A Patient Perspective on the New Health Records Regulations
The federal government has been busy trying to get doctors and hospitals to use electronic health records (EHR) and to make appropriate access to the records easier. They do this by issuing regulations for EHRs linked to tens of $Billions in incentives. Stage 1 of this effort began a few years ago and has had almost no visible effect on care coordination and patient access to records. Stage 2 is about to turn up the heat. If things stay on track, by the beginning of 2014 patients will have vastly increased access to their own information and will have a secure email system to communicate with their doctors.
HHS released the proposed Meaningful Use Stage 2 regulations last week. I’ve abstracted the 455 page document to less than 4 pages of items that directly impact patients. My preliminary conclusion is that Stage 2 is a huge leap toward coordinated, patient-centered care and makes unprecedented efforts toward patient engagement.
By mandating comprehensive structured summaries be available to patients for download as well as on-line viewing, Stage 2 enables patient-directed health information exchange as an alternative to hidden provider-provider transactions that characterized earlier HIE efforts.
Although not mentioned by name, the implied use of Direct secure messaging for physician-physician and patient-physician communications will hopefully finally cause all EHRs to communicate with all other EHRs and PHRs without costly interfaces.
Also, new requirements for accessible imaging should eliminate the hassle of CDs for patients and doctors alike and make referrals and second opinions easier than ever.
All of these privacy, transparency and accessibility enhancements come none-too-soon as ACO payment reforms implicitly drive providers to keep patients in their particular network. Effective patient access to both cost and medical data is essential to preserving informed choice, reducing fraud and enabling the independent assessment of quality.