Patient Engagement Key to EMR Success

Hospitals are spending billions of dollars to achieve meaningful use of electronic medical records, but if patients don't use the new technology,  hospitals may not reap the federal stimulus payments that await.

That's the conclusion of a report -- Putting Patients into Meaningful Use – from  PwC's Health Research Institute, which found that 14% of 1,000 consumers surveyed last fall said they get their medical records electronically from their physicians, and 30% of patients said they didn't know why they would need to.

Bruce Henderson, director and national leader of the EHR-HIE Practice at PwC says  hospitals need to build in patient input earlier in the process to comply with Stage 2 of meaningful use requirements.

"Successful use of electronic health information will ultimately be measured in better patient outcomes, higher quality and reduced costs," Henderson said. "Health systems need to have both patients and physicians actively using the health information to make care decisions, and they aren't there yet."

Henderson said providers must first understand what healthcare consumers want before they can be sold on the benefits of EMR. "Then, they need to build new, technology-enabled healthcare delivery processes around patient preferences and convenience, which means changing how clinicians work," he said.

• Half of patients said they call their physician's office or hospital for a paper record, and 11% said they don't know how to get their health record.
•  Of those who access their medical record electronically, 34% share the information with primary care physicians and specialists.
• While basic information about prescriptions and appointments are readily available to consumers who have electronic access to medical records, 55% can't access lab results or physician visit notes.
• Only 13% of consumers said they'd been asked by providers what they think about EMRs, even though 56% said they'd be willing to talk about what they'd like in an EMR and how they'd like to use it.
•  When asked how they would like EMR to be used, 66% of consumers said for physicians to follow-up on their condition, 59% said for scheduling follow-up appointments, and 53% said to learn about treatment options.
•  35% of consumers said they would like their physician to use the information to monitor treatment compliance, and 34% said they would like their physician to monitor their health condition, such as blood pressure, remotely via a device that automatically sends information.
• Approximately one-quarter of respondents would like to share electronic health information with family members to better understand family medical history.

Comparatively, data from the Healthleaders Media Industry Survey 2011, shows that:

• 13% of health leaders have an interactive patient portal in place, while
• 66% have a physician portal in place

HHS' Stage 2 proposed standards for meaningful use may require hospitals to offer 80% of patients with the ability to access to view and download their health information via a Web-based portal within 36 hours of discharge. Doctors and other providers must have at least 20% of their patient populations electronically accessing their health information, including access to diagnostic test results. Providers must meet these minimum requirements by October 2012 to qualify for additional stimulus money.

While 90% of more than 300 provider executives surveyed by PwC in the spring of 2010 said they expected to achieve meaningful use standards before the penalties kick in, their confidence is waning slightly as new realities set in and health organizations rethink their work plans to devote more attention on engaging external stakeholders. By the fall of 2010, 82% of the executives said they will meet the timetable.

Henderson said there are significant social, educational, and access barriers that providers are trying to overcome – including a gap in expectations between what patients and physicians want, and conflicting views about turnaround time. PwC's cited one hospital's internal research that found that physicians thought 45 days was a reasonable timeframe for making test results available electronically, while patients expected this information within 30 minutes.

"A patient's medical record and the health information within it should not be a history lesson. Those days are over," Henderson said. "To be meaningful, health information needs to be relevant, actionable, integrated into care and treatment decisions and available in real-time."

PwC's survey also found progress. Nearly one-third of health systems said they are now adding patient input into their meaningful use initiatives, up from 19% last spring. Approximately 50% of health systems are providing assistance to physicians who need support tools for using EMR in their clinical work.