Patient access to EHR information key to meaningful use stage 2

Meaningful use requirements are intended to spur health care organizations into implementing their electronic health record systems in new and resourceful ways. For much of stage 1, the Centers for Medicare and Medicaid Services was content to allow hospitals and small practices to purchase EHR software and transition to storing the bulk of their medical information in the electronic systems.

However, many industry observers have noted that meaningful use stage 2 requirements will be more inclusive of EHR technology. Rather than just an inert cache of information, the CMS will reward health care professionals who optimize the uses of the data in effective ways. To achieve this degree of interoperability, many hospitals are beginning to give patients widespread access to their information stored in hospital-based EHR systems.

Engaging patients for meaningful use
The CMS has not been reticent when it comes to what it expects out of the health care industry for meaningful use stage 2. In addition to population health measures, increased patient safety and improved care coordination, physicians and administrators are also expected to increase the interoperability of patient data stored in EHR systems and health information exchanges. 

Speaking to EHRIntelligence, Chris Bradley, chief executive officer of Mana Health, and Kimberly Harris, director of marketing and business development at Health Access San Antonio, both believe that health networks that extend EHR access to patients will have an easier time attesting for meaningful use stage 2

The CMS requires at least 5 percent of all patients to be in some way engaged in the flow of EHR information, and while that number may not seem like a difficult hurdle to clear, Bradley argued that practices that do not begin adapting their IT networks will see problems in the future.

"Clearly there's a long-term goal, which is far beyond just hitting the numbers, which is engaging patients to be healthier, especially if we're transitioning toward more value-based care instead of fee-for-service based care," Bradley told EHRIntelligence.

Harris added that for some small practices, creating and maintaining their own Web presence may be cost-prohibitive. However, joining up with a larger hospital or provider network and participating in an HIE may be a more cost-conscious model. With an HIE, patients can view their health information through a single online portal. The convenience of this system may be integral in improving engagement numbers and complying with meaningful use stage 2 requirements.

Playing catch up
If an organization falls behind in its scheduled meaningful use workflow, there are only so many ways that time can be made up. Vendor testing of EHR systems may be cut short, or smoothing out disruptions in clinical processes may be pushed back. However, because patient engagement deals with a third party external to the health care community, waiting to reach out to patients may have costly effects down the road.

According to a report by researchers at the Medical College of Wisconsin and published in the American Journal of Medical Quality, specialty physicians are lagging in terms of patient engagement figures. The researchers reviewed the EHR data from a multispecialty group practice, as well as the information from 10 primary care clinics. 

The report found that 87 percent of the primary care physicians would have successfully attested to the CMS' requirement for patient email engagement. Only 37 percent of specialists would have passed the same bar.

The researchers speculated that specialists who do not send and receive as many emails as primary care physicians may be at a higher risk of not receiving meaningful use incentives. For these professionals, participating in an HIE may help them achieve patient engagement minimums without sacrificing large amounts of time to a new health IT initiative.