HIE portal efforts, Meaningful Use program need better alignment

Patient portals being developed by health information exchanges so far have focused on helping providers attest to Meaningful Use, but must also center on the value to the patient to achieve widespread adoption, according to an article at the Journal of Medical Internet Research.

The study focused on the efforts of four HIEs: Kansas Health Information Network (KHIN), Healthcare Access San Antonio (HASA) in Texas, Keystone Health Information Exchange (KeyHIE) in Pennsylvania, and Santa Cruz Health Information Exchange in California.

Providers' decisions about whether to use a portal associated with the electronic health record system or one offered by an HIE often involve tradeoffs in functionality, connectivity and cost. For instance, a vendor-provided portal might incorporate billing or appointment scheduling, while a HIE portal might not. However, HIE-sponsored portals might be available to providers at a lower cost.

While the EHR Incentive Program is influencing these decisions, it may not be enough to drive adoption, the authors say.

"We argue that optimizing patient value should be a prime principle underlying efforts to promote online patient engagement in the third stage of the MU program, which is set to start in 2017," they write, also urging strengthening incentives to portals that cross multiple providers with the goal of providing patients with a single portal.

The report outlines a need:

  • To better align reporting requirements for Meaningful Use and the operation of HIEs
  • To improve patient matching
  • For ONC to provide guidelines and other technical and organizational support in developing shared, untethered portals
  • To promote further integration with providers' EHRs
  • For the Office of the National Coordinator for Health IT, Centers for Medicare & Medicaid Services, and the patient portal-developing HIEs to engage in a dialogue to define realistic targets for developments and outcomes of the HIE-sponsored portals and time-specific goals

Providers remain concerned about being penalized for patient actions they can't control, and patients largely remain unaware of and unimpressed with portals.

However, as participation in patient portals grows, physicians need reimbursement and clinical structures that allow them to effectively use that tool, according to a Health Affairs article. As reimbursement moves toward global payment, however, the authors say participation in secure messaging likely will grow.

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