Breaking news hits the wires from the College of Healthcare Information Management Executives (CHIME), which has responded to a recent query by a group of six Republican senators who are hell bent on slowing down the meaningful use program to ensure its operating efficiently and not just handing out money to everyone claiming they’ve met Stage 1 (and eventually the other stages).
What’s remarkable about the news, though, is that CHIME actually issues a letter calling for a one-year extension of meaningful use Stage 2. According to CHIME’s letter, as reported by Healthcare Informatics,
Guest post by Fauzia Khan, MD, FCAP, is chief medical officer and co-founder of Alere Analytics.
This has been a very interesting year for the healthcare industry, which appears to be on the brink of a real sea change. Government mandates are driving transformative discussions in the C-suite circles on topics such as meeting meaningful use Stage 2 and Stage 3 requirements, satisfying Accountable Care Organization (ACO) standards, care delivery models in the patient-centered medical home and much, much more.
With the patient engagement quandary hanging its head over the next phase of meaningful use, healthcare leaders of all kinds continue to wrestle with how to meet mandates that are beyond their control.
Previously, the assignment was simple: do this, get that. But here, in stage 2, there’s a little outlier – required patient engagement – that has some physicians worried about how they are going to handle their second attestation.
Even though there are rumblings that CMS may look the other way when dealing with patient engagement, or decides not to enforce it, at least in the beginning, or chooses not to audit this measure, it’s still a mandate and it’s being taken seriously for all providers seeking the second set of financial incentives.
Some practices are taking measures that they haven’t had to in the past or at least with as much passion as they are now. They are marketing and advertising directly to patients, even if the campaign extends only to the interior of their own practices.
Such is the case for Dr. Stephen Bush, of Fox Valley Women and Children’s Health Partners in St. Charles, Illinois.
The first step in the process, Dr. Bush said is the implementation of a patient portal, which is though to help get the practice’s patients engaged or, in the very least, getting them more involved in their care protocols.
“The problem is, patients have to sign up to use the portal,” Bush said. His worry, though, is when pushing patients to engage, that if patients are pushed too hard, patients push back and essentially disengage.
“We receive significant push back from patients who get upset when trying to engage too much,” Bush said. Examples include posting too many times on Facebook or posting too many tweets to Twitter. According to Bush, patients will stop liking the practice on Facebook and stop following on Twitter if they feel the practice too involved socially.
Bush said his practice is working to implement new marketing and educational strategies to prepare for the patient engagement mandate, just to be safe, even though there’s little that can be done to audit how often patients use the portal after they have signed up.
There also may be too much attention put on patient portal’s capabilities, he said.
“They are not education tools, and they’re not meant to provide better healthcare, and in no way does it educate the patient,” he said.
Despite the patient engagement portion of the Stage 2, Bush said meaningful use is needed and ultimately, will help patients become more informed and get them involved in their care, which may help reduce costs overall. “The management of healthcare for patients is important, and can make lives better and healthier,” he said.
“All physicians are concerned about their patients are being taken care of and informed. Meaningful use gets patients involved. Patients now deal with things when there is a problem occurs rather than managing a healthy lifestyle.”
Physicians are trying to engage patients, and always have. Eventually, a change will come to the landscape, but as long as patients remain laissez-faire, there will be some push back when they are pushed.
I heard a stat recently that it would take eight years to view all of the videos loaded to YouTube each day. With such a volume of content flooding the market, it makes sense to have a plan.
Social media isn’t such a new phenomenon and it absolutely has an impact. As far as patient engagement is concerned, many say it’s one of the only ways to draw patients into the fold; especially important now, of course.
According to a new post from ClickZ, a marketing news site, almost 90 percent of all businesses are utilizing some sort of social media effort (I think that number is a bit high), but it’s very obvious that not as many of these campaigns are even remotely as impactful as they could be.
Establishing a successful program takes a little practice and patience, and probably a little luck. It helps, though, to identity mistakes and to try your hardest to avoid them.
Here are some of the biggest, courtesy of the folks who know at ClickZ:
Not having a plan. No matter the business sector or the business, you have to have a plan. The plan includes strategic objectives and, well, planning. Simply opening some accounts and posting your thoughts isn’t a plan. Plans include goals, and goals are something you work toward and attempt to measure. Just posting any old thing typically doesn’t produce anything of value and, therefore, is pretty much a waste of time.
Not optimizing content. Don’t simply post the same content to all of your social sites. It will grow redundant and bore your audience. According to ClickZ, you have to optimize your content. If you don’t, “You’ll end up with content that isn’t right for the medium, and people will start to ignore you. Take a few extra minutes to customize your post for each medium.”
Posting whatever comes to mind. Don’t simply write whatever comes to your mind and throw it on the web for the world to see. This seems pretty intuitive, but it’s a good reminder that there are often boundaries, especially in healthcare. Think about what you want to write, try to make it interesting and relevant. Think, think, think.
Forgetting not to show not tell: I quote directly from ClickZ. “Stop telling people what you want them to believe about your business and start showing them.” Show them with reports, videos, blog posts and observations. ‘Think about your key value proposition and point of difference, and figure out how to show people via social media.” Good point.
Are you boring? If you don’t have a “voice” and come of as un-insigthful, chances are, you’re boring. “Think about how to make your message interesting to your audience: compare it to something else; use a picture or video; find a more relevant way to share your angle. Just stop being boring.”
Losing focus. Stop trying to speak everyone’s language. Reel it in. Focus your message and stick to your strong points. You know what you do well, why you’re an expert; it’s time to focus speak your mind, but speak of the things in which you know well. Speak your mind, and speak your heart, but stay on point.
With these tips, and your best practices, there’s a good chance you’ll develop an engaged audience.
The fact that mandatory Stage 2 patient engagement is considered one of the largest meaningful use hurdles should come as a surprise to no one. If it is, that’s somewhat similar to saying that the day before a presidential election you still haven’t decided who you are going to vote for.
I think at this point it’s pretty short sighted to disregard this fact. Healthcare reform does not (yet) reform patients; it’s still a set of mandates for those in the field, practicing in the field and drawing money from the system.
Meaningful use is meaningless as far as patients are concerned. In almost every case they don’t know what it is nor do they care. They’ll only care when one of two things happen. You can take this to the bank: 1.) they are forced to pay or contribute financially in some way or 2.) you take away their right to care (in other words, you mandate them to do something in some way.)
I speak from experience gained from my time leading communication programs for a mandated statewide health insurance program.
If we want to hold patients responsible for their health outcomes, we need to either take away their right in some regard or tax them for their behavior. This is also commonly known as a sin tax. You smoke and you pay the tax on cigarettes.
I’m being a bit overly dramatic on purpose and I don’t recommend either of the two points above, but we should be fully aware that putting meaningful use in the hands of the patients are going to produce disappointing results for every physician and practice hoping to achieve Stage 2.
Just because a practice implements a patient portal doesn’t mean patients will use it. I have used my doctor’s patient portal. Even as a technology enthusiast and healthcare writer, I don’t particularly find it fun to use nor do I find it really helps me engage with my physician. Sure, I can send some emails and pay some bills through it, but that’s just the case. To me, it’s more of a bill pay system and I’m sure I’m not alone here. How many of you enjoy using your credit card company’s online bill pay system?
The only good news on this front is that Centers for Medicare and Medicaid Services might have finally figured this out and may allow for an exception to the ill-conceived requirement, despite Kathleen Sebelius’ insistence that a measure of patient engagement be included in the Stage 2 requirement.
But, I’m not holding my breath that what’s best for physicians in regard to meaningful use attestation will be upheld, though, when the only response to physician frustration over the requirement because patients are not showing any interest is for physicians to “push” their users to use it.
In principal, that response is a lot like breaking a toothless law. Sure a law is on the books, and you broke it, but there’s nothing that you can do about it.
And, as anyone who works in communications understands, push communications only goes so far in the 21st century and not nearly as far as it may have 15 or 20 years ago.
Push and pull; now that’s the kind of conversations that engage. You give, you take; you speak, you listen.
Anything else is nothing but mandatory arrogance from political forces far from the field of actual care.
My fascination with the benefits of patient portals continues to grow as the technology continues to grow in popularity.
Given their resurgence in popularity over the course of the last three or four years, and with the latest push for patient engagement through stage 2, clearly they have a very strong future in the practice of healthcare for the foreseeable future; probably until a game-changing technology moves us beyond the era of EHRs.
Until quite recently, patient portals have been viewed as a novel concept, and, overwhelmingly, practice leaders and physicians kept coming back to how they were going to get patients to actually use the communication systems, and, likewise, what benefit would they deliver the practice if the patients used them.
It’s safe to say we’re now living in a different time than even just a few years ago. People are more mobile, landlines have been cut and actually using a phone to make a call is essentially going to the way of the tube television.
We’re in an always on society where access to information, regardless of the subject, must be had. As you’re well aware, portals don’t necessarily come automatically with your EHR; they’re not bolted on, in other words. They cost money in addition to what you pay for your practice management system and electronic health record. In some cases, they’re actually quite expensive, or have been known to be in a traditional sense.
And, if the case could be made to invest in the technology (practice portals that is), the most obvious question often went unanswered: How can a practice bill for the time spent by its physicians when administering it and when responding to communications from patients, for example.
I digress. This is all water under the bridge. Everyone knows this stuff. It’s been overworked and underpaid.
The feds now require portals to play a huge part in health IT through meaningful use. Insurance companies are now jumping on board and allowing physicians and practices to bill for the time they spend administering data collected through portals, and patients have become so engaged in their mobile lives that it’s only a short matter of time before portals are utilized as heavily as online banking and ATMs, let’s say.
When I began thinking about this post, I thought of grandiose ways in which I could depict the usability of the portal and speak to its ever-increasing importance to the world of heath IT, but I just don’t think I can sum up their benefits better than simply listing them, as they speak for themselves.
As we know, patient portals can increase patient engagement by providing secure access to medical information online. Additionally, they allow physicians to:
Send and receive messages to and from doctor’s office
Communicate with patients through secure messages
Post lab and imaging results
Send reminder notices to patients
Post patient consent forms
Make billing information available
Provide patient education materials
With patient portals, patients can:
View and enter medical history
View and update allergy and medication lists
Send messages to their doctor’s office
Complete registration forms
Update demographic information
Request appointments and prescription refills
Obtain patient education materials
View account statements and pay medical bills
Not a bad day’s work for a fascinating bit of technology that’s changing the face of healthcare IT.
Will meaningful use Stage 2 reach patient engagement?
Patient engagement now requires patient action. So says the Department of Health and Human Services in meaningful use stage 2.
As a patient, your physician is counting on you to engage with him or her. It’s up to you, folks, to bring it home. Your physician’s incentive, and ultimately his or her potential non-penalty for Medicare, is on your shoulders.
That’s an awful lot of weight to bear. Can’t you feel it? It’s overwhelming. I’m exhausted just thinking about it.
Seriously, though, I’m confused. Someone please set me straight; seriously.
Meaningful use is now up to the patient? Whether or not I choose to interact with my physician via electronic means determines his/her level of success as gauged by the government?
I’m sure I don’t need to recite the language from the ruling, but I’ll do so for good measure.
In short:
Five percent of more of patients must send secure messages to their physicians (yes, I said “must”)
Five percent or more of patients must access their health information online (yes, I said “must” again)
The language isn’t written in an inviting tone, but one that tries to demand respect. It doesn’t say “may’ or “can,” if says “must.”
Is this a Ray Kinsella moment and HHS’ field of dreams?
“If you build it, he (they) will come,” sounds the whispered voice across the sky.
Cue the sound of rustling corn fields blowing in the wind as each of us imagine memories of our happy places where dreams live on forever.
If this gets built, will we all come and play? How can this be a requirement of our physicians? How can their level of success, the quality of the care they provide, be gauged based on whether or not I choose to interact with them via the web? After all, I want healthcare, not a Facebook friend or a Twitter follower. (I’m using obvious over exaggeration to make a point.)
I am all for patient engagement and believe it will increase given time and effort behind it, but forcing me — as a patient — to do something makes me a little less likely to follow so easily along. I’m not a lemming, and I don’t intend to be.
Sure, five percent seems like a manageable number; not that big of a deal. Surely, it’s just a few people, right?
Until next time, when the number increases to 25 percent of the overall patient population then 50 percent then 75 percent and so on until it’s just mandatory.
What might be the most troubling, though, is how this affects physicians and practices. Engaging patients to receive incentives and keep from being penalized becomes a marketing function, not a care function.
I can see it now: Your doctor will start offering club-type discount cards and try to cajole you with attractive terms like, “Sign up today for the patient portal and after you send just one email to your physician, you’ll be receive a $5 credit to your account.”
Or, perhaps the whole thing will have physicians sounding like to cashiers at Target: “Sign up for your patient portal access today and you’ll not only receive a nifty tote bag for your things, but you’ll get 25 percent off of of your next purchase!”
Lastly, I’m reminded of the lines of credit card pushers lining the student union of every college in the U.S. trying to convince our young and inexperienced that credit is the same as cash, don’t you know.
As noted on HealthWorks Collective, meeting this portion of the stage 2 requirement will take everyone in the practice, not to mention the support of those outside it.
But portals can only facilitate access to patient’s information, but it can’t force the participation of people to do something they don’t want. Requiring physicians and their practices to encourage me to engage with my care providers is up to me, and no matter how useful or entertaining, whether I choose to engage is something I commit to on my own terms.
Just because “they” build (read as “require”) it doesn’t mean I’ll come.
