Electronic Health Records

Policy & Regulation News

Debating Meaningful Use Requirements for Patient Engagement

By Kyle Murphy, PhD

The proposed reduction of patient engagement meaningful use requirements between 2015 and 2017 has received a mixture of support and criticism from industry stakeholders.

Both the Medical Group Management Association (MGMA) and Healthcare Information and Management System Society (HIMSS) support reducing the threshold for view, download, and transmit and secure messaging as well as many other components of the proposed modificaitons to meaningful use in 2015 to 2017.

Conversely, the Consumer Partnership for eHealth (CPeH) and Consumer-Purchaser Alliance (CP-Alliance) contend that the modifications to patient engagement meaningful use requirements constitute a "dramatic retreat."

"CPeH, C-P Alliance, and the undersigned organizations and individuals are dismayed that CMS intends no longer to require that five percent of patients view, download or transmit their health information or send a secure message to their providers," the organizations state in a letter to the Centers for Medicare & Medicaid Services (CMS) Acting Administrator Any Slavitt.

The two organizations and their cosigners argue that the proposed modifications have serious ramifications for patients and their caregivers, such as undermining national initiatives for healthcare reform.

"A minimum standard of 5 percent signals a genuine expectation by CMS that organizations make the process changes necessary to support online access; it is meaningful enough to drive real progress in patient and family engagement and real change in clinical culture," they continue. "Dropping to just one patient, and merely turning secure messaging on, signals a drastic reversal in CMS's expectations of providers and patient engagement."

In contrast to these comments from the patient perspective, MGMA and HIMSS have issued comments from the point-of-view of providers struggling to meet these meaningful use requirements.

"While we may agree that as technology improves patients may become more engaged in their healthcare, the industry is clearly not at the stage to support arbitrary thresholds for patient engagement measures," writes MGMA President and CEO Halee Fischer-Wright, MD, MMM.

MGMA claims that many specialty physicians do not have the ongoing patient relationships necessary for meeting the five-percent VDT requirements. What's more, the organization debates whether the patient engagement requirements put forth by CMS address the needs and wants of patients.

"It is true that more and more patients want to leverage online functionalities when interacting with the healthcare system," the MGMA letter states. "However, our members report that patients are far more interested in utilizing online administrative tools such as appointment scheduling, prescription refill requests, reviewing and paying outstanding balances, and completion of registration, HIPAA, and other forms."

According to MGMA, getting patients to use these administrative services should lead them to leverage VDT of their records.

For its part, HIMSS is calling on CMS to take a phased approach to patient engagement requirements for the EHR Incentive Programs going forward:

As a part of this approach, given the tight timeline between the publication of this Final Rule and the end of calendar year 2015, CMS could leave the proposed measures in place for 2015, and then phase-in increased threshold requirements for 2016 and 2017, increasing each 1%, 2% to 3% per year to propel the field forward.  We propose that this approach continue for Meaningful Use Stage 3 in 2018 and beyond; we emphasize that incremental increases avoid substantial jumps from year to year, or between stages.

The organization maintains that a phased approach will allow technology to evolve and become more user-friendly, making it a highly valuable tool for patients.

The comment period for these proposed meaningful use modifications closed on June 15.

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