Doctors and other eligible healthcare providers, such as dentists and nurse practitioners, who meet the federal government's upcoming meaningful use criteria for health IT could earn up to $44,000 or $63,000 each in incentives depending on the patients (Medicare or Medicaid) they treat. But meeting those criteria won't be easy. A new CSC report lists the top ten challenges healthcare providers face in cashing in on the incentives.Meaningful use criteria will come into effect in three incremental stages. Stage one starts in 2011, followed by stage two in 2013, and stage three in 2015. Healthcare providers have until end of 2014 to achieve any of the stages, but the more stages they achieve before 2015 the bigger the payout in meaningful use bonuses they'll get. (By 2015, penalties will begin kicking in for non-compliance.)

Right now, it's estimated that fewer than 6% of the nation's healthcare providers have health IT--such as e-health records and computerized physician order entry systems--in place to meet even stage-one meaningful use requirements, said Walt Zywiak, a CSC principal researcher in an interview with InformationWeek.

"Many healthcare providers are still trying to figure it out," in terms of the basics, like picking out the software and other technology they'll need in their practices, let alone the workflow and other issues they'll also need to tackle, said Zywiak, who is also a co-author of the new CSC report, Meaningful Use For Eligible Providers: The Top Ten Challenges."

With so few healthcare providers on track right now for stage-one compliance, there will also be a scramble for health IT talent to help implement these systems, said Zywiak. The government's HITECH program creating dozens of "regional extension centers" across the country to help assist doctor practices and hospitals should help some, "at least that's the plan," he said.

In the meantime, CSC has pinpointed the top challenges eligible healthcare providers face in meeting stage-one meaningful use requirements. Here you go:

1. Capture the data--that includes collecting and entering data in a structured formats so that data can be sorted and selected for reporting purposes, said Zywiak.

2. Establish effective workflows to reinforce data entry, including medication reconciliation. For instance, "often, an organization's workflow needs to be modified to make sure data is entered," while patients are being cared for, whether it's vital signs like blood pressure or allergy updates, said Zywiak.

3. Drive provider involvement in adoption of the EHR. "The primary users of these systems need a say" in what's selected, said Zywiak.

4. Computer-based provider order entry (CPOE). "In ambulatory settings, 80% of orders, including tests, referrals and medication prescriptions, will need to be entered electronically," he said.

5. Start e-prescribing. "Do this as soon as possible," he said.

6. Develop a process for managing clinical decision support. This could include different clinical reminders for individual doctors in the same multi-specialty practice. For instance, a primary care doctor might need different alerts than a dermatologist caring for the same diabetic patient.

7. Implement patient health information exchange workflows. As a healthcare provider, "you've got to provide patients access with information--but will you do this via a patient portal or through a [third party] personal-health record" site, such as Google Health, said Zywiak.

8. Formulate a provider health information exchange strategy. "How will you exchange patient summary data with hospitals, specialists?," he said.

9. Ensure privacy and security compliance. "Most primary care organizations haven't been on an EHR, so they think of HIPAA in terms of protecting paper-based information," he said.

10. Initiate EHR-based quality performance measurement support. "You'll need to report quality measures to Medicare and Medicaid," he said.

What's your biggest meaningful use headache so far? Tell us how you're planning to tackle these challenges, and what tips you suggest to others.

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