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most grand visions however, the devil is in the details. Meaningful
Use basically requires that practice data systems such as EMR's and
patient portals are not merely installed, but actually used. The rub -
creating objectives and measurements that are applicable to all types of
providers. A lot is at stake with the incentive payments for 2011
through 2015, however these payments pale in the light of benefits
possible from fully utilizing the available information technology (IT)
applications.
Profitable Business Applications
Although a rational approach might be to just get 'er done, meet the
"minimal use" of Meaningful Use and leave the grand vision for another
day. Doing so may qualify for the incentive payments, yet leave a lot on
the table. Using these powerful IT tools can create profitable business
efficiencies. To explain, I've added a fourth column to the abbreviated
chart summarizing Meaningful Use. In the highlighted column are business
opportunities that result from going beyond "minimal use". These IT
applications create the opportunity for double barreled improvements to
the bottom line on both the expense and revenue sides that will continue
well beyond 2015.
The attached chart is self-explanatory, but let’s elaborate on two of
the business opportunities. The first deals specifically with the
exchange of information with other providers. The second involves access
to health information and engaging patients and families in their
healthcare, spanning multiple objectives.
The "minimal use" for improving care coordination calls for a single
test exchanging information to another provider. The business
opportunity comes from creating a network of referring physicians and
optometrists to securely share necessary information, coordinating care
and co-management. This would enhance all aspects of the referral care
cycle, from booking the appointment, to transferring information pre and
post appointment to coordinating co management. Being able to
efficiently manage these information flows through a referral portal
reduces costs and improves care. The dividends from happy patients,
happy referring physicians and improved care can be huge.
Creating a Dialogue
Engaging patients and families in their health care calls for efficient
access to information. This can be accomplished by establishing a portal
based dialogue with patients enabling a full seven of the fifteen core
set and four of the ten menu objectives of Meaningful Use. But why stop
there? Why not expand both the scope and scale and go beyond the
"minimal use" of Meaningful Use, driving all routine patient
communication to a patient portal? If you haven't noticed, the financial
services industry has just about completed the transition to secure
portal based communication and self service. In addition to satisfying
the core and menu objectives, establishing communication over the portal
opens the door for secure messaging, on-line appointment booking and
receiving statements and paying bills. Lastly, making all of this
functionality available leverages the practice's web site increasing
traffic and the availability of a cornucopia of other informational
links.
So over the next year, whenever the subject of Meaningful Use comes up,
think through the potential business opportunities as you ponder how to
meet the objectives for the incentive payments.
Meaningful Use with a Patient Portal
|
| Objective |
Type |
Stage 1 Measure |
Business Opportunity Using a Patient Portal |
| Record demographics as structured data
|
Core |
> 50% of patients of the EP with demographics entered as
structured data |
Use a patient portal to
enable patient self entry of all demographics and medical history
reducing data entry costs and clerical errors. |
| Provide patients with an electronic copy of their health information
upon request. |
Core |
Core > 50% of all patients of the EP who request an
electronic copy of their health information are provided it
within 3 business days. |
Use a patient portal to enable patients to securely
request and receive requested information reducing clerical costs and
postage. |
| Provide clinical summaries for patients for each office visit. |
Core |
Clinical summaries provided to patients for > 50% of all office visits
within 3 business days |
Use a patient portal to securely send patients
electronic copies of their office visit summaries. Allow adult
caregivers secure access to improve care of elderly parents, reduce time
and effort coordinating care. |
| Provide key clinical information among providers of care electronically.
|
Core |
Perform at least one test of certified EHR technology's capacity to
electronically exchange key clinical information |
Establish a Referral
Portal for referring optometrists and physicians to coordinate all
aspects of the referral cycle: appointment booking, pre and post
appointment information exchange and co management. |
| Maintain up-to-date problem list of current and active
diagnoses. |
Core |
> 80% of patients have a current problem list |
Use a patient portal to enable patients to update to their
medical histories avoiding errors by engaging patients in the
process. |
| Maintain an active medication list. |
Core |
>80% of patients have a current medication list |
Use the patient portal to reconcile medication list when
the patient is able to access their medications at home to improve
accuracy. |
| Record smoking status of patients >13 years of age
|
Core |
>50% of patients have their smoking status recorded. |
Use the patient portal to enable
patient self entry of smoking status. |
| Send reminders to patients for preventive/ follow up care. |
Menu |
> 20% receive an appropriate reminder.
|
Use a patient portal to send all
patients an appointment reminder reducing staff time and postage costs.
|
| Provide patients with electronic access to their health
information within four business days of the information being
available. |
Menu |
>10% of all patients provided electronic access to their
health information subject to the EP’s discretion. |
Use a patient portal to allow access to
pull up their current health information along with any clinic office
visit summary.
|
| Identify and provide appropriate patient-specific education
materials. |
Menu |
>10% of are provided patient-specific educational resources. |
Use a
patient portal to create a dialogue sending condition specific
educational material based on the demographic and medical information.
|
| Provide a summary of care for patients transitioning to
another provider or care setting. |
Menu |
>50% of transitions of care and referrals have summaries
provided. |
Use Referral Portal to initiate sending data to the
referring doctor or specialist who has been added to your secure sharing
network.
|
Sources:
http://www.ofr.gov/OFRUpload/OFRData/2010-17207_PI.pdf |
