Healthcare providers starting from scratch with projects to implement e-health record systems in hopes of cashing in on the government's $20 billion-plus meaningful use incentive programs had better get going.It's going to take a while for healthcare providers to get those systems running and users trained on them, let along using their new digital records, e-prescribing, computerized order-entry and other applications in the "meaningful" ways the federal government will require before it sends out HITECH rewards to doctors and hospitals.

Certainly, healthcare providers are in a bit of a quandary: Even though the government's health IT financial incentives begin kicking in next year, the "meaningful use" compliance requirements for qualifying for those rewards aren't even settled yet, and it's already mid-2010. The Dept. of Health and Human Services expects the rules to be finalized and published by "end of spring."

Still, the near-final rules released earlier this year provide good clues about what's most likely to end up in the final version, aside from any tweaking the government makes after digesting the more than 2,000 public comments its received about the proposals.

Yet, the fact that the meaningful use rules aren't final yet is surely being used as an excuse by laggards to further procrastinate making a move toward adopting e-health.

But those dawdlers should heed the advice of healthcare providers that have already gone through the transition of paper to electronic records: It's going to take longer than you think to get everything running smoothly and to get clinicians using the systems correctly and effectively.

So, now's the time to figure out what your practice needs to do.

"Spend a lot of time with the planning side" advises Aman Bhasin, CIO at Preferred Health Partners, a 170-physician, multi-specialty practice with nine facilities in Brooklyn, N.Y.

Preferred Health Partners began rolling out its NextGen EHR and practice management system in 2004, and by 2007, the group became "100% paperless," he said.

But even with six years (not six months)of e-medical record and other health IT tools use under its belt, Preferred Health Partners is still doing tweaking to make sure the practice will meet the various upcoming meaningful use requirements.

"Of course we're still waiting for the final meaningful use draft," he said. The practice is "not overly concerned" but it's also not being "nonchalant" about making sure it's doing what's needed to comply to the approaching meaningful use regs.

"We don't want to leave money on the table," he said.

So, Preferred Health Partners is forging ahead with work that were planned anyway but will also likely bolster the practice's "meaningful use" compliance, as well as help the group achieve other goals and milestones.

Among those "enhancements" are ensuring that e-prescribing--which Preferred Health Partners implemented last year--is used by its clinicians 75% to 80% or more of the time; participation in initiatives to facilitate data exchange with clinicians outside of the Preferred Health Partners' immediate circle; and the rollout of a patient portal.

The Patient Portal is also expected to help Preferred Health Partners achieve patient-centered medical home certification from the National Committee for Quality Assurance, Bhasin said.

Historically, digitizing medical records "is a long process" for healthcare providers, said Bhasin.

But with so many laggard organizations in the same boat attempting to do this all at once, healthcare providers and their vendors should benefit from the "momentum" in the industry right now, as well as the lessons learned and work perfected from earlier adopters like Preferred Health Partners.

"The wheel isn't being reinvented, it's being rerun," and so the struggles encountered in earlier efforts should be ironed out more easily now that others have had a chance to examine and learn from them.

"Do your homework," said Bhasin. "Your biggest challenges won't be infrastructure, uptime, technology--it's whether your doctors will accept and use" the e-health tools, he said.

Make sure project management is solid, that your workflow is understood, and that you engage your clinicians, he said.

"You have a lot of work ahead of you, be prepared."

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