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The Download Button

May 6, 2010
by David Raths
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Experts discuss how the push to get patients more involved in their care might shape meaningful use criteria.

How will the healthcare industry’s stated goals of getting patients more involved in their own care translate into upcoming meaningful use criteria?

That was one of the focal points of the May 4 meeting of the Meaningful Use Workgroup of the Health IT Policy Committee.

The first stage of meaningful use guidelines already pushes providers in the direction of developing patient portal technology to allow access to EHR data. Distilling what they heard at an April 20 public meeting, workgroup members talked about how other patient engagement goals might be translated into meaningful use criteria rolled out in 2013 and 2015.

While he supports getting more health data to patients, Neil Calman, M.D., president and CEO of the Institute for Family Health, said that the workgroup shouldn’t underestimate how transformative patient engagement efforts would be to the relationship between providers and patients, and they shouldn’t minimize the pushback they may get from many providers. When they talk about how patients own their own data and records, it may be true legally, but it is not the way the system functions today at all.

But Art Davidson, M.D., director of public health informatics at the Denver Public Health Department, suggested that physician reluctance to change could be overcome. He recalled the patient engagement hearing presentation of James Ralston, M.D., of the Group Health Research Institute in Seattle. Initially, there was concern on the part of Group Health doctors about using secure e-mail for patient interactions, but studies suggest doctors like using it now. Thirty percent of all primary care interactions at Group Health are now done through secure e-mail. That is the kind of transformational change that may be possible nationwide, Davidson suggested.

David Lansky, president and CEO of the Pacific Business Group on Health, summarized what many in the group were saying: that there might be three pathways to create criteria around patient engagement:

· First, they like the simplicity of the concept of a “download button,” which would mean patients should have access to their data anywhere, anytime;

· Second, criteria could be developed around the level of communications between patients and the team of providers working with them and perhaps also involving how the information from out-of-office interactions gets into the patient’s record;

· Third, the quality outcome measures being developed around controlling blood pressure and diabetes will likely be affected by team-based communications, so those measures may involve ensuring that patients are part of the communications loop.

Workgroup members agreed that whatever criteria are established, they should be written in a way that avoids being too prescriptive about how providers achieve them. A workgroup meeting in early June will study how meaningful use criteria could address disparities in the healthcare system.