The commenting period for the proposed stage 2 meaningful use rules has closed, but until the final rules are released, doctors, EHR vendors, and others will continue to debate about the most controversial of requirements proposed by ONC: patient engagement.
As the rule stands, physicians must provide patients the ability to view online, download, and transmit their health information within four business days of the information being available to the EP. Access to records must be provided to more than 50 percent of patients, and 10 percent of those patients must view, download, or transmit their health information to a third party. ONC proposed other requirements to encourage patient engagement, but this is the one that most of the debate centers on.
The reasoning behind this requirement actually makes a lot of sense; the more involved patients are in their care, the more effective US healthcare will be. Patient portals, telecommunication, and apps designed for smartphones and tablets make it much easier for patients to be involved and for doctors to share information.
However, few patients are taking the initiative to view and download their records, especially if they are healthy. The requirement, then, that 10 percent of patients must download their records is a bit unfair for doctors, who will not be able to qualify for meaningful use incentives if their patients don’t meet this requirement for them.
Both sides have strong arguments, so it will be interesting to see what ONC ultimately decides to push forward.
It is always best to be prepared, though, so there are a few steps doctors can take to ensure their patients will already be engaged in their care when it comes time to comply with stage 2 requirements. It is crucial that a practice have a patient portal; without it, providers will not be able to qualify for meaningful use, simple as that. Doctors would be wise to start inviting patients to patient portal now, so that by the time 2014 rolls around (or whichever year stage 2 begins for the provider) there will already be patients “engaged” in their own care. Target the younger patients, as they seem to be most willing to try out digital tools.
Not all providers have to be power users of their EHR, but the patients whose doctors use digital tools will be more likely to use similar tools on their own time, so make sure you are using your EHR fully.
In some areas, patients are already using the tools available to them—primarily the internet—to research their own health problems. Health-related queries are the third-most searched items on the internet, which means that patients are interested in information that affects their health. A lot of patients aren’t aware that their doctors have information that could benefit them. For instance, family members might want to monitor whether their elderly parents are attending all of their appointments and taking their medications. The public needs to know that these types of options are available; it is the doctor’s job, then, to make sure patients know about them.
The doctor-patient relationship is slowly shifting toward one of partnership, in which both parties work together to provide care solutions. Using technology to engage patients in their own care is still a relatively new practice, but it’s the way the future is headed. Regardless of whether ONC requires patient engagement under stage 2 MU rules, patients will eventually be taking a much more active role in their care than they are even today.