HLM: Do you have concerns about the proposed requirements for 2013 or 2015?
Sottile: We are on target, but we have to purchase a few additional applications. The maintenance of the problems list is going to be an operational and cultural issue. That will take a little clinical work with physicians—getting agreement to the maintenance of that list. As you come into healthcare today, it is a complex environment and you are seen by multiple physicians. So who has the right to add or delete problems? That is the issue we need to work through. Can a dietician define you as obese or nutritionally malnourished or does it require a doctor?
HLM: Are you concerned about the certification of your system--whether you have the right version of software?
Sottile: I'm more worried about the reporting requirements and how do we document and report that we have achieved meaningful use. Some of the systems are not designed for reporting. You have to extract it out.
HL: Key lessons you've learned along the way?
Sottile: It is all more complex and time consuming and costly than you anticipate. It is important to get the board of trustees on board and understanding the road you are going to travel, understanding the measurement of ROI may not always be there, and keeping the medical staff informed and involved to the extent you can. We've had a monthly open meeting for the medical staff for the past five of years. That has served us well. There may not be a lot of physicians coming every month, but they know that there is an open forum for them if they want their voices heard.