I am with a large health system. We too have been anxiously awaiting federal-level clarity on the “meaningful use” heading. As that continues to play out and as clarity comes, we are preparing for this opportunity by creating national planning and implementation committees who will push for “meaningful” IS integration at all levels in the system. In order to fuel these groups, we have also started a parallel set of analysis activities to understand the cost and returns associated with IS integration, to review our current use, and to consider areas of expansion and vendors.

My assumption is that the timelines are tight but achievable, if a health system reacts quickly. Further, I expect vendors (particularly the reputable and well-known ones) to be swamped with contracts and interest within 24 months. So, one should consider engaging this area of work now rather than waiting for clarity on “meaningful use”.

I am not an IS person or an executive leader. That said, my personal opinion is that larger, more vertically integrated systems have a size advantage with this piece of stimulus funding.

I also work for a large health system. Due to the timelines mentioned above, my hospital expedited the implementation of EMR. What changed in regard to strategy was the increased emphasis on integration (as mentioned in the PPT slides for this lecture). Initially service lines were empowered to research the most effective EMR system for their needs. I work within Women's Services. We brought in two vendors for product demonstrations, Digichart and Cerner. Digichart's EMR is specific to Ob/Gyn and the company has exclusive rights to ACOG's medical record form. Cerner, on the other hand, was developing an OB package and would rely heavily on the creation of templates by our medical staff. During deliberations regarding which product to purchase, the interoperability of Digichart was a concern. Most of our clinical support systems are made by Cerner. We did not want to make a decision that would undermine the benefits of an EMR system, namely portability of the medical record to improve patient care quality. Digichart assured us that they could work through the technical issues and that the record would interface with our other systems. However, due to the advanced timeline, we ultimately decided to go with the system that was guaranteed to be fully interoperable with our existing systems. This significantly reduced the timeline for implementation. Our pediatric clinics recently went live with the Cerner EMR, while Women's Services is scheduled during the second phase of the go-live.