Meaningful Use & Value Based Purchasing - What the OR Can Expect

Meaningful Use sets specific objectives that eligible professionals (EPs) and hospitals must achieve and attest to in order to qualify for CMS incentive payments. Since the incentive payments are upwards of several million dollars for many hospitals, attesting to Meaningful Use has been an initiative at or close to the top of many hospital leaders’ agendas. However, hospitals are struggling to meet attestation deadlines and requirements due, in part, to lapses of interoperability within their organization(s).

One requirement that has been a challenge has been capturing anesthesia related data elements for the electronic reporting on quality measures.  Meaningful Use Stage 1 requires that hospitals electronically capture and include anesthesia types (in codified formats) as well as anesthesia start times and stop times in their quality measure calculations. The electronic capture as well as the interface of this perioperative data with the hospitals’ clinical systems has the organizations spending thousands of dollars and dozens of man hours on data extracts and interfaces to amalgamate perioperative and clinical system data...  even when the applications are from the same vendor…

It is anticipated that Stage 2 and 3 of Meaningful Use will require even more perioperative data elements and, therefore, the band-aid approach to Stage 1 may not be sustainable. As a result, the focus will turn to perioperative system optimization and workflows to ensure that:

  • required perioperative data elements are being captured appropriately;
  • data elements are being codified to specifications; and
  • data is able to be seamlessly integrated with the hospital-wide clinical systems / electronic health records.

Value Based Purchasing (VBP) stands to have a much more significant impact on perioperative performance.  It too, is a CMS driven initiative that is aimed to improve the quality of care that patients and other consumers of health care services receive (in addition to improving quality care it is also focused on increasing “consumer” satisfaction and decreasing costs).  Under VBP, hospitals are given performance scores and seventy percent of their total performance score will be based on the clinical process of care and outcomes measures and there are significant financial penalties tied to performance.  An initial focus of VBP is on clinical process of care and outcome measures with a particular emphasis on the Surgical Care Improvement Project (SCIP) Program.

In order to prepare for VBP, hospitals and consequently ORs as well, are encouraged to:

  • Review the final listing of clinical process of care and outcome measures (which can found by searching “Final Measures for FY 2013 Hospital VBP Program”).
  • Review the organization’s current measures and survey results as submitted and reported on the Hospital Compare website to national averages as well as for accuracy and completeness.
  • Identify and focus on clinical care and outcome measures that are below national averages.

Due to the emphases on SCIP and the significance of the potential financial penalties associated with VBP, it is certain that the OR performance and analytics will be high on the hospital administrative agendas.

Feel free to contact us for more information on the role of perioperative services and how you can help position your organization for success in the era of Value Based Purchasing and Meaningful Use.