Meaningful Use and more family shenanigans

My last several weeks of professional time have been filled with analysis of the Final Rule on Meaningful Use.

In short, the government has designed a program to reward physicians for practice good medicine, and using Electronic Health Records to document the quality of care. It's our job as EHR developers to build the tools that the physicians will need to capture the data necessary to qualify for the incentive payments.

The long story is... the Final Rule on Meaningful Use is 864 pages long! Not just any old 864 pages, but 864 pages of Government Rules and Regulations :) So, our team of programmers, quality reviewers, and physician content experts has been grinding out the computer protocols ('rules') to assess 45 different criteria ('measures') for the docs to apply to their practices.


Most of the measures are quite sensible. For example:

• Don't overuse x-rays for patients with back pain;
• Make sure to counsel your smokers to quit;
• Be sure your patients get their flu shots and pneumonia shots...

The concepts are straightforward, but the government regulations are strict.

• Who is "my patient"? Someone who just came in once for a quick rash or runny nose? Or does the distinction require evidence of a more consistent relationship?
• What about the patient who is allergic to the flu shot? Or the patient who just doesn't want one? Are they going to be counted against my immunization rate?

And finally, the computer logic required to document these requirements is even more complex:

• "If the patient was seen at your office twice in the past 12 months, OR if the patient was in the hospital in the past 12 months, they are included in the denominator."
• "If the patient had the new onset of back pain, AND if they didn't have cancer, trauma, IV drug use, or evidence of nerve damage, AND if they did NOT have a previous episode of back pain in the 6 months before this episode of back pain..."

So, the logic involved in creating a rule within the EHR, both from the medical, technical, and governmental perspectives, has been a highly complex and thought-provoking endeavor. It is a very challenging and stimulating role, and I love this job more and more each day!

Life for the kids has not been nearly so stimulating. Four weeks in a new town with no school and no friends has made the boys bored and antsy. So, like any good brothers do, they cope by turning to each other. Not as friends, as TARGETS! Witness the hilarity of this recent exchange:

I am sitting in the family room with Paul, when Chris walks in. Suddenly I hear a ringing "SMACK"!

"Oh no...", I think to myself, "this is really going to escalate!"

Paul: "Chris!!! WHAT did you just hit me with?!?!?"

Chris: "A Fruit Roll-up."

Paul: "Oh.. we have Fruit Roll-ups? SWEET!"

Paul bounds away happily, headed to the pantry, and the situation ends without bloodshed.