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Engaging the Challenges of Meaningful Use Rules and Regulations

Since 2009, the Meaningful Use program has progressively rolled out its multi-stage program designed to enhance patient engagement through the adoption of certified electronic health records technology (CEHRT) usage rules and guidelines. The program is being rolled out over the course of several years in multiple stages.  The primary goal of introducing the program this was to minimize the software integration curve for medical service providers. Additionally, the program was designed to effectively implement infrastructure that would facilitate interoperability and quality reporting that would present a new healthcare model for the 21 century.

Although most experts predict that the long-term benefits of the structure provided by the Meaningful Use program will be obvious, the guidelines have not been introduced without creating some significant challenges for healthcare providers. New and existing guidelines, especially with regard to patient engagement, which have been introduced as part of the Meaningful Use rollout, have not been an exception to the rule.

Portal Enrollment Requirements Increased to 25 Percent

One challenge that has a significant number of healthcare providers on edge is the increasing percentage requirement for patient portal enrollment, which will see a bump up from 5 percent to 25 percent in Stage 3 specifically. The current 5 percent seen in Stage 2 was actually the result of a decrease from requirements in Stage 1 that occurred when providers claimed that they could not force patients to log into the portal to obtain their records. Now, the concern is if providers were struggling to meet a 10 percent portal enrollment in Stage 2; how will they possibly meet the lofty goal of 25 percent in Stage 3?

Hospitals and other providers will have to become highly creative in convincing one fourth of their patients to access and view their medical records online. Although it seems perhaps that private practices will not find this to be as much of a challenge as hospitals, with private practices producing a medium performance of 32 percent, while hospitals lagged behind at 11 percent.

Secure Messaging between Providers and Patients

Guidelines for MU not only require that secure messaging be made available to patients, but they mandate that secure messaging be used to communicate with patients. The mandate dictates that a certain percentage of all patients who have been seen by a provider be messaged from the provider through the Meaningful Use certified portal. With regard to Stage Three, there will be a significant increase when considering that the Meaningful Use Stage 2 requirements did not set a minimum engagement at all.

To exacerbate the matter, the Office of the National Coordinator for Health Information Technology (ONC) is not accepting all patient-to-provider communications as a part of the required metric. The messages have to, in some particular manner, relate to clinical care provided, while excluding messages that relate completely to billing, administrative subjects and appointment scheduling.

Consuming Patient-Generated Health Data

If the requirements surrounding secured messaging and the increase in portal engagement haven’t sufficiently alarmed medical providers, there are additional objectives that focus on consumption of patient-generated health data. These directives dictate that data that is generated by the patient as well as non-clinical data be effectively incorporated into the core functionality of the EHR for a certain minimum percentage of discharged patients.

The type of non-clinical data that will be accepted under this mandate has been identified as data from care providers, such as physical therapists, psychologists, nutritionists, occupational therapists and home healthcare providers.

With the significant emphasis in the requirements centered on patient engagement, the challenge will be for providers to find a way of engaging with their patients and bringing them on board to use patient portals. On the other hand and with regards to the Stage 3 draft, historically, patient engagement requirements have been highly scrutinized and targeted for removal. It is therefore open speculation as to whether any new patient engagement requirements will be able to withstand all initial scrutiny and make it to the final draft to be implemented in 2017.


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