I’ve been a big fan of the “engaged patient” for about as long as I’ve known what the term meant, but until earlier this week, I hadn’t given much thought to the burden Meaningful Use requirements potentially place on providers to create these types of folks.
As I’m sure most readers know, comments on proposed Meaningful Use Stage 2 requirements were due to CMS this past Monday. Many organizations not only turned in comments, but released summaries of those comments to various media outlets as well.
Lynn Scheps, Vice President of Government Affairs at SRSsoft, has done a nice job of drawing out a few major themes from comments submitted over the 60-day period. In her most recent Meaningful Use Monday blog, she points out that:
“While increased patient engagement is recognized as an important goal, providers are expressing concern about having their incentives be dependent on actions by patients—actions over which they have no real control. For example, one proposed measure would require that 10% of patients access their information on the physician’s portal, and another that 10% of patients send a secure e-mail message to their physician.”
Now, as I’ve written (or tweeted) about before, I’ve tried to get into using a personal health record, and just found it to be too much trouble, too time consuming. If I, a fairly digitally savvy healthcare consumer (and thankfully a fairly healthy one), can’t keep up with a PHR, how likely is it that patients who don’t even have an email address will immediately jump onto their physician’s portal or send e-mail messages to their physician.
And it should probably be pointed out that those who make up the bulk of healthcare costs in America – the chronically ill and/or obese – most likely consist of patients in underserved communities, people who don’t have consistent access to the Internet. It’s a systemic problem that I could write at length about, but I’ll save that for another blog altogether.
On the flip side, the Robert Wood Johnson Foundation, in its Stage 2 comments to CMS, called for the criteria around patient engagement to be either maintained or enhanced. Its views on doubling the 10-percent threshold of patients viewing, downloading or transmitting their health information seems fairly indicative of their stance on the criteria as a whole:
“This change would provide an incentive to health professionals to adopt patient-facing platforms that have the potential to increase patient engagement and self-care.”
Needless to say, it will be interesting to see what route CMS takes when it issues a final rule sometime in August. I do hope that it errs on the side of conservative optimism, and keeps its proposed patient engagement criteria, rather than decreasing or banishing them altogether. Hopefully this can help healthcare overcome its bad habit of protracted procrastination and, with the tiniest of baby steps, help physicians get over the hump of getting themselves, and their patients, on the digital bandwagon.