PwC: Meaningful use means patient use

One of the primary benefits of image access in the EMR is patient education.

As the U.S. rolls out its largest ever investment in health IT, meaningful use promises to dramatically transform the delivery of care. However, until patient feedback takes the meaningful use stage, progress will remain slow, according to a February report issued by PricewaterhouseCoopers’ (PwC) Health Research Institute.

Personal health records (PHRs) spell improved patient care largely by consolidating patient-physician communication. Unlike EMRs and EHRs, PHRs are under patients’ control and require patients to upload information, while also including EMR-type information like lab results, diagnoses and medications.

As the nation’s hospital information systems turn increasingly digital, the Office of the National Coordinator for Health IT (ONC) has proposed higher standards for Stage 2 meaningful use (MU), calling specifically for more thorough electronic communication of results and information to patients on the part of providers. PwC argued that PHRs may forge this communicative link—but poor access (25 percent of Americans lack home internet) and limited knowledge of EHRs (44 percent of Americans don’t know the acronym) pose significant challenges to MU.

Surveying more than 300 provider executives and 1,000 consumers/patients, PwC found that the proportion of hospitals anticipating fulfillment of the 2015 Stages 1 through 3 MU deadlines is falling, from 90 percent in spring of 2010 to 82 percent currently. This translates to extended delays in EMR implementation and penalties for those institutions that fall behind the curve.

At present, PwC estimates that 14 percent of patients access their medical records electronically. And while prescriptions are the most common piece of digital health information, more than 55 percent of patients are believed to be unable to access lab results or physician visit notes via electronic records.

Still, underscoring ONC’s stepped up patient initiatives, PwC found signs of progress, including an increase in the proportion of health systems incorporating patient input into the MU process, from 19 percent last year to nearly 33 percent today. Moreover, ONC has stepped up its efforts to tackle interoperability, a significant challenge to communicating information to patients and other providers.

In the wake of heavy competition but slacking adoption of PHRs, one is left to wonder whether their limitations are partly inherent. As PwC noted, “Unless they are interfaced with a provider’s EHR system, commercial PHRs require patients to populate their own data—a cumbersome task,” and one that many patients may not find enticing. In this way, interoperable systems could spare patients the trouble while furnishing providers with unabridged and possibly more accurate access to patient information.

Based on its findings, PwC offered four recommendations to reaching a more patient-integrated MU:

• Step 1: “Health systems need to find ways to help their physicians buy in to PHRs and build processes to design, use and support them,” the report argued. The first step toward achieving this, PwC said, is choosing a physician or advanced-practice nurse to champion the cause.

• Step 2: “Define expectations for active participation in healthcare.” MU needs to be a coordinated effort between providers and patients, beginning with agreement between the two groups on what constitutes active participation in care and where responsibilities lie, particularly in the use of IT tools.
• Step 3: “Get family members on board,” the report insisted. PwC believes family caregivers represent “a critical element in driving patient adoption.”
• Step 4: With studies indicating that patients prefer PHRs offered by their providers, as opposed to commercial or other sources, hospitals can establish themselves as primary caregivers by including patients in the design and deployment of PHRs.

“The U.S. is embarking on the largest investment in health information technology ever, and success will ultimately be measured in better patient outcomes, higher quality and reduced cost,” the report concluded. To get the realization of these goals underway, PwC continued, “health systems need to have both patients and physicians using PHRs when making care decisions.”

To access PwC’s Putting patients into “meaningful use,” click here.