For Vendors, “Patient-Centered” Not a Problem for Now

In addition to encouraging providers to adopt EHRs, the federal meaningful use program nudges them to share more of the information they collect in their new systems with patients. That’s a shift in focus for both providers and vendors, who have concentrated on IT systems designed around the needs of clinicians.

That nudging occurs in several of the measures related to engaging patients and their families in their healthcare. The measures are primarily met by providing patients with easier access to information about their health.

Despite the shifting focus to patient needs, EHR vendors have had little trouble meeting the meaningful use specifications, says Karen Bell, MD, MMS, the chair of the Certification Commission for Health Information Technology (CCHIT), one of six organizations authorized to approve EHR products for use in the program. While some vendors have struggled to meet certain of the system requirements, few have struggled with the criteria related to patient-centric criteria, she says.

“It hasn’t been a major change …,” Bell says. “There have been some areas where [vendors] have had to make significant changes to their products in order to accommodate the meaningful use criteria,” she reports, “but not so much on the patient-centric piece.”

To date, CCHIT has certified more than 200 EHR modules and systems for use in the meaningful use program.

Vendors a “Step Ahead”

“The vendor community in many ways is a step ahead of the criteria when it comes to patient-centricity,” according to Bell.

One reason is that vendors already had been responding to provider requests for the functions that the federal government later specified under meaningful use.

In addition, many of the criteria have been required under CCHIT’s own certification program, which predates meaningful use. Vendors that had received CCHIT certification were well positioned to meet the meaningful use requirements, Bell says.

CCHIT, an independent organization, develops its certification criteria through a voluntary, consensus-based process that involves a range of industry representation. It began certifying EHR products in 2006.

Simple for Now

The patient-centered measures are relatively simple in the first stage of the meaningful use program.

For example, stage 1 requires physicians to provide patients a copy of their clinical summaries for each office visit. While the information must be generated electronically in an EHR, it can be printed or faxed to patients to meet this measure. Most vendor products have been able to demonstrate this ability, Bell says.

Another criteria, which is optional in stage 1, requires that EHRs identify and provide patient-specific educational resources. CCHIT certification also has required this ability for some time, according to Bell.

The patient-centered objectives may be basic in stage 1, but patient advocates should not be discouraged, Bell says. Just requiring vendors to provide patient-centric aspects is a good first step.

Certification requirements in later stages of the program will increase in difficulty and influence product development that makes it easier for patients to get access to their information, Bell says. A preliminary draft of the stage 2 measures released last month does reflect a raised bar for patient-centricity.

“Meaningful use stage 1 is really about the structured data, very little of it is about actually beginning to exchange it at a level that really will meet the needs of most patients,” Bell says. “So it is a first step. It is an important first step, but it really is just that first step.”

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