Meaningful Use and the Patient Portal

12:36 pm by | 1 Comments

Some, but not all EHRs include the integrated presence of a patient portal to enable patients electronic access to some subset of their medical record. In the simplest terms patient portals, as defined by Wikipedia are “healthcare-related online applications that allow patients to interact and communicate with their healthcare providers”. Pretty good definition for me but of course the functionality in the various patient portals is all over the map. Some allow patients to communicate with their providers and request prescription refills, schedule appointments, allow updating of demographic/insurance information, and access lab results. The sky is the limit with the potential for patients and their healthcare providers to communicate and collaborate electronically through a patient portal.

Under the CMS EHR incentive program for Eligible Professionals there is Stage 1 meaningful use menu set measure that touches on the concept of patient portal functionality. But what is required for a vendor to demonstrate to gain certification? It certainly does not rise to the level of Wikipedia’s definition. For an EHR vendor this module would be certified by meeting the requirements for §170.304 (g) Timely Access. The vendor would need to demonstrate to their ONC Authorized Testing and Certification Body the functionality to:

“Enable a user to provide patients with online access to their clinical information, including, at a minimum, lab test results, problem list, medication list, and medication allergy list.”

There is no requirement for co-communication. For the purposes of Stage 1 EP certification all a vendor has to demonstrate is that they could show a patient’s capability to use “online access” to a minimal set of their health record. To meet this requirement some vendors have demonstrated complex, highly functional patient portals. Some vendors achieved certification by demonstrating they could upload a PDF of patient data to Microsoft HealthVault. Essentially they outsource the patient portal functionality to Microsoft. Some choose other ways to achieve certification for Timely Access. I would expect that Stage 2 requirements will be substantially higher for patient portal functionality. We will know all the details by the expected final rules next summer.

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Jim Tate

By Jim Tate EMR Advocate | Meaningful Use Audits & Appeals

Jim Tate is known as the most experienced authority on the CMS Meaningful Use (MU) audit and appeal process. As one hospital CEO stated, “we were notified by CMS that the adverse audit decision was being overturned and we did not have to return the 2011 EHR Incentive Payment. I would recommend the services of Mr. Tate and EMR Advocate in the event your facility is notified that it will be subject to a Meaningful Use audit or your facility is audited, or you have an adverse outcome and need to file an appeal." He blogs at Meaningful Use Audits. If you are a hospital with a question about the MU audit and appeal process, email him at: [email protected]
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Danny Potts
Danny Potts

Jim, In the meaningful measure for 170.304(g), it states: "More than 10% of all unique patients seen by the EP are provided timely (available to the patient within four business days of being updated in the certified EHR technology) electronic access to their health information subject to the EP’s discretion to withhold certain information." Do you have an opinion on what 'subject to the EP’s discretion to withhold certain information.' means? If we're only reporting out Allergies/Med Lists/etc... and Lab Results, would any of that need to be subjected to an EP's discretion? Or, is this intended for things like Discharge Summaries? Any thoughts would be appreciated.