The Health Information Technology Policy Committee Meaningful Use Work Group’s objectives include two measures for which I invite comments from the AmericanEHR community.
Under the category of “Engage Patients and Families in Their Care” are these draft objectives for Eligible Professionals (EPs):
1. 10% of patients/families view & download their longitudinal health information; information available to all patients within 24 hours of an encounter
2. Patients are offered secure messaging online and > 25 patients have sent secure messages online
I expect that many (if not most/all) members of the AmericanEHR community support the idea of engaging patients and families because it is good clinical care and helps people understand and manage their health conditions. However, if the objectives above are put into the Core Set of Stage 2 Meaningful Use objectives, then EPs would have to demonstrate — among all of the other Core Measures — that: a) at least 10% of an EP’s patients accessed and downloaded their clinical information, and b) at least 26 patients used a secure messaging feature to communicate with the practice.
Advocates of these objectives make the case that simply offering the opportunity for patients to download clinical information or communicate through secure online messaging is not sufficient to get patients/families engaged. They maintain that creating a threshold will motivate offices to encourage their patients to use the technology. Others believe that if the capabilities for information download and secure messaging are designed appropriately, fit into the office workflow, and are simple for patients/families to use, that such thresholds will be unnecessary. Those who hold this belief maintain that EPs and patients/families will avail themselves of these features and functionality because they will create value and provide useful (perhaps “meaningful”) information.
So… what do you think? Is it reasonable to set these thresholds (or any threshold) for EP performance based on patient/family utilization of available health IT? If your answer is “yes”, then would you be comfortable if the threshold for Stage 3 was set much higher — let’s say 30% or 40% for download and >100 for secure messaging?
If you are against the notion of setting thresholds but support the concept of engaging patients in their own care, then how would you respond to advocates of these metrics who are concerned that engagement of patients/families will be slow if the only expectation of EPs is to offer these functions without holding them responsible in some way for the use by patients/families?
Disclosure alert: I sit on the HITPC Meaningful Use Work Group.
This post is the personal opinion of the author and does not necessarily reflect the official policy or position of the American College of Physicians (ACP). ACP does not endorse a specific EHR brand or product and ACP makes no representations, warranties, or assurances as to the accuracy or completeness of the information provided herein.