The Challenge in Stage 2:
Involve the Patient
Becoming a Stage 2 EHR
meaningful user will mean
getting patients to actively
participate in health information
exchange. Providers share early
thoughts and game plans.
By Joseph Goedert
It seems that every deadline and compliance date for health I. T. leaders is just around the corner. And unfor- tunately, they are, including the start of the Stage 2 EHR meaningful use program. The beginning of the 2014 fed- eral fiscal year (in October 2013) is when hospitals need
to have their ducks in a row to apply for Stage 2 payments. The
application period for physicians and other eligible professionals
opens January 2014 (for more on attestation and reporting periods,
see sidebar, page 32).
Mind you, those are the earliest dates when hospitals and EPs can
apply. But many feel an urgent need to get meaningful use Stage 2
done so they can tackle the other pressing items on their plate, such
as ICD- 10 compliance work, as well as multiple components of the
health reform law such as new care and reimbursement processes.
As Bill Spooner, senior vice president and chief information officer at
eight-hospital Sharp HealthCare in San Diego explains it, ICD- 10 is in
October 2014, state insurance exchanges are in January 2014, Stage 2
is in fiscal 2014, “and we also have to take care of our patients.”
Providers that struggled with Stage 1 won’t have an easier time with
the second stage, as the bar for compliance is raised. In particular, two
meaningful use measures in Stage 2 could be very troublesome for
providers to comply with, HIT leaders say.
The final Stage 2 rules require that patients have the ability to view,
download or transmit their health information within four business
days of the information being available to an eligible professional, and
within 36 hours of a hospital discharge, AND then getting at least 5
percent of patients to actually use the service.
Eligible professionals have another hurdle, as they must use secure
messaging technology to communicate with at least 5 percent of pa-
tients on relevant heath information.
Having the technology for view/download/transmit won’t be dif-
ficult for providers under Stage 2, since patient portal products are
readily available, says David Borden, chief technology officer at MRO
Inc., a vendor of release of information technology and services.
There will be process changes and workflow challenges associated
with adopting the portals, but the real heavy lifting will be in getting
the required threshold of patients to participate. “For the first time,
meaningful use attestation will depend not just on what the provider
does, but in changing patient behavior,” Borden adds.
Consequently, some providers are in a hurry-up mode to get a handle on how they will obtain proof of a certain level of patient engagement. At Greater Baltimore Medical Center, initial meetings on implementation of a patient Web portal started in October 2012 with Jeanne
Day, director of health information management, and David Hynson,
CIO, leading the project and working with the hospital’s meaningful
