Key patient engagement criteria in Meaningful Use for 2015 to 2017—part of the final rules recently released by the Centers for Medicare and Medicaid Services—fall woefully short in promoting online patient access to their health information, according to consumer advocacy groups.

Mark Savage, director of health IT policy and programs for the National Partnership for Women and Families, says his group and the Consumer Partnership for eHealth have been “paying special attention” to CMS rulemaking related to patient electronic access objectives for the meaningful use programs.

“We are disappointed in their approach to having doctors partner with patients to get them to use the patient portals,” Savage said on Tuesday during an eHealth Initiative Policy Workgroup webinar on the Meaningful Use final rule released earlier this month by CMS.

Under the final rule, he argued that CMS no longer intends to require that 5 percent of patients view, download or transmit (VDT) their health information or send a secure message to their providers. Instead, the rule merely requires physicians and hospitals to show that just one patient used online access to their health information and that secure messaging was merely turned on, not whether any patient has actually used it, he said.

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According to Savage, a minimum standard of 5 percent by CMS would ensure the kind of provider changes necessary to support wider online access. While the VDT requirement “jumps” back up to 5 percent in 2017, Savage called CMS’s reversal in its near-term expectations of providers in the area of patient engagement a “significant” disappointment, arguing that simply offering but not engaging patients to use online access does not improve care and health.

A national survey by the National Partnership for Women and Families released late last year found that 86 percent of patients who have online access use it, and 55 percent use it at least three times per year. In addition, the survey revealed that the more frequently patients access their health information online, the more they report that it motivates them to do something to improve their health (71 percent for frequent users versus 39 percent for infrequent users).

When it comes to secure messaging, he said the consumer groups also see the CMS final rule as “moving backwards” on a key requirement. “In 2015, the secure messaging function just has to be enabled—nobody actually has to use it,” Savage lamented. “In 2016, just one patient has to use it.”

CMS in the final rule asserts that it simplifies requirements and adds new flexibilities for providers to make electronic health information available “when and where it matters most” for providers and consumers to be able to exchange information. Further, the agency argues that under the final rule patients will have “unprecedented access to their own health records, empowering individuals to make key health decisions.”  

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