The $44,000 incentive for attesting to Meaningful Use should have most practices licking their chops. Yet, current provider concerns indicate the golden carrot may be much harder to attain than originally thought.
During an open forum at this year’s American Medical Informatics Association (AMIA) Symposium, the ONC, EHR vendors and individual providers met to discuss the most troublesome core objectives. Properly documenting lab results, true system interoperability and patient portal use requirements topped the list of issues.
Today, we take a look at these three measures and what the ONC is doing to address them.
Clinical Lab-Test Results
The clinical lab results objective in Stage 2 calls for providers to successfully incorporate clinical lab-test results into their EHR as structured data.
But it seems that many primary care providers are running into problems with EHR vendors not allowing them to properly organize and store lab results.
While most EHRs have the functionality, many vendors charge an additional fee for the service. And for providers who have a low volume of lab results, paying for custom laboratory features in their EHR isn’t a good investment.
In order to standardize the language for lab results and allow for easier exchange among providers, the ONC has adopted the Logical Observation Identifiers Names and Codes (LOINC) version 2.40 as the standard code set.
However, ensuring all lab results are coded in LOINC can be a costly and complex undertaking. It may require months of work depending on the size of the practice and the configuration of lab data.
The ONC is aware of the problem and is looking at broader policy levers and different avenues to approach it. Their main focus right now is making sure any future Meaningful Use EHR certifications require vendors to increase pricing transparency and adopt better interoperability language like LOINC.
Data Exchanges
To meet Stage 2 criteria, EPs must provide a summary-of-care record for more than 50% of all “transitions of care” documents and referrals. In addition, EPs have to exchange a summary at least once with a recipient who uses a different EHR from the sender’s EHR or conduct a successful exchange with a CMS-designed test EHR.
The problem lies in figuring out how to safely transfer clinical data between providers. This is leading an increasing number of healthcare organizations to turn to Direct Secure Messaging (DSM) protocol.
Designed in 2010 by a public-private consortium, DSM identifies how a clinical message, such as a summary of care, can be transmitted from one trusted provider to another.
Currently, companies are known as “health information service providers,” or HISPs are being created to work with DSM to route messages, maintain provider directories and verify sender authenticity.
Moving forward in Stage 2, all EHR vendors must now incorporate the ability to send and receive DSM in their software.
Still, many practices are having difficulty finding other EPs on the direct system. ONC responded by saying that DirectTrust and HISPs are working together on creating tools that will make provider directories more readily available.
Patient Portals
In Stage 2, EPs are also required to give at least 50% of patients online access to their health information. Furthermore, at least 5% of patients seen in that period must actually view, download or transmit their health information to a third party.
The first step to reaching these thresholds is deciding how you’ll give patients access to their medical records. The obvious method is using a patient portal, but this can be problematic.
The cost of buying and implementing a portal changes by vendor. EHR vendors that include a portal in the cost of their software ensure product compatibility, but you’ll still have to figure out how to enroll enough patients to meet Meaningful Use requirements. Highlighting portal features like appointment and refill requests, educational resources and online consults will certainly help.
Fully understanding the Meaningful Use criteria and how they apply to your individual technical and clinical situation is difficult. If you can afford it, consider assigning a project manager to focus on Meaningful Use attestation.
Also, work closely with your EHR vendor to see how they’re addressing pain points. In the end, they’re supposed to be the experts on all things Meaningful Use.
Although Stage 2 has already commenced for hospitals, smaller providers are still working diligently to prepare. Planning appropriately will help you focus on the key challenges keeping many providers from meeting objectives on time.
Want to learn more about Patient Portals and Meaningful Use? Watch the free “Patient Portals: What You Need to Know for Stage 2” webinar today.
