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Michael Brooks

The healthcare industry is reaching a point where information is recognized as a strategic asset that has a direct impact on patient care quality, safety, customer service, and the success of the organization. There is a great deal of interest, some terrific success stories, and many valuable lessons that can be used to improve the management and delivery of high quality healthcare information. In this blog, I'm going to try to keep things simple and focus on the real world strategies, processes, technologies, and resulting lessons learned by healthcare organizations as they strive to get more insight from their information based assets. If you have specific questions, topics of interest, or examples that you would like to share, I invite you to share them with the rest of us.

About the author >

Michael Brooks, Dearborn Advisors LLC, has more than 25 years experience in healthcare information systems, strategy development and business intelligence. During this time, he has provided information systems strategy and consulting assistance to more than 100 healthcare provider and payer organizations throughout the U.S. Michael is a service line leader in the Strategy & Value group of Dearborn Advisors, a healthcare professional services firm that partners with healthcare organizations to maximize their return on advanced clinical information technology investments. He can be reached at or (303) 499-6767.


Last January, the Office of the National Coordinator for Health Information Technology (ONCHIT) published the Notice of Proposed Rule (NPRM) which provided further definition of "Meaningful Use" and outlined the specific health IT functional measures and clinical quality measures for Stage I compliance. During the subsequent comment period, concerns were expressed by providers, vendors and other parties highlighting the fact that collecting and producing the required measures could be as challenging as implementing the software capabilities.

I believe the respondents concerns are well founded. For decades healthcare software vendors have focused on the automation of specific tasks and workflows while reporting and metrics were treated as a byproduct or the "exhaust" of the healthcare computing process. The result was a tremendous amount of "data noise" with limited content to let decision-makers at all levels understand where the organization stood and what actions were needed. To remedy the situation, extensive manual processes and spreadmarts were implemented to produce the reports needed by senior executives. To be fair, some HIT vendors recently begun to recognize that their customers need better reporting tools and have expanded their reporting capabilities but there is still a lot of work to be done.

On May 17th, the Centers for Medicare and Medicaid Services (CMS) awarded Northrop Grumman a $34M contract to develop a National Level Repository database to process HITECH incentive payments.  This database will store informatin about whether medical professionals and hospitasl are meaningful users of electronic health records, the date and amount of any incentive payments made to them and their tax identification number.  It will serve as a key component of CMS' infrastructure to collect, analyze and act on the data submitted by providers and will evolve as subsequent HITECH reporting requirements evolve.

While the term "Meaningful Use" has recently become in vogue, many leading healthcare providers have been investing in physician adoption, clinical excellence, and informatics for several years.  These pacesetters recognize that improving the quality of cost-effective care is impossible without the ability to capture and act intelligently on quality management and clinical information.  Many of these same providers also understand that the primary reason for pursuing these goals is to improve the quality and delivery of cost-effective care while the HITECH incentives are merely a temporary facilitator.  As government and payers collect additional information, providers must become more adept at using clinical and performance measures if they are to survive.

As Meaningful use requirements continue to evolve, it is clear that providers will need the data infrastructure and business intelligence capabilities in place in order to measure, monitor, act on, and submit the required measures.  Just as demonstrable excellence in care delivery requires measurable results, there is "no Meaningful Use without meaningful measures".

Posted May 27, 2010 10:00 PM
Permalink | 2 Comments |


Mike, great article. Something I tried to preach to folks at my last gig. Unfortunately those folks did not have time to listen to my thoughts and experiences. Meaningful use does mean proper measurements down the road, something most likely will go beyond functional boundaries commonly found in off the shelf products such as MEDITECH-DR. Government has some very tight mandates over performance these days and require mining the data and doing further analysis. Having worked on a warehouse in State Government, performance indicators and measurements were quite common warehouse activities. Offering Meaningful Use with that big financial carrot offered for participation, may end up hurting the smaller rural health care organizations. Many may have not envisioned what it would take to have the right trained people who can pull the data out, do activity over time measurements so they can say to CMS, yes we are performing within minimum requirements, or believe the data can tell them such.

Good article. This strikes me as a scenario of 'applied ontology'. You have these a plurality of data systems which all operate on a set of definitions dreamed up by a jungle of third-party software contractors and committees- and they all mean just slightly different things. There some efforts to ease these kinds of ontological difficulties, so I'm hopeful.

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