As I wrote last week, HHS’s Office of the National Coordinator (ONC) for Health Information Technology (HIT) and the HIT Policy Committee advising it have made substantial progress in defining “meaningful use” (MU) of HIT. Comments on ONC’s first draft MU definition are due today, and the IxCenter has been working in collaboration with many other consumer-oriented organization through the Consumer Partnership for eHealth (CPeH). The Center for Information Therapy enthusiastically supports the CPeH input, which has been spearheaded by Eva Powell and Christine Bechtel from the National Partnership for Women & Families.

First, it’s important to be clear about what the tens of billions of dollars in the American Recovery & Reinvestment Act (ARRA) for HIT incentive were designed to promote. The legislation made it clear that taxpayers didn’t want to pay providers for “flipping a switch” to turn on an HIT system. American taxpayers want their money to be spent on “meaningful use” of HIT that improves the quality and efficiency of care delivery. So, CPeH frames the issue with the following statement:

“HIT is an essential tool for providing patient-centered care, and therefore the definition of its meaningful use should be patient-centered, reflect a clear, stepwise approach for workflow redesign and should signal, from the outset, a bold shift in the culture of health care.”

That framing is important. It also reflects, at least to some degree, ONC’s starting point with its June 16 draft definition. Building on this approach, there are some important areas in which CPeH believes the MU draft definition can be strengthened. I will outline a few of the key points below, and provide some commentary of my own. The full comments of CPeH include considerably more detail.

“The objectives and measures should be linked more clearly to the ultimate goal of improving health outcomes and the efficient use of health care resources, and be verified in robust ways.”

By tying each goal to a patient engagement component of meaningful use, we can guide MU of HIT to whether it delivers meaningful, useful information to patients and families. We should measure things that directly matter to consumers in terms of their functional status and experience with care, and we stratify measurement by gender, race, ethnicity, and primary language spoken to determine MU is achieved for all populations.

“Care coordination should be emphasized as a top initial priority for meaningful EHR use.”

It’s important that MU of HIT not lead only to good silos of information distribution, but rather allow for the efficient exchange of meaningful information. Health information exchange (HIE) can reduce fragmentation of the delivery system and facilitate effective care coordination if meaningful information can be transferred not only among providers but also to and from consumers. After-visit care summaries for clinicians and patients are a critical piece of this care coordination.

“Patient engagement must be fully integrated into all aspects of health care delivery through the innovative use of technology.”

We must ensure consumers access to information in a way that they can understand and use it. That information needs to provide decision support and assistance in managing health behaviors for prevention and chronic care self-management. MU of HIT also should facilitate better communication among clinicians and patients to encourage participatory medicine. And HIT systems should allow inputs from all relevant actors, certainly including data and information deriving from the consumers themselves.

“Information about patients’ experience of care should be collected and used for improvement….We recommend that steps toward this goal should be taken in 2013, not delayed until 2015.”

Measuring consumer experience of care is central to what MU of HIT is all about.

Today is the last day for providing comments to ONC on the first draft of its MU definition (see here for instructions). As the iterative process of defining MU develops, we’ll continue to follow and update here on this blog.

This entry was posted on Friday, June 26th, 2009 at 10:07 am and is filed under Engaging Consumers, Inside the Beltway, 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.