Patient Engagement & Meaningful Use
In a recently published article on Meaningful Use Patient Engagement, several C-Level hospital executives respond to the low attestation numbers for Meaningful Use use Stage 2 (only 78 hospitals as of August 1), stating several reasons for the low numbers, one of which is the struggle with meeting the patient engagement core measures. They even go so far as to suggest that patient engagement should not be a core requirement for meaningful use attestation.
Patient Engagement is an important aspect of medical care, allowing the patient to become a member of their care team, not the object of the care team. While there are many things that the eligible provider or eligible hospital can do to encourage patient engagement, it is not the requirement for patient engagement activities within Meaningful Use that is the problem, rather the attestation requirements that need to be addressed.
No matter how hard the provider works to engage their patients, as the old saying goes, you can lead a horse to water, but you can’t make it drink. The attestation requirements depend on actions that are outside the control of the eligible provider / hospital. They measure the patient engagement by calculating a percentage of patients or authorized representatives that access / use the technology, not what the EP/EH is doing to engage their patients. In a lot of practices, a majority of patients are elderly, or low income, and these patients may not have the tools, skills, or support system required for electronic patient engagement.
Patient engagement through the use of portals, secure messaging, patient education, and the ability to view, download, and transmit health information is great and allows the “connected” patient to fully engage in their medical care. However, in the current environment, the “connected” patient still has to go to multiple platforms to get the full picture of what is happening with their medical history. More than likely, they have to visit (and remember URLs, account IDs and passwords) for each physician they see, one for each pharmacy/pharmacy chain they use, maybe one for each lab system they use, for their insurance provider, etc.).
We will not reach a high level of patient engagement until the focus for patient engagement changes from the provider to the patient. The patient needs to be able to access an integrated platform where they can go to access and manage ALL of their health information, communicate with ALL of their healthcare providers, and view their insurance information, which in and of itself is so complex that most don’t understand.
Until the patient’s needs are taken into account; the complexity of medical information is simplified such that the layman can not only understand, but use the data; the process of accessing and managing health information becomes as easy as balancing your checkbook in Quicken; and the general public understands the importance of managing their health (even when they are healthy) there is not going to be a lot of adoption from the patient community.
As for the call to remove patient engagement from Meaningful Use, my recommendation is to continue to require the tools that enable patient engagement, but adjust the attestation requirements to not hold the providers and hospitals accountable for circumstances way beyond their control. What we need to achieve a higher level of patient engagement is a full revolution that truly puts the patients in the center of their own healthcare and provides them with tools they can use to make it intuitive and easy to manage their health and wellness without disrupting their daily routines.
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