use governance committee.
The initial plan calls for completion this
month of a charter document outlining the
purpose of the project, key stakeholders and
participating personnel within the hospital,
selection of a patient portal vendor by the end
of February 2013, and portal implementation
starting in July when the hospital’s new fiscal year—which includes portal funding—
begins. The hospital is not yet considering
process and workflow changes that the
portal will require, believing it will better
understand what changes are needed as
they learn of various portal functions during the vendor selection process, Day says.
A patient portal is a must-have to comply
with view/download/transmit, and it also
could help with secure messaging as well,
Spooner says. He envisions discharge coordinators, admissions staff and nurses will
handle patient education in the hospitals
with front desk personnel and nurses doing
the same in ambulatory settings, although
that might vary based on the practices.
But his message on the timetable to get
ready is clear: “You need to be thinking of it
now and you don’t have a lot of time. There
are a lot of moving parts and it does overlay
with ICD- 10 and everything else, so don’t
There’s another timetable factor associ-
ated with meaningful use as time periods
for Stage 2 were changed in the final rules
and trying to figure out the best time to at-
test may be confusing .
comfortable they’ll be moving along well
with Stage 2,” he says.
But challenges remain to meet the view/
download/transmit and secure messaging
measures in Stage 2, not the least of which
is reaching the 5 percent patient threshold.
The move toward accountable care organizations, with their heavy reliance on health
information exchange and data analytics
to make treatments more personalized will
help with patient engagement, Spooner believes. He hopes that becoming more cus-tomer-focused will get organizations past
the 5 percent threshold.
Another challenge will be using the
SNOMED-CT terminology for problem lists
under Stage 2, and that means a large learning curve ahead for physicians as most do
not use the terminology, he adds.
Even with portals in place, work remains
at Sharp Healthcare to enhance them for
Stage 2 requirements. The organization
built its own portals to ease interfacing and
that worked well. But the portals are first-
generation, offering online scheduling,
payments, refill requests, lab results, recent
visits, problem lists, e-mail with providers
and downloading of patient summaries.
In some ways, Sharp HealthCare is in decent shape at this early stage with portal
readiness. The seven-hospital delivery
system two years ago built an ambulatory
portal, which gets significant traffic, and an
inpatient portal, which has had little use so
far. And the ambulatory portal already supports secure messaging.
CIO Spooner got a good roadmap on
Stage 2 preparations from Sharp’s core inpatient EHR vendor (Cerner) and ambulatory vendor (Allscripts) this fall. “Both vendors were pretty good with Stage 1, so I’m
Health care providers have plenty of challenges ahead of them to be able to quickly give
patients the ability on online view, download and transmit their health information under
Stage 2 of the electronic health records meaningful use program, and so do their services
and software vendors.
Vendors that offer outsourced release of information services have to expand out of the
traditional boundaries of what they do—copy images of records and give them to patients,
says David Borden, chief technology officer at MRO Corp., King of Prussia, Pa. Now,
they’ll have to generate and hold discrete data.
MRO created a patient portal to make electronic copies of records or discharge summaries available to providers who wanted to comply with a menu (optional) measure under
Stage 1, Borden notes. In Stage 2, he believes every EHR will have to include a portal, but
MRO will continue to offer its portal if clients want them to handle view/download/transmit
The vendor also is building a personal health record to offer another tool for facilitating
patient access to their information. The PHR will support a Continuity of Care Document
at a minimum, but also will be able to access data from multiple sources. Further, MRO is
becoming a health information services provider, which builds secure gateways for health
organizations, to support the core measure for physicians to use secure messaging technology to communicate with at least 5 percent of patients, and to provide clients with Web
domains and e-mail addresses.
Release of information outsource vendor IOD Inc., Green Bay, Wis., also is building an
infrastructure to support view/download/transmit and secure messaging. The company
has adopted the Direct Protocol messaging specifications embedded in an Inbox for
physicians to communicate with patients, and is creating a digital rights system to manage
the process of authenticating the identity of physicians and patients, says Bill Sweeney,
chief technology officer. Among other features, a database from identity management firm
IDology Inc. in Atlanta, will store specific consumer information pulled form a multitude of
market intelligence and public records databases across the nation to ask patients specific
questions, such as, “What was the name of your landlord in Washington, D.C.?”
IOD also is working with personal health record vendors HealthVault and Dossia to en-
able patients to access their records via the PHR platforms.
Vendors Also Face Stage 2 HIE Challenges