A very interesting post at Thehealthcareblog on Meaningful Use, and why it might be wise to take a deep breath before a mad rush for implementation. Protima Advani has some very good points, may of which are relevant to pharmacists. A week or so ago we talked about what Stage 2 and 3 could mean for the pharmacist. Taking many key points from the article, it might be advisable to wait for more standardization and codification of data. In fact, some might recommend waiting as long as you can before implementation to ensure better adoption by HIT vendors. RxNorm is a current front runner for medication naming, and some data vendors are already supporting its translation database. However, we have a long way to go for codified Allergies, SIGs, and other components of medication order transmittal.
Most of meaningful use regarding medication use surrounds prescribing and actively maintaining pertinent information in patient specific lists. Without codification, it will be very difficult to achieve what many pharmacists consider true meaningful use of medication information. However, meeting the standard might be a few measures lighter.
One of the more critical points in the article surrounds adoption timeframes, and suggests that because the "first" year does not necessarily have to be 2011 it might be prudent to wait to implement. This is certainly a valuable agrument, but as a pharmacist I would challenge with advocacy for patient safety. Many hospitals and health systems are integrating EHRs this year, and meaningful use goes a long way in helping guide them to better patient safety. Providers and nurses are not accustomed to doing their work in computers, and this presents a risk to patient safety. As a pharmacist the more I can do to prepare my EHR, CPOE, eMAR, BCMA, and supporting systems for appropriate use, the better off patients will be. However, we should not sacrifice safety for speed of implementation. If you need the time, take advantage of it to improve the deliverable.
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