There seems to be no letup in the barrage of healthcare reforms that providers are facing in the US today. Leading the charge is the CMS and the ONC, both working tirelessly to capture and demonstrate the valuable part information technology can and should play in the healthcare sector. Perhaps their pièce de résistance, the Meaningful Use program is at the heart of EHR-focused reforms and innovations that the medical industry has been brought to recon with. From its inception in 2011, MU has assumed two stages with a certain level of success. Seeing this level of success, the government has been spurred on to cast the net even wider and see what exactly they can add to the program without crippling the medical sector outright. The result is an addition to MU in the form of Stage Three, a patch, if you may, to Stage Two with some characteristic additions and clarifications. In this article, we’ll be looking at the four major patient engagement topics in MU and what they mean for healthcare providers.

Order Tracking

This is less of a patient engagement clause than an administrative one. It states that the EHR system in use should be able to support the follow-up on orders to improve the management of results. For instance if a lab test is requested from a different provider, then the system should be able to track these orders. This also applies to specialty consult requests where a specialist is requested to consult on behalf of the primary provider. This is also treated as an order and the EHR must be able to track this. A certified EHR system will therefore satisfy a number of criteria when implemented and these include:

• The system should display the abnormal flags for test results if it is indicated in the lab-result message
• Provide ability for ordering provider to optionally indicate a date that the order should be completed by when entering the order, which triggers notification to the ordering provider if the results are not returned by the indicated date
• Notify ordering provider when results are available or not completed by a certain time
• Record date and time that results are reviewed and by whom
• Provide the capability to match results (e.g., lab tests, consultation results) with the order in order to accurately results each order or to detect when an order has not been completed

The outcome of this is that the EHR you use must have extended capabilities to cater for this functionality and by extension, have a level of interoperability with the corresponding parties the party is liaising with.

Patient Generated Health Data

This clause provides for providers to receive patient-generated health data or to use a better-known term, user generated content (UGC), in the form of structured data from the users through the EHR system. What this means is that your EHR will need to have a questionnaire function or something similar that allows the provider to request certain structured information from patients and to receive this through the system in a structured format. This information is as varied as the sort of inference the provider wants to adduce after analyzing the data. This item does not seem to present any form of challenge on the outset as there are no specific thresholds that must be attained to ensure compliance.

Medication Adherence

This MU objective seeks to create some form of synergistic feedback loop between the provider and the pharmacy benefit manager (PBM) to track how users are adhering to medication through the course of their treatment. Previously this information had to be inferred from disparate sources of data but with this new requirement, it’s hoped that providers can more easily merge data from the pharmacy and gain deeper insights into medication adherence. This EHR feature is also expected to patch into Prescription Drug Monitoring Program (PDMP) data in a more streamlined manner.

Amendments

Previously, patients who wanted to have their health records amended needed to follow a lengthy process that required them to submit written or electronic requests to the provider through traditional communication means. This meant these requests would exist outside of the EHR system even though they affected the data within the EHR system. This item changes that. It calls for functionality to be built into EHR systems to enable patients to request amendments to their medical records from within the system. These amendments could include corrections, additions, or updates to the record among other changes. The anticipated outcome is to have these requests live within the EHR system and so can be easily referred to when tracking changes effected on a patient’s medical records.

These are the main objectives of Meaningful Use that directly impact patient engagement. Whereas many of these requirements are directed towards software vendors in order for them to upgrade their systems appropriately, they are still highly instructional for medical professionals to benchmark the systems they use against to gauge whether they are keeping pace with the changes coming.