A coalition of 25 consumer groups and unions is asking federal officials to hold firm on more stringent criteria for Stage 2 of electronic health records meaningful use, and expressing support for going further.
For instance, because patients still trust their providers more than other information sources, holding providers accountable for actual usage of a patient Web portal "is entirely appropriate and we strongly urge ONC to resist pressure from the provider community to absolve them from responsibility for making these services available and useful to their patients," according to a comment letter to the Office of the National Coordinator.
"In other industries, performance is routinely based on how well customers needs are met, as indicated by sales or usage of a particular product," the groups contend. "Providers have a significant impact on whether or not consumers use the tools provided to them, as has been shown by leaders in consumer engagement efforts. The fact that they do not have 100 percent control over whether a patient uses a 'portal' is no justification for backing away from this critical step."
The consumer organizations and unions express support for providers informing patients of the existence of advance directives, providing online access to patients' own data and secure messaging capabilities, requiring a longitudinal care plan for chronically ill patients, and substantially more robust use of health information exchange technologies.
"If Stage 2 meaningful use is meant to focus on HIE, then providers receiving incentive money should be well-beyond simply testing their ability to exchange information; they should be doing it on a regular basis, at least for a subset of their population," according to the groups. "Requiring the provision of the summary of care record in an electronic format for 30% of their patients transitioning to another setting of care would not only be a practical step of real value, but would also assist providers in identifying the 'three external providers in a primary referral network' since they could simply identify the three providers to which they most often discharge patients."
Signers of the letter include the National Partnership for Women & Families, AARP, AFL-CIO, Consumers Union, Families USA and SEIU, among others. The letter is available at nationalpartnership.org/MU2.
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