How the Meaningful Use of Health IT Could Benefit Consumers …
If CMS Publishes a Strong and Robust Final Rule
FACT SHEET
In December, CMS released a proposed rule detailing incentive payments for the meaningful use of certified
EHR technology. This rule included many important provisions that would ensure that the public truly
benefits from the incredible investment of taxpayer dollars the country has put towards accelerating the
adoption and meaningful use of health information technology (HIT). But today CMS is facing
considerable industry pressure to greatly weaken this rule – potentially to the point where doctors and
hospitals could receive incentive payments to maintain the status quo.
Consumers agree that a final rule that does not build a foundation for tangible advancements in quality,
safety, and costs, and the systemic changes necessary to reform our health care system would be a waste of
taxpayer dollars and not set us on the needed course for the future. To make sure that incentive payments
do not simply go to digitizing paper records, but to actually improving the quality of care for patients and
consumers, CMS must maintain a strong and robust rule that includes the following:
1.
Patient Access to Their Personal Health Information. One of the most immediate needs
patients and their caregivers have is direct access to health information that supports them in better
managing and coordinating their care and making educated health care decisions. The proposed rule
moves us in the right direction by requiring doctors and hospitals to provide patients with timely
electronic access to their health information, along with electronic clinical care summaries and
discharge instructions at the end of an encounter. The final rule can and should go further, and
require doctors to also provide patients with education materials that will help consumers interpret
and make good use of their health information. Future stages of meaningful use should ensure
patients and caregivers have real-time, ongoing access to both personal health information and
patient-specific education materials.
2.
Protection from Dangerous Drug Interactions and other Medical Errors. Chronic
illness is a growing problem as Americans live longer, but sicker lives. To help maintain their health
and quality of life, many Americans take multiple prescription drugs – in worst case scenarios, up to
50 or more prescriptions a year.1 The proposed rule requires providers and hospitals to maintain
active medication and medication allergy lists for their patients and perform medication
reconciliation (a process for identifying the most accurate list of all medications the patient is taking)
at each transition of care or relevant encounter to protect patients from dangerous drug interactions.
Plus, by encouraging doctors to enter electronic orders (for labs, diagnostic tests and other services)
and progress notes, the proposed rule will help reduce the number of errors caused by illegible
handwriting.
3.
Improved Coordination and Communication to Ensure Safe Care Transitions.
Transitioning from one care setting to another can be one of the most perilous scenarios for
vulnerable patients. Often key information is lost in the shuffle between different physicians,
hospitals, and/or home. To receive meaningful use incentives in stage one, doctors and hospitals will
be required to ensure that a summary care record travels with the patient to any new providers
during a care transition. Hospitals will also have to provide patients with electronic copies of their
discharge instructions upon request when the patient leaves the hospital to go home or to another
facility. This information will help patients and caregivers better participate in decisions about and
manage their care.
4.
Reducing Health Disparities. The first step to improving care for vulnerable populations is
acquiring better information to identify what disparities exist where and to develop strategies to
reduce those disparities. In Stage One, providers will be required to record patient demographic
data, including race, ethnicity, preferred language and gender, which can then be used to stratify lists
of patients by specific conditions. Providers then can pinpoint gaps in care for underserved and
vulnerable populations and make improvements.
5.
Patient Reminders for Preventive and Follow Up Care. The health care system needs to
begin engaging patients so they can take the necessary steps to stay healthy, or, if chronically ill, to
manage their conditions to maximize their quality of life. A critical first step is letting patients know
when they need preventive and follow up care. The proposed rule requires providers to send patients
age 50 and over reminders for such care. That’s a beneficial first step, but patients of all ages need
preventive care, and many have conditions that require follow up care. The final rule should require
that clinically appropriate reminders be sent to all patients who need and want them, regardless of
age.
6.
Enhancing Patient Privacy and Security. As the health care system moves from paper to
electronic records, patients need to know that their personal health information will be secure and
kept private. The proposed rule requires providers to conduct risk assessments of their EHR systems
and implement improvements. In addition, all EHR systems will have to meet a set of privacy and
security standards and criteria to be certified, a requirement for any systems used by providers
seeking to qualify for meaningful use incentives.
7.
Meaningful Quality Reporting. Quality reporting keeps providers informed and aware of how
they are performing, where improvements in care are needed for patients, and how they compare to
their peers. It lets patients know how good their hospital or doctor is, and allows them to have
confidence that new delivery and payment models will not skimp on care to cut costs. While the list
of specific measures will have to be streamlined (with a focus on measures that matter to patients
and caregivers, such as outcome, care coordination and patient experience measures), the quality
reporting requirements in the proposed rule are essential to letting everyone know if the meaningful
use of health IT is delivering on its promise to improve the quality of our health care system, and to
helping providers succeed in the future as new models of care delivery are implemented under health
reform.
8.
Reducing Costs. The proposed rule includes many provisions that will greatly improve the
efficiency of our health care system and help reign in out of control costs. By fostering better
coordination and communication and making all of a patient’s relevant health information available
to providers in real time, the rule will reduce the number of repeat tests and medical errors patients
have to endure. In addition, with electronic access to their health information and educational
resources, patients will be able to better manage their own health and have fewer costly encounters
with the health care system.
9.
Rejecting the Status Quo and Transforming the Health Care System. Patients are not
going to benefit if their doctors and hospitals receive tax payer dollars simply for buying computer
systems and digitizing their records. Instead of reinforcing the status quo, the incentive payments
must catalyze innovation and transformation that moves us closer to a patient-centered health care
system that benefits the American public. The proposed rule strikes the right balance between
transformative and achievable and builds a foundation for change.
To take action against efforts to weaken health IT, please send a letter to Secretary Sebelius to urge her to
issue a final rule on the meaningful use of health IT that requires tangible improvements in quality and sets
the foundation for the systemic changes necessary for health reform.
1
Berenson, R. & Horvath, J. (2002). The Clinical Characteristics of Medicare Beneficiaries and Implications for Medicare Reform.
Prepared for: The Center for Medicare Advocacy Conference on Medicare Coordinated Care, Washington, DC. Retrieved September
24, 2009, from www.partnershipforsolutions.org.
The National Partnership for Women & Families is a non-profit, non-partisan advocacy group dedicated to promoting fairness in the
workplace, access to quality health care and policies that help women and men meet the dual demands of work and family. More
information is available at www.nationalpartnership.org.
© 2010 National Partnership for Women & Families. All rights reserved.
April 2010
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