A patient's perspective on Stage 3 of Meaningful Use

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There's been a lot of press about provider concerns that they may not be able to meet the patient engagement requirements of the more advanced stages of the Meaningful Use program.  The Centers for Medicare & Medicaid Services has responded, suggesting that if the burden is too great on providers, the agency may revisit the patient engagement requirements in Stage 2 of Meaningful Use. There's also been some scuttlebutt that patients really weren't interested in their records.

So it was particularly refreshing to hear Eva Powell, director of health IT programs for the National Partnership for Women and Families, present the consumer perceptive on the recommended Stage 3 Meaningful Use requirements, which significantly ratchet up patient engagement. According to Powell, speaking on a webinar this week sponsored by eHealth Initiative, patients and caregivers want to be more engaged. She said it's a "no brainer" that health IT can simplify access, ease navigation, and enable patients and caregivers to contribute information to electronic health records in a secure way.

"Patients and caregivers can and should be partners [with providers] in their care," Powell said.

In fact, while Powell acknowledged that the Stage 3 request for comment, published this week in the Federal Register, makes a number of advancements when it comes to patient involvement, she said that the Stage 3 proposals don't go far enough. For instance, she said, while Stages 2 and 3 both require providers to record in EHRs whether patients 65 and older have an advanced directive, that's not overly helpful, since it doesn't capture what the patient's actual preferences are, and doesn't require that the information be conveyed to other providers.   

Stage 2 requires 5 percent of patients to communicate with their physicians online and access records through a portal. The Stage 3 request for comment goes further, requiring providers to offer patients options for submitting self-generated information, requesting amendments of their records online, and including caregiver names and contact information in such records.

Personally, I think it would be great to have the ability to review my electronic health information. Just last month I had an appointment with a new physician. As I was sitting in the exam room waiting for his arrival, I decided to take a peek at my newly-created EHR, which was sitting next to me (it was my record, after all). As it turns out, my name was spelled wrong. The physician corrected it immediately, of course, but had I not noticed, my EHR would have been fundamentally incorrect--and much harder to locate. And it's not often that the patient gets to view the screen. Who knows how many other mistakes are lurking in our records?

Here's the funny thing: While some of us are EHR vendors, and some of us are providers, all of us are consumers. It benefits everyone to have the ability to double check such information to catch discrepancies.

Powell mentioned that the industry could take "more creative" approaches to advance patient engagement without adding burdens on anyone. I believe that everyone can agree to that.

Now let's share those ideas with ONC. - Marla