Box Butte General Hospital (BBGH) CEO Dan Griess (at left) used his monthly Governance/Strategy Focus report during the Board of Trustees regular meeting held Monday evening to inform them of his participation in a virtual hearing with the national Health Information Technology Policy Committee on BBGH’s experience with Meaningful Use implementation. Meaningful Use defines the use of Electronic Health Records (EHR); establishes a set of standards that are standard nationwide for portability, as defined by the Centers for Medicare & Medicaid Services (CMS); and establishes funding incentives or penalties for hospitals that meet or do not meet minimum standards in core categories.
The hearing took place over a three hour period Tuesday, May 20, with Mr. Griess one of five individuals giving testimony. The first 90 minutes were devoted to testimony from physician representatives, with the last 90 minutes allocated to hospital representatives. Mr. Griess focused his comments on the key challenges and success factors in the hospital’s experience with meeting the requirements of Electronic Health Records (EHR) Stage 2 (EHR Stage 1 has already been implemented), and his advice to the Policy Committee for EHR Stage 3 that stem from that experience, as well as the benefits and costs to BBGH and its patients from implementing an EHR and pursuing Meaningful Use.
Mr. Griess told the Trustees that “being chosen was an exciting opportunity. A journal called Health Data Management actually picked up my testimony. What really pleased me was the fact that their highlighted comments were from individuals representing rural health care.”
He said his testimony focused on the fact that the implementation of Meaningful Use was moving too fast for vendors to meet deadlines in an efficient, cost effective manner. “For example, we’ve had a relationship with Healthland, our vendor for EHR and financial software, for 20 years. Deadlines established early on to meet the various stages of EHR Meaningful Use have consistently been pushed back. Right now we’re using Healthland’s certified Classic 2011 product. Just tonight, our IT department is migrating to the updated certified 2013 Classic product, and on September 8, we will go live on their 2014 Centriq platform, which is their long term platform for Meaningful Use. So our employees and physicians will have been using three different platforms over a four month period of time. That shouldn’t be the norm, especially when we’ll have to push very hard over the last quarter of this fiscal year to be certified so that we won’t be penalized, through no fault of our own, for possibly not meeting meaningful use core measurement criteria simply because we didn’t receive this HIT product in a timely manner. Healthland (who has 400 clients) is just one of many such vendors struggling to meet criteria guidelines.”
He said he believed CMS is listening to testimony provided through forums such as the virtual hearing he took part in. “Later that day, CMS put out a proposed rule to make changes to allow the 2011 certified products to go into the year 2015, which will allow vendors and their clients an additional 12 months to meet criteria without facing penalties.”
The Health Data Management article supports Mr. Griess’ assessment that CMS is listening, stating, “…CMS and the Office of the National Coordinator for Health IT late yesterday (May 20) announced a proposed rule allowing providers the use of 2011 Edition of certified EHR technology for calendar and fiscal year 2014… Hospital executive Griess told the workgroup that the two-year cycle for meaningful use is not realistic and that CMS should extend the length of each MU stage to three years for all providers. ‘The current two-year cycle is simply too short for vendors to develop safe, usable products that providers can then deploy in safe, efficient ways that really help them better coordinate care, engage patients and control healthcare costs,’ he said. ‘The cultural changes that are needed to fully realize the promise of EHRs requires more time than the current year-over-year changes in meaningful use allow.’ And in the proposed rule, Griess and others will get that third year.”
The Trustees also conducted the following business:
The board recognized Diabetes Education Department’s Sue Steele, RN, CDE, for being named the May Employee of the Month. Also recognized for recent accomplishments were: Sally Bryner, MSN, for completion of her Master’s Degree in Nursing; Dialysis Department’s Cari Krauter, LPN, for completion of her National Certification in Dialysis; Diagnostic Imaging Department’s Bryce Kirkpatrick for his completion of CT Registry and Donna Ryan for her completion of Bone Densitometry Registry. Also recognized was Jessica Anders, the hospital’s new PCU and OB Clinical Nurse Manager and The Rehab and Wellness Center’s newest staff member Emily Miller, PTA.
After unanimously approving the consent calendar, the board heard Chief Quality Officer Mary Mockerman present her monthly Quality Management and Safety report. She focused on the hospital’s current policy of only stocking DTap and Tdap vaccines in separate locations in the hospital to mitigate the Nebraska Coalition of Patient Safety Matters focus on the two vaccines being easily confused due to their similar abbreviations, as well as storing td and Tdap tetanus vaccines in clearly marked separate Omnicel bins. She also touched on how the hospital is using the Lean Six Sigma protocol to identify the cause of medication errors. Ms. Mockerman informed the board that 125 employees participated in a recent fire extinguisher training course using the facility’s new BULLEX fire extinguisher simulator, with the remaining employees to be trained at a future date. The BBGH Tornado Response Plan has been updated, with all staff required to read the new plan through the hospital’s SWANK learning system.
Mr. Griess gave an update on the new addition/renovation project, stating the placement of steel support beams has really brought activity at the site into the public eye. He also gave a timeline of plant upgrades (e.g. boiler replacement and AC replacement) that will eventually result in a new mechanical plant meeting all the requirements of the new addition as well as those of the current facility.
Chief Nursing Officer Jane McConkey reported who the recipients of the BBGH and Box Butte Health Foundation (BBHF) Scholarships were. For BBGH, the recipients are, $500 High School Scholarships: AHS graduates Rylee Trout and Ashley Quick; $1,000 college recipients: Kameron Heckman, Tessa Retzlaff, Amanda Hare, Regg Strotheide. BBHF $1,000 college winners: Lauren Reiber, Sydnie Hiemstra, Bridget Scherbarth, Darin Bottiger and Mackenzie Nordeen.
Mr. Griess presented the proposed Minor and Capital equipment budget for the Trustees review. The proposed Minor Equipment budget (items less than $5,000) totaled $211,852. The proposed Capital equipment budget (items $5,000 or more) totaled $856,425. The Trustees will be asked to approve the 2014-15 fiscal year budget at their next board meeting in June.
Box Butte County Commissioner Sandy McCarthy, along with Veterans Service Officer Gloria Swires and another representative of the Veterans Service board were present to discuss improving communication between the County, the Veterans Service office and the hospital. Ms. McCarthy said recent communications, especially with CFO Tracy Jatczak, helped clear up some misunderstandings regarding services available to veterans referred to the hospital from VA facilities. Recent developments in VA operations have indicated an increased use of private care for veterans may be on the horizon to mitigate wait times for services. As Ms. Swires stated, “When the recent confusion (of a local veteran trying to obtain an appointment, referred to the hospital by a VA facility) first came up I figured it was due to training issues. Since my background is in training I knew things like that happen. If your hospital staff has questions on veteran issues, please call me right of way so that I can come and work with you and that family to provide intervention between the VA health care system and the private health care offered through the hospital.” The two systems have distinct differences and that is going to cause confusion for veterans. “I can help with that.” She added she looked forward to working with Ms. Jatczak and BBGH Admissions Manager Melanie Johnston in the process.
After approving all credentialing requests, the board adjourned the meeting at 8:05 pm. The next meeting will be held at 7:00pm Monday, June 23, in the BBGH Alliance Room. As always, the public is invited to attend.