Stage 2 of Meaningful Use may do more than spur the adoption of EHRs and the growth of health information exchange (HIE). It could change the way that providers regard their patient records, a panel of experts said during a roundtable discussion hosted by the National e-health Collaborative, a public-private partnership established by a grant from the Office of the National Coordinator (ONC) to foster national HIE.
The proposed rule for Stage 2 of Meaningful Use requires, among other things, that 10 percent of transitions of care and referrals be conducted electronically across vendor and provider boundaries. That means that providers must sending patient data to unrelated entities that may use a different EHR system, said Claudia Williams, director of ONC's state HIE program. Stage 2 also increases providers' obligations to provide patients with on line access to their health information.
"We're going to need functionalities, to make sure the information follows patients and the information gets into the EHRs," she says. Currently there isn't widespread capability for providers to accomplish that, she said.
As a result, HIEs, particularly public ones may see renewed interest from providers. "If you just have tethered personal health records [to proprietary EHRs] people can't get at the information. If data is [accessible] on a community level, one can get all of one's information," said Leslie Lenert, professor of medicine and biomedical informatics at the University of Utah. Lenert wrote a recent article published in the Journal of American Medical Informatics Association on public HIEs.
But Stage 2 may have more fundamental impact by changing the way that providers perceive their patients' data. Instead of seeing it as proprietary and hoarding it, sharing it via an HIE may be a way for providers to set themselves apart as offering better customer service, say by offering electronic data to patients faster than their competition.
"Stage 2 brings the potential to shift the basis of competition. Doctors used to look at data as a competitive asset. I can see public policy moving us to a shift to make it competitive to share data," said Vince Kuraitis, principal, Better Health Technologies.