We’ve had a few weeks to wrap our heads around the Meaningful Use Stage 2 Notice of Proposed Rulemaking (NPRM) and it’s clear that the Feds are looking to shake up the industry a bit. Why? It’s time to pursue the true objectives underlying healthcare I.T. adoption in HITECH.
Meaningful Use Stage 1 has been successful in moving the industry toward medical record adoption. The hurdles for demonstrating Meaningful Use in Stage 1 are low, but have caused organizations to begin implementing basic infrastructures – and this will turn out to be a good foundation for what’s to come. Unfortunately, Meaningful Use Stage 1 requirements have not broken the boundaries that exist between providers, hospitals and patients.
As we predicted, Meaningful Use Stage 2 seeks to give everyone involved the data they need by placing renewed focus on sharing information between providers, submitting public health data, and engaging patients and families.
The requirements around engaging patients and families have been amongst the most often deferred by provider organizations in Meaningful Use Stage 1. The NPRM clearly establishes that this goal of the HITECH Act isn’t going away and raises the bar significantly for connecting with patients and their families online.
Meaningful Use Stage 2 Criteria
The following is a summary of the Meaningful Use Stage 2 criteria for patient and family engagement (with comparison to Meaningful Use Stage 1 in parenthesis):
- Of all patients who are discharged from the inpatient or emergency department:
- More than 50% have their information available online within 36 hours of discharge (Stage 1 was 10% and optional)
- More than 10% are provided patient-specific education resources identified by Certified EHR Technology (Stage 1 was optional)
- More than 10% view, download or transmit to a third-party their information during the reporting period (New)
- Of all unique patients seen by the eligible providers during the EHR reporting period:
- More than 50% are provided timely online access to their health information (timely is defined as within 4 business days after the information is available) – ( Stage 1 was 10% and optional)
- More than 10% view, download, or transmit to a third-party their health information (New)
- A secure message was sent by more than 10% of unique patients (New)
- For office visits:
- Clinical summaries provided to patients for more than 50% of office visits within 24 hours (Stage 1 was within 3 days)
- Patient-specific education resources are available for more than 10% of all office visits (Stage 1 was optional)
Many of these points tighten the standards of requiring that data be made available to more patients more quickly. And many optional components from Stage 1 are becoming required.
Being Used Meaningfully
The game-changers of the group are the new rules that require consumers use technology to view, download or transmit health information and send secure messages. It makes sense that consumer-facing tools aren’t “meaningful” unless they’re actually used by the patient. On the other hand, the idea that Meaningful Use dollars will be awarded based on the use or non-use of these tools by consumers (over which we have no control!) is startling for many providers.
The move seems to be in response to complaints by consumer advocates who point out that many patient portal solutions are basically unusable by the average consumer. Healthcare organizations have implemented patient portals with a “check the box” mentality – get it up, check the Meaningful Use box, and who cares if it gets used.
Well, it turns out lots of people care – patients, their families and the Feds to name a few.
Ensuring patients actually communicate with their care teams is central to other proposed financial models, including Accountable Care Organizations, bundled payments and pay-for-performance. The Patient Centered Medical Home requires regular, structured communications between the patient and the care team for chronic condition management. Accomplishing this will force better, more user-friendly technology as well as incentives for incorporating the technology into clinical practice.
In a way, Meaningful Use Stage 2 changes everything … for the better. But knowing patient engagement is important isn’t the same as knowing how to make it happen.
To learn how to improve the patient experience at your organization, as well as get more information on Meaningful Use Stage 2 (and what may lie ahead in Meaningful Use Stage 3), watch our webinar Meaningful Use Puts Patients Front and Center.