Healthcare providers and hospital staff should take a more active and defined role in helping patients understand and use electronic health records (EHRs) and personal health records in order to achieve meaningful use. That was the conclusion of PricewaterhouseCoopers (PwC) Health Research Institute's report, "Putting Patients into Meaningful Use," released Wednesday at the Healthcare Information and Management Systems Society's (HIMSS) 11th annual conference & exhibition in Orlando, Fla.
"This report really has to do with the patient, and the research we did to test where organizations are in achieving compliance with meaningful use; testing how they're conducting the execution of compliance and whether or not they have talked to constituents who are impacted by the adoption of clinical records," said Bruce Henderson, director and national leader of the EHR and health information exchange (HIE) practice at PwC.
One of the primary goals of the EHR meaningful use initiative is to make medical records more accessible to patients electronically, when and where they need it and in a way that helps patients and providers make more informed healthcare decisions.
According to PwC's research, even though more health systems are involving physicians, health insurers, and patients in their meaningful use initiatives, they seem less confident about achieving full adoption within the government-specified time frame. By 2015, health systems that have not achieved Stages 1, 2, and 3 EHR compliance will see their Medicare reimbursements decrease. But the report found that only 82% of respondents -- down from 90% last year -- said they will achieve meaningful use before penalties kick in. As health systems finalize the workflow data requirements, they appear to be more concerned about the meaningful use complexities and time needed for implementations.
"Some healthcare organizations have had a strong foothold in EHRs for quite awhile, but most have not," Henderson said. "There's a lot of activity around meaningful use; the industry is doing its best to understand and learn the value of these systems, the best way to implement them, and how to achieve positive results, but I'm not sure everyone fully understands their impact -- intended or otherwise -- and this is contributing to the lack of connecting with key stakeholders in the process."
Not only is there a void in patient access to electronic data, but also a lack of understanding of the requirements for achieving access. Henderson is, however, encouraged by the work some healthcare facilities are doing to educate and involve patients in the EHR process. "As EHR implementation progresses [some are] engaging focus groups; looking at what the end results should be; and gaining valuable input from patients on how the EHR should look -- its level of interactivity, addressing any privacy concerns, and achieving -- much like what's done with physicians and nurses as inpatient systems are rolled out -- engagement," Henderson said. "This is not only 'a getting it right initiative,' but also the patients' taking ownership in the EHR."
Organizations who are engaging patients, "not only to the fact that we're installing an EHR, but what it means to the patient and what's the value-proposition for them?" are seeing positive results, Henderson said. "Ultimately, the most important aspect is the patient's ability to view and interact with clinical information."
Nearly one-third of health systems said they are seeking patient input into their meaningful use initiatives, up from 19% last year. But according to a separate PwC healthcare consumer survey, only 13% of respondents said the provider/hospital had asked what they thought about electronic records. Consumers want to provide feedback: 56% said they'd be willing to talk to hospitals/providers about their EHR preferences or how they'd like to use them.
A key to achieving patient-centered care is that healthcare systems and providers will need patients to buy into the concept and use health IT tools. PwC said the implications of not involving patients early in the process might be lower and slower adoption of health IT tools.