Healthcare // Electronic Health Records
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5/14/2012
09:41 AM
Paul Cerrato
Paul Cerrato
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Stage 2 EHRs Require Meaningful Patient Engagement

Many of the government’s proposed Stage 2 Meaningful Use criteria for e- health records won't be easy to meet. Here's how providers are meeting the challenge.

9 Health IT Tools Patients Should Understand
9 Health IT Tools Patients Should Understand
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For many healthcare organizations, Stage 2 Meaningful Use feels more like Stage 2 cancer: a threat to life and limb.

As written, the proposed regulations will require providers to give more than half of patients e-access to their health information; make sure more than 10% view, download, or transmit their health information to a third party; and provide more than 10% with EHR-generated educational resources.

Those are high hurdles, especially for smaller hospitals and practices. Several health IT and clinical stakeholders have taken the Centers for Medicare and Medicaid Services to task on these issues.

The American Hospital Association, for instance, in a letter to CMS, says it wants the agency to let hospitals provide patients with information about their stay--including discharge instructions--within 30 days, rather than 36 hours. Of what use is 30-day old discharge information to patients?

[ Learn about some of the newest e-prescribing tools. Read 6 E-Prescribing Vendors To Watch. ]

AHA also opposes the requirement that patients be able to view, download, and share personal health information via Web portals. "The AHA believes that this objective is not feasible as proposed, raises significant security issues, and goes well beyond current technical capacity," the letter said.

The College of Healthcare Information Management Executives (CHIME) has taken a somewhat different approach. While not opposed to the aforementioned rule about giving patients the ability to access their medical data, it complained about the requirement that makes providers responsible for ensuring that at least 10% of patients view, download, or share their medical records.

The public comment period for Stage 2 MU ended on May 7, so we'll soon find out whether these and other objections affect the final rules. It's clear, however, that providers aren’t waiting around. Many are taking major steps to make their EHR systems much more patient-centric.

As you might expect, big players like Kaiser Permanente are taking the lead in this regard. Earlier this year, it provided a convenient way for its nearly 9 million patients to access their EHRs using smartphones and other mobile devices. Just this week, KP released an iPhone app as well.

The apps help KP meet Stage 2 criteria for patient engagement by letting members email clinicians, check lab test results, order prescription refills, and manage appointments.

Similarly, the U.S. Department of Veterans Affairs has its Blue Button tool that lets veterans download as a simple text file or PDF personal health indicators, such as blood pressure, weight, and heart rate; emergency contact information; test results; family health history; military health history; and other health-related information.

But even smaller providers can get patients engaged with the right tools. Companies like Avado, for instance, offer a range of services to medical practices. Along with basics like website creation, Avado's tools let patients schedule appointments, receive reminders to take vital signs, schedule appointments, take medications, and perform their physical therapy. The mother of a child with hypertension, for instance, can be sent a reminder to her iPhone to take the child's blood pressure. The doctor can then track the data electronically. If he sees dangerous trends, the system lets him ping the child's parents with recommendations.

Unlike Stage 2 cancer, Stage 2 Meaningful Use needn't be life-threatening. In fact, with the right resources, it can get patients more involved in their own care, which will likely improve clinical outcomes.

The 2012 InformationWeek Healthcare IT Priorities Survey finds that grabbing federal incentive dollars and meeting pay-for-performance mandates are the top issues facing IT execs. Find out more in the new, all-digital Time To Deliver issue of InformationWeek Healthcare. (Free registration required.)

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pbug
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pbug,
User Rank: Strategist
5/29/2012 | 3:40:51 AM
re: Stage 2 EHRs Require Meaningful Patient Engagement
The idea of institutional health providers even having their act together enough to allow patients to get at their records feels like decades away. My local hospital, part of a fairly advanced hospital network, can't even get my name right, and I've been going there on and off for 20 years. Some of the medical practices at this hospital are still 100% paper based, and they never had a real picture of me as a patient - even for what they've done for me, even while I've been still checked in.

The sad part - I first worked on (as a hospital volunteer when I was in high school) an early EHR system - in the early 1970's. Everything ordered for the patient - tests, xrays, meds, all went into the system TO GET IT TO HAPPEN, not just to record it. To get an xray, the xray department received the order by computer. Too early to attach images, but way ahead of its time - for some hospitals, even today.

Even more frightening - hospitals where I live don't want to hire IT experts to install these systems - they insist on hiring friends of friends... They have jobs begging for months but reject anyone the nurse recruiters don't know personally. I do understand that - the hospital staff members are scared stiff of these systems. In the meantime, I'm studying to learn how to implement them, but suspect that no matter what certifications I earn it won't make any difference as they stonewall like crazy.
justaskjul
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justaskjul,
User Rank: Apprentice
5/25/2012 | 1:52:28 AM
re: Stage 2 EHRs Require Meaningful Patient Engagement
Just like Stage 1, I think the public/medical industry comments will be taken heavily into consideration and we'll see Stage 2 as not being a stringent as is being threatened in the proposal.

Julie
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