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ONC panel seeks provider comments on Stage 3 recommendations


By Joseph Conn
Posted: November 8, 2012 - 2:45 pm ET
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Patient communication has typically been a two-way street, at least at the start of an encounter with healthcare providers.

The advent of health information technology in the hands of providers and multiplatform information technology in the homes and pockets and purses of patients will open up a potential torrent of two-way information exchange possibilities long after the patient leaves the exam room.

In its soon-to-be-released request for public comments, the federal Health IT Policy Committee seeks industry input on a host of its recommendations for proposed meaningful-use criteria for Stage 3 of the electronic health-record system incentive payment program. The Stage 3 rules are expected to go into effect in 2016.

The policy committee, which reports directly to HHS' Office of the National Coordinator for Health Information Technology at HHS, incorporated in its 38-page request for comments a sneak peek at its thoughts on Stage 3 meaningful-use rulemaking. One new proposed Stage 3 criterion calls for physicians and hospitals to "provide 10% of patients with the ability to submit patient-generated health information to improve performance on high-priority health conditions and/or to improve patient engagement in care." Patient input could be based on their experiences, patient-created health goals or advance directives, or could involve "shared decision-making," according to the policy committee.

"This could be accomplished through semi-structured questionnaires" that focus on those high-priority health conditions of the providers' choice, the policy committee said in its recommendations. The group also asked for public input on the "readiness of standards to include medical-device data from the home."

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In addition, the committee asked for comment on how consumer-reported data could be incorporated into clinical quality measures, which have been a part of meaningful-use requirements since the program's inception and are to be continued in Stage 3. Examples are sought of how patient-directed data is used in shared decision-making and whether this data should be kept separate from the information generated and placed in an electronic patient record by the provider.

The ONC submitted its own seven-point addendum to the policy committee's request for comments. The office seeks feedback from providers on what information they would consider to be the "most valuable to receive electronically from patients."

Meanwhile, the ONC has released a pair of "quick reference grids" to compare the Stage 2 meaningful-use objectives, measures and exclusions created by CMS rulemakers and their correlated 2014 EHR certification criteria and standards for both Stage 1 (updated from the 2011 criteria) and Stage 2.

Steven Posnack, director of federal policy at the ONC, and Elizabeth Holland, director of the HIT Initiative Group in the Office of E-Health Standards and Services at the CMS, have posted an explanatory article by about the grids at Health IT Buzz, the ONC's blog.

An earlier version of this story incorrectly stated that the request for comments was released Wednesday.


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