Meaningful Use and ACO Reporting: Why an EMR Is Only a Partial Solution

data from multiple sources, and drill down and graphical trend data to the individual patient level in one report.  Texas Children’s Hospital did an analysis and found that on average one EDW report is equal to 10 EMR reports.

Compare the EDW reports shown below with the sample EMR report provided above, noting these key differences:

      • Integration of data from multiple source systems – staffing, labs and radiology, risk acuity, department capacity, financial, etc.;
      • The ability to drill down to the individual patient level;
      • Use of filters and tabs to view the data based on user selected criteria, including care pathways;
      • Graphical trending data without the manual exercise of combining separate reports; and
      • Use of visual tools such as heat maps that quickly show when arrivals exceed discharges by hour and day.

Healthcatalyst EMR Report

Single Patient flow emr report

EMR Summary


2.      Binding data into an EMR limits or eliminates the ability to multipurpose the logic that goes into reports.

Meaningful use is just one of many reports that healthcare organizations create. Using the example shown above one can see the ED measures are reported to CMS and TJC.  The ability to define and aggregate the logic across the various reports can help reduce the need for more staffing and enable patient safety and quality professionals to operate at the top of their license – moving from reporting to preventative care.

3.      EMR reporting is focused on a single-vendor, homogenous environments and only provides clinical data.

EMRs provide clinical data. Healthcare reporting requirements are expanding to include patient satisfaction, financial and operational measures. A healthcare EDW integrates these disparate data types and can provide measures that are required for organizations such as the Integrated Healthcare Association California Pay for Performance Program.

And what about the growing trend of mergers and acquisitions that create a heterogeneous environment with multi-vendor EMRs and point solutions? One of my colleagues described her healthcare organization’s meaningful use efforts as using “bailing wire” to piece together their EMR and other healthcare IT point solutions (ED, OR, etc.) in order to collect, aggregate, calculate and report meaningful use.  She was working in a community hospital, with one facility and one EMR vendor. EMR reporting becomes even more challenging as you look at reality of heterogeneous multi-system healthcare environments.

Healthcare EDW Versus Other Meaningful Use Point Solutions

Some clients who have come to the conclusion that an EMR alone will not meet their meaningful use and healthcare reporting needs have asked me about meaningful use point solutions.  I investigated one of these types of solutions, spending many hours in discussion with them about their data model and logic. In the end we found that is more effective for our clients – technically and financially – to take the Northwestern and Intermountain Healthcare approach of deploying a healthcare EDW.

Northwestern was one of the first organizations to qualify for meaningful use incentives with an EDW and achieve certification.  Clients can mistakenly think that only an EMR can be used for reporting due to certification requirements.  An EDW can be certified as demonstrated by Northwestern who received certification through the Certification Commission for Health Information Technology (CCHIT).

Healthcare EDW: Enabling Healthcare Reporting and Analytics

A healthcare EDW provides near real-time multi-dimensional reporting that allows you to monitor, understand root cause issues and make corrections well in advance of when reports are due. It enables aggregation of clinical, financial, patient satisfaction, operational and other data across heterogeneous environments and provides a platform for streamlining your internal and external reporting needs.

And when you deploy an EDW platform you can use the data logic for much more than meaningful use and ACO reporting. With a few modifications, you can also use the logic to help with internal clinical quality improvement programs, population health and predictive analytics, enabling you to meet all eight stages of the Healthcare Analytics Adoption Model, which is similar to the seven-stage EMR Adoption Model (EMRAM) from HIMSS Analytics.

Healthcare Analytics Adoption Model

Healthcare analytics adoption model

Want to know more about meaningful analytics? Learn how to move from meaningful use to meaningfu analytics. What do you think about the proposed delay of Stage 3? How are you satisfying your meaningful use, ACO and internal and external reporting needs?

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