Medscape today carried a quite an depth look at what’s ahead for Meaningful Use part 2 and lays out some of the areas to where confusion and and stumbling blocks stand to occur. The article begins with speaking with a doctor who is currently using eClinical Works EMR and how he is already using a patient portal.
Through using his EMR he is quite confident he will be able to meet Stage 2. Also it’s worth noting that eClinical Works has gone a few extra degrees with creating their own “Join the Network” program. Part of meeting Meaningful Use 2 is to be able to connect to another brand EMR to exchange records or to use the test connect supplied by CMS to show it can be done by the doctor. eClinical Works has a portal too, so it appears there are choices here on whether or not to use one and any doctor using almost any EMR can join the “network”.
There is somewhat of a break before kicking in with Phase two of Meaningful Use and some doctors felt this was a good thing to really begin boning up on the new requirements, which in itself sets the stage for a lot of what Phase 2 requires. Those who missed out on Phase 1 will have it a little tougher as there will be a shorter learning curve with having to attest for more complex and addition items.
The big question of portals comes back around to giving access to more than half of the patients seen during the reporting period within 4 days of a patient visit along with a requirement that 5% do something with the records, like download or send to a 3rd party designated by the patient to have access. Portals work easier for patients but can be costly to add if the EMR doesn’t have one.
In addition personal health records come in to play with an alternative of allowing patients to transfer and/or upload information from the EMR to the personal health record (PHR). Some EMRs, and eClinical Works is included here, allow for the EMR to connect to a PHR through an integrated process and some of these are made available for the patient through a portal, but it can be a stand alone. In 2014 the ability to generate the patient summary in a CDA format (Health IT standard format) will be needed. Currently the CCD format is used but this has been a little tough going beyond a printed format as normally most want the information and data tabulated into fields of the same at the other end.
Security is also a big issue and again eClinical Works via their program is one of the answers to securely transferring data and there are a few other alternatives.
Another network that seems to be gaining recognition in this area is an HIE network from Surescripts, with their solution. It is not free but affordable. There are public networks being created and they are limited at present and many are still work in progress.
Labs use will have to be 2 way compliant, in other words both receiving and sending lab orders. Many doctors are probably well familiar with receiving but the sending side may be a learning curve. 10% of patients also must be set up to receive reminders, and this is primarily for those with chronic conditions at minimum. If it is not presently in the EMR to do this directly 3rd party software can be used in this case.
Those are some of the high points covered by the article and then of course the doctors also have an incentive for Phase 2 to really begin an active role in getting the patient involved as you need their participation to meet Phase 2.