Swedish Covenant Medical Group

MU ASSISTANT® software has not only improved Trier’s ability to manage the entire MU process, but also improved communication about the MU of the organization’s existing EMR.



About Darcie Trier, MS, APN, CNM, Quality Manager

She’s an advance practice nurse, certified nurse midwife and the mother of twins. As if that wasn’t enough, she’s also the quality manager responsible for the day-to-day management of Swedish Covenant Medical Group’s meaningful use (MU) program. With more than 125 multi-specialty physicians, nurse practitioners, and physician assistants (of which more than 80 are eligible providers) across 20 office locations, her days are filled with a flurry of activities associated with MU.


In 2012 and before Trier entered the scene, the MU program was managed by the hospital’s Medical Group’s information technology (IT) manager and one other associate. There were approximately twenty providers being monitored and attested for at the time, and they were in the process of switching their existing electronic medical record (EMR) to eClinicalWorks. After Trier came on board as the quality manager, the IT manager began looking to her for advice with clinical quality measures (CQMs) and from there on she became more and more involved with the MU program. She spent the first couple of months scouring websites reading up on all the MU material she could get her hands on. “The task was daunting to say the least. MU was new to everyone and even those of us with a clinical background struggled to read between the lines of the constantly changing regulations,” stated Trier.

Then, just as she was getting somewhat acclimated, the IT manager left, and she had to continue to self-educate; now not only having to focus on the MU regulations, but also on the who, what, when, and where of what IT had previously established from a process standpoint. However, there was a small ray of sunshine, in that just prior to the turnover, IT had met with SA Ignite’s (SAI) vice president of client services, Beth Houck. Trier was interested in continuing the conversation to learn more about SAI’s MU ASSISTANT software. Trier knew she couldn’t go the MU road alone and was hopeful the SAI software would ease the burden of trying to sift through the sheer volume of data required for MU for all of their providers who were in different specialties, programs, and payment years.

“We were a growing organization approaching nearly one-hundred providers and while eClinicalWorks did provide some of the data I needed on the MAQ Dashboard, I was still unable to filter MU Stage 1 and Stage 2 data by provider for example,” said Trier. “And with providers coming and going on a regular basis, I had to have a way to better manage the entire MU program.” Trier went on to say that she and other leaders within the hospital discussed adding additional staff, but ultimately decided if they went with SAI’s solution she could make it work without having to do so. And, so the medical group signed an agreement to purchase MU ASSISTANT software from SAI.

Improvements Realized

Trier has been using MU ASSISTANT software for a year as of September 2014 and has experienced first-hand how it has not only improved her ability to manage the entire MU process, but also significantly helped to improve communication around the MU of the organization’s existing EMR. For example, the medical group has more than ten practice managers and site supervisors responsible for the daily activities within all of their ambulatory sites. Consistent and regular communication with these persons is critical to continued successful use of their EMR and in meeting MU measures and thresholds.

“With the help of MU ASSISTANT software, I can view, monitor and schedule provider scorecards to be sent to clinic managers and supervisors on a monthly and quarterly basis,” said Trier. “The scorecards allow me to zoom in on areas where providers are not meeting the necessary thresholds in order to maximize incentives and avoid penalties.”

She pointed out there have been many instances where the scorecards have helped them identify areas where all that would be required to meet the threshold would be a how-to session. In one instance, for MU Stage 2, Trier noticed none of the providers were meeting the family history requirement. What she found was the providers were actually completing this step, but they just didn’t realize there was a box that needed to be checked within the EMR. Fortunately, with the help of IT and the creation of some tips sheets, the issue was quickly resolved. Another challenge they faced was meeting the MU Stage 2 requirement – collecting email addresses during the check-in process. Entering this information was on the second screen of their EHR and front desk staffing were skipping over this screen, not realizing they were missing the opportunity to collect this information. Again, with the help of IT, Trier was able to develop a stop measure that wouldn’t allow front desk personnel to bypass the second screen and they instantly saw an improvement in meeting this measure.

Reaping The Financial Benefits

Swedish Covenant Medical Group has well-established regular board meetings, ambulatory practice meetings, and provider meetings. Trier and her vice president will often attend these meetings to provide an update on the financial impact MU incentives have had on their organization. At first, before incentives starting flowing, the fifty to seventy-five providers who would attend the quarterly all provider meetings weren’t as interested in hearing about MU.

“I could tell they didn’t fully understand the impact of MU and why I was asking them to click boxes,” stated Trier. “But as soon as I could begin to show the dollars coming into the organization because of MU and the potential associated penalties, they definitely perked up.”

With the help of MU ASSISTANT software, Trier often reports on the sum total of incentive dollars they’ve received, what they stand to lose and estimate what they think they can achieve in the future. The organization budgets for estimated incentives by provider and by practice, and Trier especially appreciates MU ASSISTANT software’s financial incentive payment reconciliation report. When finance receives a check from CMS, she can easily provide this report to show which physicians and the total of incentives make up each check.

“The financial impact to the organization is tremendous when you calculate what we could be missing if we didn’t have a system like MU ASSISTANT software to help us more easily gather, monitor, and analyze provider data,” stated Trier. “We regularly communicate our success and identify areas for improvement and together we continue to achieve our MU goals.”


“Now that I’ve experienced the benefits of using a MU management solution I couldn’t imagine doing it any other way,” said Trier. “SA Ignite stays up-to-date with the regulations and builds those into the system giving me the ability to focus on making sure we are maximizing every incentive dollar.”

Trier loves what she does and says she isn’t going anywhere anytime soon. And she sees the MU incentive program as a stepping stone for other and future pay for performance models. She appreciates the ability to work with Houck and the client services team to find ways to continually improve the system. When asked what advice she would give to another facility considering the purchase of a MU management solution she said, “You have to keep your ducks in a row. MU ASSISTANT software helps you do that.”