Putting patients into “meaningful use”

The Health Research Institute at PricewaterhouseCoopers released a report today entitled Putting patients into “meaningful use.” It begins with the anecdote I’ve blogged about previously regarding a diagnosis by Facebook in lieu of a PHR, which some have highlighted as a great success for social media in health care.  I am much less sanguine on that front.

The PwC report, of course, has much more than that story in it; here are the key takeaways, backed up with some survey data and interviews:

  1. Engaging external constituents may postpone achievement of “meaningful use.”
  2. Patient awareness of and access to available health IT tools is low; social, expectation, and education hurdles also exist.
  3. Patient engagement in “meaningful use” is still low, despite consumer interest.
  4. “Meaningful use” has yet to explicitly call for measuring the level of patient engagement.
  5. Health systems will need to compete for consumers in the PHR market.

Point 4 is on the cusp of change, as draft Meaningful Use standards for Stage 2 are now being considered by ONC.  PwC contacted me for input on this question, and I was happy to be able to provide it on behalf of the Society for Participatory Medicine.  The report identifies the Society and its mission, and notes that we have “aske[d] ONC to strengthen the ‘meaningful use’ standards and to add to them certain measures that would assist providers in gauging how well they are involving patients in such activities as work flow redesign and quality improvement initiatives.”

Finally, PwC notes that “healthcare providers can follow four steps to promote adoption and utilization of PHRs:”

  1. Make the physician/advanced-practice nurse the face of the PHR.
  2. Define expectations for active participation in healthcare.
  3. Get family members on board.
  4. Design PHRs alongside patients to keep them coming back.

It is heartening to see healthcare providers and their advisors adopt these as guideposts along the path to meaningful use.

Where have these principles already been adopted?  What other principles need to be observed?  We’d love to hear about case studies — whether in process or already rolled out — in the comments.


Posted in: general | medical records | policy issues | pt/doc co-care | reforming hc | trends & principles




2 Responses to “Putting patients into “meaningful use””

  1. TJamieson says:

    “Meaningful Use”, is attempting to correct the philosophy that patient medical information is the ownership of medical providers who have created it. Even though most medical professionals are willing to talk about including patients in their care including the information that defines their diagnosis, treatments and results, have not worked in that direction.

    EMR/EHR systems have been created for medical providers to capture information about their clients (patients) and the typical functions of their business like scheduling, billing and workflow to improve their specific organization. These systems are similar to all of the fundamental IT systems used in other industries such as Insurance, Banking & Manufacturing. None of these business systems share data across multiple companies or medical providers to build a centric record of the same client.

    There are technology companies that cover the “Meaningful Use” visions and intends. PriceWaterHouse is incorrect with their assessment stated in “1. Engaging external constituents may postpone achievement of “meaningful use.”” It is imperative that EMR/EHR systems do what they do well, cover medical providers’ business needs, and that Patient-Centric Informatics systems support “Meaningful Use” requirements. Personal Health Record (PHR) systems that only capture the patient’s rendition of their medical information is not going to solve the “Meaningful Use” requirements either. Systems that combine the patient’s health information with the medical information from medical providers are the solutions needed that provide value, quality and efficiencies to the three entities of the healthcare paradigm, patients, medical providers and insurers.

    • David Harlow says:

      Thanks for your comment. I would take issue with a couple of points, though.

      First, access to and ownership of patient health information is a HIPAA issue, not a Meaningful Use issue.

      Second, the paradigm for interoperability that many folks keep coming back to is the ATM network form the banking industry. “Just-in-time” supply chain management requires these sorts of linkages as well. While there may not be a single central record encompassing all data points, neither is ther in the health care EHR model. Multiple providers; multiple EHRs.

      Finally, in order for Meaningful Use to be , um, meaningful, external constituents — i.e., patients — must be fully engaged, and since there has been, generally speaking, a lag in doing so to date, taking this step will take some additional time. Accordingly, the bar is set fairly low for Meaningful Use Stage 2, as it was for Stage 1, thus ensuring that provider organizations will get their stimulus dollars.

      I think we all hope that the hard work of fully engaging patients continues nonetheless.

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