Meeting current criteria while preparing for the future
The Centers for Medicare & Medicaid Services designed Meaningful Use (MU) requirements to encourage healthcare organizations to adopt electronic health records (EHRs) and use them in a “meaningfulway” to improve patient care. Yet the question remains: What does it really mean to use technology in a“meaningful” way?Some would say it involves leveraging technology to integrate and share information seamlessly acrossthe care continuum. Others might mention that accurate reporting is key to enabling providers to usecomprehensive data when making critical care decisions. While both of these components are important, the true realization of “meaningful use” comes when technology is used in a way that fundamentallyenhances patient care and improves the patient experience. Reaching this goal requires organizations to keep patients top-of-mind throughout technology implementation—and beyond.
Rather than focusing on adopting technologies that “check the boxes” for MU Stage 1, organizationsmust keep their emphasis on the patient. Think years down the road, when MU incentive dollars are no longer on the table. Will the technology in place best serve the long-term needs of the organization andthe patient?To that end, this white paper offers strategies for taking a patient-centered approach to Stage 1 andStage 2 MU efforts. More specifically, it discusses how the use of robust technology – including data-enriched patient portals – can help organizations successfully meet MU requirements now and in the future, while still keeping focus squarely on what is important: sustaining meaningful relationships with patients.Meeting MU Objectives and Reporting Requirements MU criteria are staged in three progressive levels that aim to move a healthcare organization from: 1) initial data capture; to 2) consistent and seamless information sharing; to 3) clinical process enhancement and outcomes improvement. Stage 1 sets the baseline for electronic data capture and information sharing, while Stages 2 and 3 expand on that baseline and push providers to exchange information to further drive continuous quality improvement. (See Sidebar 1 for an overview of MU requirements.) Although most organizations are focused on meeting only the MU Stage 1 requirements directly in front
of them, it is imperative to understand the window of opportunity currently open in regard to technology implementation. Organizations now have the power to put systems in place that not only meet existing MU requirements, but also anticipate and satisfy criteria coming down the line. Keep in mind that each successive stage of MU raises the “capability bar” substantially. (See Sidebar 2 for a timeline of the
three phases of MU criteria.)
For example, MU Stage 1 largely asks organizations to show that they have adopted technology capable of capturing and exchanging patient data. In other words, at this stage, the mere implementation of technology is the primary goal. By contrast, those looking ahead will notice the distinct emphasis one-reporting found in Stage 2 and beyond. More specifically, the reporting requirements in Stage 2 call for certified technology capable of output reporting that can measure when patients receive, download and view information sent to them. Furthermore, an organization must be able to quantify the percentage of its patient population that receives healthcare information electronically—plus achieve a designated percentage of patients using the technology. Later MU stages require providers to further leverage technology to facilitate communication between providers and patients.While this kind of communication and reporting might sound simple, an organization’s ability to meet
the increased requirements could be challenging to manage and maintain. The difficulty increases when technologies are only used to meet immediate criteria, rather than considering the long-term resources needed to achieve all stages of Meaningful Use.
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Benefits of Leveraging Patient Portals for MU – Now and in the Future To effectively meet MU requirements at any stage, an organization must use certified technology.Typically, this takes the form of an EHR. However, many vendors’ solutions are not currently able to
fully meet the advanced stages of MU. An EHR on its own, for example, will seldom be able to satisfy the patient engagement requirements that make up an important component of the later stages of MU. These technology gaps could be challenging to close, and may slow down a healthcare organization’s progress toward achieving MU Stage 2 or Stage 3. Selecting technology, such as a patient portal that is ONC-certified as an Ambulatory EHR module, can help an organization meet the current requirements of Stage 1 and position itself to meet more demanding long-term needs. Unfortunately, the platform is at times overlooked as a technology capable of helping with all stages of MU compliance. Often, portals are viewed merely as a “nice to have” tool used only for enhancing direct patient-to-provider communication. Even among those organizations that do have portals, few take full advantage of their full capabilities.
In fact, estimates reveal that most healthcare organizations only use about 15 percent of the capabilities of their portals or EHRs, despite investing millions of dollars in the technologies. The situation is much like that involving ubiquitous Word or Excel applications; many people use the technologies, yet few truly understand how they work or know how to access the sophisticated components that can help take
performance to the next level.Built on top of a foundational platform, a small segment of patient portals can act as a comprehensive data repository and therefore can perform many different tasks to fulfill MU requirements. These portals are able to collect, standardize, normalize and store data supplied by patients or by any EHR system, allowing easy receipt and exchange of health information among patients and providers with different technology.
These select portals can help meet several core measures in MU Stage 1. For example, Core Measure 5 requires an organization to provide patients with an electronic copy of their health information upon request. Using a portal, a patient can view their Continuity of Care Document (CCD) on demand and download it, thus meeting the requirement. In Core Measure 6, clinical summaries for each visit must be provided. This information also can readily be available and accessible via a patient portal. In MU Stage 2, a portal can help meet criteria such as Core Measure 7, which requires that patients have the ability to view online, download and transmit their health information. Core Measure 8 involves providing clinical summaries for each patient visit, while Core Measure 15 stipulates that the provider supply a ”summary of care” record for each transition of care or referral. Each of these measures can be met and the required information provided to the patient via a portal.
When patients provide information through a portal, they often are simultaneously satisfying other MU criteria, as well. For example, patients who update their health history information via a portal or who complete and submit an interactive form found on a portal may help an organization meet MU Stage 1 Core Measure 9, which requires providers to maintain an up-to-date problem list of current and active diagnoses, or the Core Measure 10 stipulation of an active allergy list. Similarly, in MU Stage 2, the patient may help meet the Core Measure 3 requirement to record demographic information or the Core Measure 5 call to record smoking status of patients age 13 years or older. Readmore
