Dr. Stasia Kahn's persistence and motivation led her to be a vanguard among her colleagues. Being an owner of a newly formed two provider practice presents many challenges and barriers, but Dr. Kahn leverages clinical experience along with a positive outlook about technology to find solutions to challenges and improve healthcare quality.

Achieving Meaningful Use in a Small Practice

As an Internal Medicine physician, Dr. Kahn frequently shares data with other healthcare providers and patients, making a system to efficiently collect patient data vital. With the release of the Meaningful Use Stage 1 core and menu objectives, Dr. Kahn's practice planned for an electronic health record (EHR) implementation that would not only meet the needs of the practice but position them to achieve meaningful use. For a small practice this meant a significant investment of time and resources with barriers including:

• Hardware, software, and interface costs
• Slowdowns in productivity due to staff training
• Limited physician time to devote to meaningful use project management

Despite these barriers, Dr. Kahn made achieving meaningful use a priority, and the practice started the attestation process in 2011. Beginning the process early allowed time for Dr. Kahn to complete a meaningful use gap analysis and map meaningful use measures to data fields she wanted to incorporate into her practice's EHR. As the physician champion in her practice, Dr. Kahn worked with IT consultants to create training materials and checklists for providers and staff that explain how to:

• Populate new data fields,
• Use the e-prescribing system,
• Provide clinical summaries to patients,
• Identify transitions of care, and
• Send patient reminders using the EHR.

Benefits of Achieving Meaningful Use

Dr. Kahn found that achieving meaningful use required physicians and staff members to work outside of their comfort zones, which resulted in new policies and procedures that improved healthcare quality.

While the financial and time resources required to achieve meaningful use were demanding on Dr. Kahn's small practice, the benefits are tangible. By implementing an EHR and achieving meaningful use, Dr. Kahn's practice is now using technology to help improve patient care such as:

• E-prescribing
• Automated recall processes for preventative services and chronic disease follow-up
• Patient registries (e.g., diabetes and coronary artery registries)

Dr. Kahn's practice has seen improved safety and reduced healthcare costs, as well as improved population health. For example, Dr. Kahn notes that "being alerted when my patients' BMI falls out of range prompts me to do something about it and has resulted in more frequent discussions with my patients on the importance of weight management."

Achieving meaningful use also fostered a relationship between Dr. Kahn's practice and the State of Illinois Immunization Registry. Without the meaningful use incentive payments, it was unlikely that the practice would have gone to the trouble of implementing a system that was able to participate in a statewide immunization registry. While the path to Stage 1 Meaningful Use was steep, Dr. Kahn believes having a positive attitude about technology and being willing to address barriers will lead to excellent patient care delivery and practice transformation. Dr. Kahn is already reviewing Stage 2 Meaningful Use to assess the measures and find solutions for her practice's next step on the path to making meaningful use meaningful for her patients.