A multi-institutional group of researchers believes that specialist physicians who are among late adopters of electronic health records may have trouble generating sufficient e-mail correspondence to satisfy Meaningful Use Stage 2 requirements.

The research, published in the American Journal of Medical Quality, also states that late-adopting primary care physicians are likely to meet the Stage 2 email thresholds.

The study focused on physician/patient communication patterns via an online patient portal in a multi-specialty group practice in the Midwest.

"Patient portals linked to commercial EHRs probably offer the most practical way for new EHR users to meet CMS MU patient access regulations," the authors wrote. "Reports from early adopters of patient portals also support the portal’s potential. In some centers, portal enrollment is now as high as 50 to 60 percent, and patient satisfaction with portal features such as appointment scheduling and access to medical records is high. A substantial number of patients at these centers also initiate emails to doctors using the portals, and most are very satisfied with this communication."

The authors believe that, while specialists may have trouble meeting the Stage 2 e-mail mandates for patient access, other avenues of patient engagement may lead to greater patient interaction with their EHR.

Operating under the theory that surgeons and some medical specialists who do not perform much chronic care are unlikely to generate substantial numbers of e-mails over time, the authors state "it might be more appropriate for specialists to have alternative requirements for MU payments, such as providing patient education or postoperative instructions online. Further research into patient communication with such specialists could focus on patients’ perceptions of the most valuable online information as well as the role of care teams consisting of both specialists and PCPs."

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