For the past several months, the Center for Information Therapy (IxCenter) has been working alongside other consumer advocates to guide the HHS definition of “meaningful use” of EHRs to include consumer access to meaningful information. Part of that collaboration has been with the Consumer Partnership for eHealth (CPeH), which has brought together many organizations dedicated to advancing a patient-centered care delivery system. We also believe it’s important to build a meaningful use definition off of robust definitions of patient-centered care, such as that proposed recently by Don Berwick.

With the decisions on meaningful use now being hammered out by the Office of the National Coordinator (ONC) for HIT with input from the HIT Policy Committee (with detailed guidance from a meaningful use workgroup), CPeH has developed a consumer pathway to meaningful use to help inform the discussions.

Here’s an overview of our recommendations:

• To ensure care is comprehensive, coordinated, personalized and planned:
  • By 2011:
    • Care summary is generated and shared with the patient and other authorized providers and family caregivers after every visit or
      discharge.
    • Reminders about preventive services, medications, necessary/routine tests, and follow-up care are sent to patients via their preferred medium
  • By 2013:
    • Prompts and key information (patient preferences, health goals, functional status, preferred language, advance directives and social situation) are used to individualize and customize care
    • Patient generated data is incorporated into the clinical context for individualized care
    • Connections are made to community resources
• To ensure patients and their caregivers are partners, making informed, shared decisions:
  • By 2011:
    • Patients have electronic access to the lab results, medication lists and problem lists
    • Care summary (see above)
    • Patients are connected to resources that help them understand their medical information in the context of their specific health needs
    • Providers make available shared decision making tools to promote partnership in care and treatment decisions
  • By 2013:
    • Patients have real-time electronic access to their medical record along with linkages to tools that make the information meaningful and useful to them
    • Patients have access to evidence-based decision support tools that enable informed choices tailored to their preferences
• To ensure transitions between settings of care are smooth, safe, effective and efficient:
  • By 2011:
    • Care summary (see above)
  • By 2013:
    • Referrals are made to online patient coaching and/or other self-care management tools
• To ensure patients can get care when, where, and how they need it:
  • By 2011:
    • Patients are able to use secure messaging or email for more timely and beneficial communication with their providers
    • Personal health records (PHRs) or other consumer tools are populated by providers and are easily portable
  • By 2013:
    • Patients are able to use online scheduling for more convenient access to their care providers
    • Providers use remote monitoring to manage patients with chronic illnesses in the least restrictive way
    • Electronic tools provided by the health care team are accessible to people with visual, hearing, mobility, cognitive, and other impairments (and in multiple languages)
• To ensure patients and their caregivers are participants in continuous quality improvement:
  • By 2011:
    • Information about patients’ experience of care is collected electronically and used to improve
    • Quality data are electronically generated, aggregated and publicly reported in ways that are meaningful for consumer use
    • Information about race, ethnicity, primary language, and gender is collected and used in ongoing efforts to reduce disparities
  • By 2013:
    • Data regarding cost and the clinical quality of care are electronically collected and publicly reported for consumer use
    • Outcomes measures are reported stratified by race, ethnicity, primary language, and gender to spur disparities reduction

We firmly believe that effective, meaningful use of HIT can help create a platform for a better, more efficient health care delivery system, but only if we design it to meet consumers’ needs and preferences at the right time, in the right setting, and in the right way. The elements above will take us a long way in getting there.

For those interested in the detailed recommendations from CPeH, please contact me directly or leave a note in the comments section.

This entry was posted on Friday, June 5th, 2009 at 9:37 am and is filed under Consumer empowerment, Decision Support, EHRs, Engaging Consumers, Health Care Reform, Inside the Beltway, PHRs, Participatory Medicine, Patient-Clinician Relationship. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.