A federal advisory group supports retaining a controversial data-sharing requirement, suggesting the benefits to the patient outweigh the angst felt by providers.
But the group proposes lowering the percentage of patients who view, download or transmit their own records to meet provider requirements under the federal electronic health record incentive payment program. Since 2011, the program has shelled out $30 billion to help hospitals and office-based physicians and other eligible professionals buy and “meaningfully use” EHRs.
Providers who don't achieve these goals face a reduction in federal EHR incentive payments and/or cuts to their Medicare reimbursements for noncompliance. Under the group's latest recommendation, by 2018 10%, would be the target mark of engagement. That's down from the earlier proposed goal of 25%. Under the current policy, the goal through 2017 is to have 5% of patients view, download or transmit their own records from their providers' EHRs, but providers have objected because of the possible loss of revenue that would happen as a result of actions not taken by their patients.
In response to those complaints, the CMS suggested providers only demonstrate that a single patient had viewed, downloaded or transmitted their records. But that weakening of the rule triggered counter complaints from patient engagement activists, including a key former federal health IT policymaker.
Dr. Farzad Mostashari, the previous head of the Office of the National Coordinator for Health Information Technology at HHS, recently called for patients to ask their providers for electronic copies of their records to demonstrate the need for this form of health information exchange.
Advocates take as an article of faith that engaging patients in their care will improve outcomes, and giving them access to their medical records, for review and possible correction, will lead to greater awareness of, and engagement in, the care process.
The work group also recommended that the government embrace both the use of traditional Web-based portals linking patients to their providers' EHRs and the proposed new use of application programming interfaces, or APIs, which are pieces of software code that hold great promise in giving patient access to their information on their smartphones and other mobile devices.
Using portals and APIs concurrently, “will give the marketplace time to figure things out,” said Christine Bechtel, president of Bechtel Health Advisory Group, Washington, D.C., the work group's chairwoman.
“We feel that maintaining both is important,” Bechtel said. Portals, in addition to providing patients access to their medical records, also are already being used by patients for secure messaging with their healthcare providers, scheduling appointments, requesting prescription refills, uploading patient-generated data and downloading patient education materials, she said.