare organization include the well-being of their IT analysts and the satisfaction of their end users – both of which can be positively affected by a successful help desk function. An outsourced help desk service line that is well established in the industry can deliver what an internal help desk sometimes cannot: an already considerable knowledge base, experience with issues and resolutions from working with other organizations and 24/7 reliability and functionality possible through its virtual and remote nature.

As illustrated in the case of the help desk function, outsourcing is a capable middle ground when resources are limited and staff workload is already high. Additionally, the significantly reduced operational time and costs outsourcing provides can be very valuable, as reflected by the forecasted growth of the healthcare IT outsourcing market.

Meaningful Use is a long road and one that requires an organization’s full attention and support to be achieved in a way that provides some return on investment. Resources will always fall short and the time we have will never feel like enough – so organizations must act proactively and strategically with what is available to do their part in working towards a successful future in healthcare. In the words of Teddy Roosevelt, “nothing in the world is worth having or worth doing unless it means effort, pain, difficulty” – a fitting caption for our journey to a transformed, improved healthcare system.

Maximizing the Full Potential of Meaningful Use

During this year’s annual HIMSS conference, we conducted our second annual industry survey to identify and address the leading challenges and topics in healthcare technology today. We set out to receive insights, opinions and perspectives from health IT leaders by asking five questions that incorporated the most often-cited subjects and issues from our customers, as well as our own observations on the current industry environment. Recently, we released the complete survey findings – find them here. The results painted an interesting portrait of the industry’s journey so far to a transformed healthcare system, and we’d like to dive deeper into what this all actually means in terms of the future.

This is the first post of our HIMSS industry survey blog series. We welcome your comments!

If your organization has met meaningful use, do you feel you’ve been able to maximize the full potential of MU?

Response: No (70%), Yes (30%)

I can’t say that I’m surprised by this response. It’s one we see and hear about often, particularly during an RFP process, and it’s a common sentiment from hospital IT staff and leadership who want to feel like the time and money being spent on meaningful use attestation has been worth the investment.

My response to them is this: The meaningful use process must be approached as a marathon, not a sprint. It’s far more than checking off a series of boxes in order to receive incentives and avoid penalties – and it goes beyond a “one and done” project that can be completed and forgotten about.

MU is a strategy, discipline and process that facilitates healthcare transformation and eases the transition to the things we all want to see in the near future, such as population health management, full patient engagement and value-based, accountable care. In most cases, HCOs need to adopt a marathon mentality to address new and emerging trends and developments, and best position their organization for success.


Changing the MU mentality from a 50-yard dash to a marathon can be done through a commitment to thinking “outside the box.” Some suggested ways to do so:

  • Identify trusted external experts and consultants with the perspective and experience to find “low-hanging fruit” in the form of measures, goals, plans, programs and projects. Doing so will prevent the wearing down of financial, human and technology resources as the healthcare organization strives to reap major dividends and position itself for subsequent stages of MU and healthcare transformation.
  • Cooperate, compromise and collaborate. Involve players from finance, operations and clinical care in MU discussions, decisions and short- and long-term planning. Also, network with other providers to discuss best practices.
  • Promote the significance of MU to your organization. Help professionals understand that MU is not another HIT project, tool or fad, but a long-term, organization-wide initiative and national movement aimed at data capture and sharing, information exchange among providers, patient engagement and improved outcomes.
  • Focus on the big picture, but remember the milestones. Avoid discussions only of final and proposed rules, objectives and comments to understand the function and scope of each MU stage and MU as a whole.
  •  Play up the relationship between the stages of MU and HIMSS stages 1-7. The Electronic Medical Record Adoption Model from HIMSS Analytics allows healthcare organizations to chart their accomplishments and compare “progress toward paperless” with other providers. Some organizations rely on HIMSS EHR adoption data to justify plans and programs to the C-suite and report MU accomplishments.
  • Look to industry resources for best practices, case studies and support. Among the organizations to reference are HIMSS, American Hospital Association, American Medical Association and College for Health Information Management Executives.

For more information:

Stay tuned for the remaining posts in our series!


A First-Time Attendee Recaps the HIMSS 2013 Conference




The New Orleans Ernest N. Morial Convention Center held 1.1 million square feet of HIMSS13 excitement.

The following post highlights a Stoltenberg Consultant Development Program team member’s HIMSS experience:

From March 3-7, the HIMSS 2013 Conference and Exhibition, the largest healthcare IT gathering with as many as 34,000 attendees, was held in New Orleans, LA.  It was my first time attending HIMSS, and I enjoyed every moment of it. Upon walking into the convention hall, I was surprised of the size and complexity of the booths before my eyes, and I couldn’t even see every booth. The isles stretched beyond my view, with booths set up for live demos, in-booth speeches, ER/ICU rooms, booths with a complete bar set up within it, and even booths spanning so large it was like walking in a house with multiple levels. Our own booth was set up with a Geodesic dome which was completely unique compared to the other booths. Trying to view all of the booths in the time frame allowable for the first day was not even a remote possibility. The range of possibilities and vendors that can encompass the words “healthcare IT” was astounding for a first time attendee to experience. I could not believe that this many people were invested in healthcare IT. Just the sheer number of EHR vendors was astounding, who were there to help healthcare providers meet government standards.

Stoltenberg’s booth theme Building a Better HIT Community featured a Geodesic dome and 12-foot fabric tree.

While surveying some participants and exhibitors, one issue stood clear as a major discussion at HIMSS 2013 and as a major discussion for the upcoming year, Meaningful Use. There is such a high demand for healthcare IT personnel, it is important to get the word out that clients need assistance with meeting government requirements. Every day, several educational sessions were offered for the major issues being talked about today, including Meaningful Use, Health Information Exchange, and ICD-10. I was able to attend a few of these educational sessions.

The floor was busy all week with attendees visiting exhibitor presentations, educational sessions, and live demos.

I was able to share my incite to attendees on what it is to be a Junior Consultant and the opportunities that I am gaining versus what I would have a few years ago when news grads were not given the opportunity to become consultants. The responses I received about the program were all very positive, with most people surprised that there is such a program available. I was also able to explain the work I have done on the Stoltenberg Help Desk and how beneficial it is for our clients.

HIMSS was a great experience to network and meet people, expand educationally, and to see what is occurring in the industry. As a new grad with limited healthcare industry knowledge, it was amazing to hear about new innovations that many major vendors are creating. It would have been great to be able to see every booth, but in the three days, it is not realistically possible.  Just remember, if you are a first time attendee, it doesn’t matter what type of shoes you wear! In the future I feel as though the conference may need to be extended in order to allow participants the ability to experience more of the booths, especially if the convention is going to keep growing as the years go by. Overall as a first time attendee, HIMSS was an overwhelmingly great experience on many levels.

Stoltenberg team members conducted an industry survey from the show floor to gauge hot topics for 2013.

Overcoming IT Challenges for Community and Rural Hospitals

With Meaningful Use (MU) in full swing, healthcare organizations are fully involved in planning and completing their tasks to keep them moving down their MU roadmap.  As of January 30, 2013, a FierceEMR article reports that incentive payments top $10.6 billion dollars. With over 355,000 hospitals and eligible professionals with active CMS registrations, the community and rural based hospital is one segment of the healthcare industry that is severely underrepresented.

The backbone of our healthcare system is the smaller community and rural hospitals located in communities across our nation.  The American Hospital Association totals the number of community hospitals at 4,973 with a total of 797,403 staff beds.  These hospitals account for almost 35 million admissions. With that kind of impact on our healthcare system, the loss of any community hospital would have dire consequences on the country as a whole.  If, however, these hospitals are not able to meet the MU deadlines, the Medicare and Medicaid penalties will cause them to close their doors.

In a Stoltenberg Consulting issue brief, Stoltenberg sat down with Char Wray, VP Clinical Operations and Information Systems/Chief Clinical and Information Officer for EMH Healthcare in Elyria, Ohio to get a CIO’S perspective on this issue.  During that conversation, Char examined the issues facing community hospitals. One of the greatest issues is how MU payments are structured. “The way MU payments are structured, a hospital needs to make an investment upfront before it receives any reimbursement.” It is because of this upfront investment that many community hospitals have not been able to embark on their MU journey and start moving toward attestation. Another large obstacle is that community hospitals typically do not have large IT staff in place to handle such a project. One of the often missed obstacles that can bring a community hospital to its knees actually occurs after they successfully implement their new EMR to start their MU attestation- the issue of providing their physician and end users the 24x7x365 support they need to utilize their new EMR so the organization can achieve their required numerics for submitting to CMS.  Due to the small IT staff, these issues becomes a costly scenario preventing their ability to meet MU unless the organization can partner with out-of-the solutions that meets their needs but fit within their budgetary constraints.

Providing insight on where smaller hospitals are finding help, Fred Bazzoli, Senior Director of Communications for the College of Healthcare Information Management Executives (CHIME) explained, “CHIME sees the need to reach out to rural and community hospitals in a really pointed way. These smaller hospitals have to put aside competitive differences and stay in contact with each other to facilitate information transfer.” Bazzoli also feels it is important for smaller hospitals to seek out experts in the industry who have experience implementing the required systems. Stoltenberg shares that view and that passion. Providing that out-of-the box solution is essential to ensuring the future of our community and rural hospitals. This passion will be a large focus of ours at the upcoming HIMSS13 conference in New Orleans, Louisiana.  Ensuring the success of our community hospitals directly impacts our individual health and we must do everything as an industry to guarantee their future.

Thank you for your time, and to our followers who will be attending HIMSS13 next week in New Orleans, stop by booth #4227. Check out the HITStoltenblog throughout next week for live blogging about conference hot topics and speakers.

To see the referenced article, go here.

Community Hospitals Moving Toward Stage 2 Meaningful Use

Community Hospitals Moving Toward Stage 2 Meaningful Use

Within the Feb. 7 EHR Intelligence CIO Series feature “Moving from Stage 1 to Stage 2 Meaningful Use” author Kyle Murphy interviews EMH Vice President of Clinical Operations and Information Systems/Chief Clinical and Information Officer Charlotte Wray, addressing the goals set for the community hospital system’s movement toward Stage 2 MU. Check out this piece tailored toward rural and community hospitals making note of the first-hand experience behind it.

Find the article here. 

Find out more about EMH here.