Meaningful Use Paves Way For Health IT Megatrends

The third big trend will be "an enormous explosion in patient engagement," including requiring that patients get access to all their data, anytime, without limitations.

"Patients will have unfretted and instant access to their information in multiple formats," Calman said. "The advocate community is very powerful [and] they are saying 'what right does a doctor have to keep my data locked up either in their computer or in their file cabinet when it's my data, it's my information. I want total access to it,'" he said. Both HITECH and HIPAA are moving in that direction and "don't be surprised" when the requirements are part of Stage 3 MU, he said.

In fact, just last week, the HIT Policy Committee approved recommendations from its Privacy and Security Tiger Team that includes a proposed MU requirement that certified e-health records software in Stage 2 have the technical capabilities to accept corrections and changes in information from patients and providers, and by Stage 3 be able to transmit those amendments and updates to others that may have received previously transmitted the data in question.

"If there's one thing that is going to revolutionize healthcare--from IT, accountable care organizations, or any aspect of health reform--you're going to see patients taking back healthcare from their providers," he said.

But that brings us to sensitive questions about security and privacy, and how do providers give patients full access to what might be the equivalent of hundreds of pages of records or more--and then allow the patients to add their own comments, corrections, and amendments.

"That's something we've been looking into," said Karen Marhefka, associate CIO at University of Massachusetts Memorial Healthcare System in Worcester, Mass., another panelist at the InformationWeek Healthcare IT leadership Forum.

UMass Memorial--the largest healthcare system in central and western Massachusetts--has been exploring several options for patient portal technology that would give individuals secure access to their information. Among the solutions Marhefka's organization liked best was one that also allows patients to enter information into their records. However, in the end, UMass Memorial's lawyers didn't approve of that capability because of worries about liability, she said.

"The lawyers freak out," said Calman, agreeing that attorneys, including malpractice lawyers, are often more resistant than doctors to the idea of providing patients with access to their full medical information--and especially the notion of patients being able to include their own comments in their records.

As for security of patient data, even though e-health records bring fears of hackers accessing personal health information, the most common privacy violations today involve healthcare employees doing stupid things, like looking at the medical records of people they know, said Calman.

In fact, Calman's organization fired eight of its 900 employees over the last four years due to record snooping. "That's almost 1% of our workforce," he said. Firing people for snooping at health records is a powerful way to drill home the rules of HIPAA within a health organization, he said.

As for HITECH Act regulations, it's important to remember that no matter what stage of MU compliance you're struggling with, make sure you have the support of the organization's top leaders, said Marhefka.

At UMass Memorial, the organization for years has been struggling with a 20-year-old e-medical record system that needs to be replaced. The system "was like MacGyver," said Marhefka referring to the fictional TV hero famous for fighting danger with duct tape.

Until recently, a project to replace and integrate the organization's e-health records "had zero support" from UMass Memorial's top executive team. "We're jamming EMRs into broken processes," said Marhefka of the struggle. But with the HITECH Act's mandates on the horizon--and millions of dollars of incentive money on the table for UMass Memorial--"leadership is coming along," she said.

The spotlight now for the IT organization is shining brightly on HITECH Act compliance. "It's drop everything, let's focus on meaningful use," she said.

But organizations like UMass Memorial and others who are sprinting toward Stage 1 compliance have to remember that MU--with upcoming Stages 2 and 3--is a marathon. And as other megatrends for healthcare transformation take shape, it's more like an ultramarathon.

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