Meaningful Use in Behavioral Health | Taming the Wild Wild West

There’s a certain allure to western movies. Of watching the main hero overcome the Wild West and all it entails, gun fights, train robberies, stampedes, fellow cowboys without the good-side the hero inevitably has. The central conflict and the main character will change with each movie, but one aspect of the movie is always consistent. The hero always wins.

Meaningful Use Cowboy

The Wild West

Before Meaningful Use (MU), there was little structure within the electronic health record (EHR) network - it was like the uncivilized American frontier. Software companies could, and did, provide and change whatever they wanted to and whatever they felt would give them a competitive advantage over others.

Behavioral health clients typically chose their treatment provider based on the level of care and their personality. Essentially, whoever made them feel more comfortable. This is particularly true in the behavioral health world, as clients in need of mental health or substance abuse treatment often take longer to fully open up to their provider. If they trust them from the beginning, they’ll be more willing to share and move forward in their treatment plan.

What doesn’t factor into their decision is which EHR their provider selected or whether or not that EHR could communicate with another one if the client ends up switching providers down the road. Or if their provider even has an EHR - some still operated using paper charts. In these cases, the first provider would print off the client’s chart for them to give to their new provider. This is not an ideal client experience - it can be complicated and stressful.

Meeting the Hero

Meaningful Use is like the hero of a western movie constantly trying to tame the American Frontier. Especially Meaningful Use in behavioral health. But instead of wielding guns on horseback, it’s trying to corral the EHR network.

This is where Meaningful Use aims to use certified EHRs to advance care coordination; maintain privacy and security of patient health information; improve quality, safety, and efficiency of care. If providers commit to using EHRs and achieving MU, they’ll have better clinical outcomes, increased efficiency, and empowered individuals. Additionally, providers will qualify for incentive programs if they implement a Meaningful Use certified EHR software system.

Meaningful Use was originally introduced as a facet of the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009. HITECH aimed to have everyone in the healthcare world-doctors, nurses, clinicians, hospitals- using an EHR system in a manner that results in better and more efficient patient care.

The Stages of MU

To accomplish Meaningful Use, it’s broken down into three stages. Each stage has unique objectives and is an important building block to achieving the overall goal of improved patient care. Providers will receive incentive funding if they complete objectives within each stage. Health Information Technology broke down each stage into a list of criteria:

Meaningful Use Stage 1

While in MU-1, providers focused on the following criteria:

  • Electronically capturing health information in a standardized format
  • Using that information to track key clinical conditions
  • Communicating that information for care coordination processes
  • Initiating the reporting of clinical quality measures and public health information
  • Using information to engage patients and their families in their care

The overarching goal of MU1 was to convince healthcare providers of the benefits to switching to an EHR and to improve data capture and sharing.

Meaningful Use Stage 2

Now that most healthcare providers had switched to EHR systems and improved data capture and sharing in MU-1, MU-2 pushed them to advance their clinical processes.

MU-2, introduced in 2014, was structured around specific criteria:

  • More rigorous health information exchange (HIE)
  • Increased requirements for e-prescribing and incorporating lab results
  • Electronic transmission of patient care summaries across multiple settings
  • More patient-controlled data

MU-2 should make it easier for providers to share patient health information among each other and for patients to become active in their own care.

Meaningful Use Stage 3

Currently, we are in the MU-3 - the final stage. Introduced in 2016, providers were encouraged to seek their updated MU certification in 2017, but were not required to do so until 2018. The main goal of MU-3 was to improve outcomes.

Providers with MU-3 certification would achieve this goal by focusing on certain criteria:

  • Improving quality, safety, and efficiency, leading to improved health outcomes
  • Decision support for national high-priority conditions
  • Patient access to self - management tools
  • Access to comprehensive patient data through patient-center HIE
  • Improving population health

By improving and simplifying access to patient information, MU-3 makes it easier to improve patient outcomes.

Prepare for the Final Showdown

When you’re watching a Western movie, the last few minutes inevitably pull you to the edge of your seat as you anxiously await the final fight scene. Whether the hero goes against his enemy armed with a rifle, whipping a lasso, or throwing old-fashioned fisticuffs, the final fight scene dramatically and fantastically brings the conflict to a resolution. But what if our hero didn’t load his rifle or didn’t check the strength of his rope? These tools would have been useless in a fight and he would have lost.

As Meaningful Use prepares to tackle the healthcare world, they need to check their tools so that they won’t lose. Just as our hero should make sure his rifle or rope is ready to go, MU needs to check their EHRs.

Providers need to do more than just implement an EHR system. They need to use it correctly and select the right one. Their EHR should be easy to use and match the organization’s business process. It should also make it easy to share patient information with the patient and other providers.

Into the Sunset

EHRs are integral to completing MU’s goals. When an EHR is used correctly, it makes the provider’s job easier which helps them to improve patient outcomes and quality of care. If Meaningful Use can rely on EHRs to support their goals, they’ll be carried to success just as our cowboy would rely on his trusty steed to carry him into the sunset in the movie’s final scene.

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