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Does Meaningful Use = Patient Portal?

May 6, 2009
by David Raths
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After reading through transcripts of the recent National Committee on Vital and Health Statistics hearing on trying to define "meaningful use" of health information technology, I was struck by several comments that focused on patient access to information as a central component of meaningful use.

In response to one panel's presentations, Paul Tang, M.D., chief medical information officer of the Palo Alto Medical Foundation, asked panelists directly: "Do you think that patients' access to and use of information contained in the electronic health records to be a part of the definition and qualification for getting the incentive?"

The answer Dr. Tang got from the panelists was an unequivocal yes.

Stephen Schoenbaum, M.D., M.P.H., executive vice president for programs at the Commonwealth Fund, noted that several years ago his organization conducted a research project with the University of Colorado Health Sciences Center, which was one of the first looking at patient access to electronic medical records. He said that despite the fears of physicians that patients were going to get confused, that they weren't going to like it, that the physicians were then going to be overwhelmed with all sorts of unnecessary requests, essentially none of that happened. Patients did like having access to their records.

Steve Findlay, a healthcare analyst for Consumers Union, also spoke about the importance of including patient access to their records in the certification criteria for EHRs. Other speakers noted that among the most successful EHR implementations in the country to date, most have a patient-facing component that is highly popular with patients.

So while providers and vendors wrestle with whether meaningful use will include clinical decision support tools, CPOE, or involvement in a health information exchange, it sounds like a patient-facing portal could end up being a requirement. I think that might be a good thing, though having written about patient portals before, I know that not many healthcare organizations have yet made progress on that front.



Adding patient portal capability to the meaningful use requirement makes a lot of sense and in no way is getting ahead of ourselves. This technology exists now. If we only define 'meaningful use' in terms of EHR function we are losing an opportunity to make some real advances.
Meaningful use — should be just that — meaningful. It should be

1. useful to clinicians in the provision of care,

2. useful in the business of 'the practice of medicine' and

3. useful to the patient.

Patient portals are one of the best opportunities to accomplish these three elements — and fundamentally create a care platform - allowing patients to 'be an active participant in their own healthcare'. A patient portal provides a host of 'meaningful functionality' including pre-registration, appointment setting, prescription renewals, appointment reminders, asking questions of the doctor and clinical staff, virtual office visits, bill payment, secure patient messaging, physician referrals and more.

This is simple, inexpensive technology that can be rapidly deployed, easily interfaces with an EHR and is the standard of service we all have come to expect in our dealings with nearly all other service industries. Without something like this, we will have an incomplete network — that inexplicably omits the principal player (and a large part of the potential value) — the patient."

Nice post David. As I've indicated in other comments, I think we are getting way ahead of ourselves as an industry. As you noted, not many organizations have made progress on the portal front. To me, suggestions that portals be part of the initial definition of meaningful use is akin to telling people they must demonstrate implementation of windows regardless of whether they have a house or not. First things first.