May 11

In this Issue:

A2K Regulatory Updates - May 15
IV Piggyback Changes in CPOE
The Meaning of Meaningful Use

A2K Regulatory Updates - May 15
On Sunday, May 15, 2011, we are required to do some Regulatory updates to A2K that will take approximately two hours to complete. This outage will start at 1500 (3 p.m.) and should be back online at 1700 (5 p.m.). The required downtime will affect Physician Order Entry, A2K and Interfaces to all external systems including  e-Chart, WebCIS and Labs.

WebCIS will NOT be down during this time.

eChart will NOT be down during this time.

GE will NOT be down during this time.

We thank you for all your cooperation.

Information Services.


IV Piggyback Changes in CPOE
On Sunday, May 8, changes were made to the CPOE IV Piggyback orders. Click HERE to review additional details about the May 8 changes.

The Meaning of Meaningful Use
Along with hospitals and providers across the country, UNC Health Care will participate in the national program to achieve Meaningful Use of our Electronic Health Record (EHR). This impacts both inpatient and outpatient environments of our health care system, and will involve many parts of our EHR, including WebCIS and E-Chart (Sorian).

The HITECH Act, part of the 2009 ARRA stimulus package, aims to increase EHR adoption, promote provider utilization of integrated decision support, formalize quality improvement reporting for the outpatient environment, build on existing requirements for the hospital, and add functionality such as population management capabilities and reporting to external surveillance systems.

Beginning in 2011, reimbursement incentives are available from the Centers for Medicare & Medicaid Services (CMS) through programs for Eligible Hospitals (EH or the ‘hospital program’) and Eligible Professionals (EP or the ‘outpatient program’) that can successfully demonstrate “meaningful use” (MU) of a certified EHR. UNC qualifies for both EH and EP incentive programs under MU. EH payments start at a base of $2 million; EP payments can total up to $44,000 over five years for Medicare, or $63,750 over six years for Medicaid. Starting in 2015, providers who are not actively utilizing an EHR in compliance with MU requirements face potential penalties of 1% of Medicare payments, increasing to a maximum of 5% in later years.

The intent of MU is to focus investment and implementation in health information technology (HIT) that leads to improvements in healthcare delivery, information exchange among health care professionals, and shared decision making with patients and families. A coordinated set of regulations have been designed to create a private and secure 21st-century electronic health information system that supports standards of care that align with national quality goals. To meet these objectives, MU is being rolled out in 3 stages over a five-year period.  Stage 1 has been finalized and Stage 2 is scheduled for release in July 2013.  Each stage will build off of the previous one, raising the bar for EHR development and utilization. 

Stage 1 contains a total of 34 requirements for Eligible Hospitals and 26 requirements for Eligible Professionals. To become “Meaningful Users,” providers must meet all of the specified requirements, including: use of a computerized provider order entry (CPOE) system to enter medication orders, perform drug‐drug/drug‐allergy interaction checks, maintain an active medication list and up‐to‐date problem list of current diagnoses, and record as structured data vital signs and smoking assessment and intervention.

The first step in MU is to adopt a certified EHR, or achieve certification of an existing system, that has the functionality to meet the standards set by the Office of the National Coordinator (ONC). Our ISD team has been working with Siemens to prepare for certification of WebCIS for EH in July of this year. Certification of WebCIS for EP will occur later this year.

The next step is to attest that the certified EHR is being used by the health care team in a ‘meaningful’ way that meets all of the requirements. Larry Mandelkehr is leading the effort for hospital (EH) attestation. Robb Malone is leading efforts in our outpatient clinics for the individual physician (EP) attestations that will begin in 2012.

Our vision is to create a relationship-based care delivery model that provides high quality, efficient care that meets requirements for reform, meaningful use, Core Measures, reducing readmissions, and other targets.

We will continue to publish information here regarding UNC’s plan to achieve meaningful use for our hospitals and physicians. Please send questions or comments to