Leslie Manganiello: What is Meaningful Use and How Will These Standards Affect Health Care?

by Columbia Surgery on March 5, 2013

Most of us have heard of the Patient Protection and Affordable Care Act (PPACAA), and at a basic level, understand this legislation. I would guess, not as many of us are aware of Meaningful Use. Meaningful Use is another large government initiative that promises to change healthcare even more than PPACAA.

I recently spoke with Leslie Manganiello, Administrative Director at the Department of Surgery, to learn about Meaningful Use and to congratulate her on winning the 2012 College of Physicians and Surgeons Award of Excellence in Administration for her success in leading the department through multiple initiatives; one of which included implementing the first phases of Meaningful Use within the Department of Surgery. Below is a transcript of our questions and answers.

Question: What is Meaningful Use?

Leslie Manganiello: Meaningful Use is part of the 2009 American Recovery & Reinvestment Act which provides a financial incentive for the “meaningful use” of electronic medical records (EMR) to health providers accepting Medicaid and Medicare.

Q: Why is Meaningful Use an important initiative?

LM: With EMR, a complete and accurate medical history is available anywhere and any time to both the patient and their doctors. This ultimately means a reduction in misinformation.

In addition to more accessible records, the Center for Medicare and Medicaid Services (CMS) can use the EMR to assess the quality of patient care provided by practitioners. Armed with information from the EMR, CMS will in the near future pay for efficiency of care instead of quantity. In simple terms, practitioners will be paid according to quality and not the number of tests or services provided.

Q: What impact does Meaningful Use have on the Department of Surgery?

LM: Columbia rolled out their EMR system Clinical Records On-Line Web Network (CROWN, an Allscripts product) in 2009. Due to Meaningful Use, all divisions and practitioners must use CROWN in a structured format or, in the short term will miss out on financial incentives. In the long-term practitioners not using EMRs will be penalized by lower reimbursement rates. Here at Columbia the Faculty Practice Organization has adopted some parts of Meaningful Use early by implementing internal penalties ahead of the government dates.

Q: How detailed are the requirements of Meaningful Use?

LM: The adoption of Meaningful Use requires a change in the work processes for both doctors and administrative staff. For instance, Meaningful Use mandates the entry of data such as the patient’s vital statistics, spoken language, ethnic background, and smoking status. Some of the detailed requirements are not part of a surgeon’s scope of practice, so we needed to restrategize & encourage the use of non-physician providers, such a PA or NP, to assist in capturing this data. Meaningful Use also requires administrative staff involvement. We have them help with printing copies of the patient’s clinical summary. Few roles within the department will be untouched by Meaningful Use.

Q: How does CMS rate the Department of Surgery’s performance?

LM: Each measure had a specific threshold we had to meet. We distributed weekly performance reports to the divisions which allowed us to stay on top of each required measure and at the end of each phase attested through the CMS-EHR website.

Q: Meaningful Use was implemented by CMS and only affects Medicaid and Medicare. Will this change?

LM: Yes. As in the past, many commercial insurance carriers adopt measures implemented by government health insurance programs. Some of the larger insurance companies have already started their own interpretations of Meaningful Use.

Q: What was the most difficult part of implementing this phase of Meaningful Use?

LM: I think the most difficult part of this initiative was awareness. Ensuring that everyone knew what was required of them & more importantly how to achieve our goals.. Meaningful Use impacts our work in detailed ways. Dr. Lyall Gorenstein oversaw the clinician implementation of Meaningful Use. I worked mainly with the Division Administrators and Practice Managers. Yet keeping in touch with everyone, and making myself available to educate & troubleshoot, was the most challenging part of this project.

Q: What is the most rewarding aspect of winning the 2012 Award of Excellence?

LM: It is a wonderful feeling knowing that you are appreciated & it is really an acknowledgment of the full Department of Surgery’s effort.

In addition to my personal feelings, I like knowing that Meaningful Use will improve the care we offer to patients. Another benefit to Meaningful Use is ensuring the same high standard of care is provided to every patient. Additionally through data analysis, the information in EMR can be used to develop new treatment options and support areas where certain health issues are prevelant.

Please congratulate Leslie on receiving the 2012 Award of Excellence in Administration, by leaving a message in the comments field below.

{ 4 comments… read them below or add one }

Bradley Jobling March 5, 2013 at 2:25 pm


Once again, congrats on winning this award! It was a pleasure to write this article with you and learn about Meaningful Use.

Brad Jobling

Harry Follick March 14, 2013 at 9:49 am

Thank you for the explanation of “meaning use”.
There are changes occuring as we type in the system of healthcare delivery, management, admin, etc. Those of us who don’t work in this field may not know what is going on.
Please do not hesitate to send me any information, references or comments you have.

Columbia Surgery March 14, 2013 at 4:18 pm

Thanks for your comment Harry.

There are many changes that are occurring in our health care system and it does seem as if communication is somewhat sparse. Since a large part of this change is originating with Medicare and Medicaid, you might want to check out their web site at: http://www.cms.gov. Additionally, the government, has set up http://www.healthcare.gov to communicate directly with citizens.

If you come across any others sites which are useful or informative Harry, please feel free to share them with us.

Karen Clinton March 19, 2013 at 12:24 pm

Dear Leslie,

I found this video while searching for information on Meaningful Use. It as helped me as a student in Health Informatics. I just wanted to say that you gave a beautiful speech. It was thoughtful, kind and motivating. Thank you. Karen

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