| | NOVEMBER 20188UTLOOK Healthcare Tech The emerging discipline of Regulatory InformaticsBy Sarah Kramer, CMIO, Yuma Regional Medical CenterWe're just over a year away from the 10-year anniversary of Meaningful Use (MU), and its transformative effect on the nation's health care industry in terms of interoperability, patient engagement, and the standardization of the electronic records taxonomy. Like many physicians in informatics, I was paired up with a project manager who was recruited to be sure that we succeeded for Stage 1. We worked with business owners and quality leaders and saw this as an opportunity for documenting standard work and otherwise aligning with our overall strategic roadmap. We attested successfully, declared victory, and went back to business as usual.Then came Stage 2, later modified, and Stage 3. The Physician Quality Reporting System (PQRS) was merged with MU and Value-Based Modifier (VBM) via Medicare Access and CHIP Reauthorization Act (MACRA), which enrolled providers in Merit-based Incentive Payment System (MIPS) unless they were part of an Alternative Payment Model (APM) such an Accountable Care Organization (ACO), per the Quality Payment Program (QPP). For the hospitals, traditional core measures began to be transitioned to Inpatient Quality Measures (IQR). We optimize Computerized Provider Order Entry (CPOE) and plan for Electronic Prescribing of Controlled Substances (EPCS). To improve adherence with radiology utilization, we implement Appropriate Use Criteria (AUC) decision support software.Webinars are attended and we learn about proposed rules and how to comment on them before they were finalized. It became an inside joke that we were in charge of complying with an "alphabet soup" of regulations and informatics initiatives. Over time, the role of the project manager changed. We struggled with titles. It became more of a program than a project. It involved quality measures, but was not "Quality." Established project management requires skills such as Agile because of a baseline need, but since so much of the troubleshooting and dependencies depended upon the Office of the National Coordinator (ONC) "certified" Electronic Health Record (EHR), a generic Project Management Professional (PMP)-certified project manager would no longer do. There appeared to be a new sort of discipline that required a thorough understanding of the capabilities and build options of the incumbent EHR, but also the ability to interpret, guide, document, and audit how the EHR had been deployed. A few months ago, in an effort to clarify but also generalize the title of our project manager position, we settled on "Regulatory Informatics".If there are other titles and descriptors out there that are superior, it's time to get these into circulation. The closest thing I could find is "Regulatory Information Management" that is used by the pharmaceutical industry. Sarah KramerIN MY OPINION
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