I saw that Jonathan Bush, CEO of athenahealth, is “filled with rage about” the weakening of one of the key components of Meaningful Use, Stage 2. Although he has now become an advocate of easier sharing information between EHR systems, I believe that both the vendors and health systems have become complicit in making patient communication more complex and confusing. Government rules also have some share of the blame.
One of the linchpins of Meaningful Use, Stage 2 is to facilitate communication with the patient through the use of portals. Unfortunately, that fails miserably more often than it could possibly succeed.
While there are a number of reasons for this, the most notable is the plethora of “user-friendly” portals, none of which communicate with each other. Some comprehensive medical centers at least coordinate messages within their system, but that doesn’t help someone who chooses professionals based on no criteria other that they all have the same employer.
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It’s even worse with one system that I use where every practice has their own unique site, none of which communicate with each other, even though they are all on the same EMR.
To make matters worse some portals allow you to choose your own username, others do not. Passwords are inconsistent.
In my case, I use three different systems and have five different portals. I recently tried to send a result to my internist but forgot the username that I was assigned. “There was a “forgot username” button but that led me to the direction to call her which I couldn’t do in the middle of the night.
Even during normal office hours that can be a daunting task. Many of my physician friends who have practices thing of Meaningful Use as a nuisance. They’ve installed heir EMR, put up a patient portal essentially just to check a required box. They also complain that they can’t force their patients to use it.
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The legitimate concern for patient privacy and accurate patient identification between diverse systems is solvable but there are multiple ways to overcome that. The easiest way to accomplish this is by putting control into the hands of the patient, either directly or through a trusted broker. Another alternative is an aggregator collect and/or display the information.
Weakening the rules for meaningful use does nothing to make the situation better. It reinforces the status quo by rewarding behaviors that continue the silos of multiple portals. EMH vendors alone are not the answer either. Each will continue to try and build a better, more user friendly solution than their competitors. We don’t need better, we need consistency.
Without trusted and standards-based there will never be a perfect solution. I’m not looking for perfection, I’m only looking for something that’s workable. Perfect can come later.
[Photo Credit: Confused from Big Stock Photos]
Albert Shar, Ph.D., is managing principal at QERT (qertech.com), a technology consultancy that works with businesses providing expert advice in the strategies necessary for success in today’s rapidly changing and competitive healthcare environment. Prior to QERT Shar was VP for IT and senior program officer for the Pioneer Portfolio at the Robert Wood Johnson Foundation (RWJF) where he helped developed innovative approaches to the uses of technology in transforming healthcare. Previously he was director for IT Research and Architecture at the R.W. Johnson Pharmaceutical Institute, a Johnson & Johnson company. Shar was director of technology services at the University of Pennsylvania Health System, and CIO of its Medical School. He has held a number of faculty positions at the University of Pennsylvania School Of Medicine (Pharmacology and Gastroenterology), University of New Hampshire (Mathematics and Computer Science) and the University of Colorado (Pure and Applied Mathematics). Shar was a visiting professor at the ETH-Zurich FIM and holds a patent in medical imaging and is the author of more than 50 articles in healthcare, computer science, and pure and applied mathematics.
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