Points to consider for future release-of-information requirements.
While many hospitals are just getting a grasp on the HITECH Act's meaningful-use Stage 1 (MU1) requirements to qualify for the maximum incentive, they are now faced with the recent roll out of the proposed meaningful-use Stage 2 (MU2) requirements. Although MU2 requirements may change once the feedback phase has concluded, hospitals and qualified providers are beginning to consider how they will meet the terms of the proposed requirements.
Not surprisingly, many of the core objectives and corresponding measures detailed in the proposed MU2 requirements are clinical based. To manage these objectives, hospitals will likely turn to their existing clinical systems. For the most part, these systems have the ability to facilitate the measures that hospitals need to demonstrate for MU2 compliance.
|One way to speed up information requests in the future: Using hospital iPads, patients can request their clinical summaries in their room prior to discharge.|
The proposed MU2 requirements also detail several objectives that are not strictly clinical in nature – objectives that will likely require the involvement of multiple departments, depending on how the hospital is structured. When it comes to those objectives, current clinical systems may not be well equipped to handle all of the aspects involved.
One of the new objectives that is not strictly clinical focuses on how clinical summaries of encounters are delivered to patients. Under MU2, hospitals will be required to provide patients with their clinical summary records electronically/online if they request the information in that format. Further, they will be required to deliver that information within four days to 50 percent of those who request it. They will also be required to confirm that 10 percent of the patients who receive the information electronically/online have actually accessed it.
The objectives that are not strictly clinical will most likely present the greatest challenge for community and rural hospitals. These organizations are less likely to have information technology resources to extend the reach of their clinical information system to meet the needs of non-clinical processes. As a result, they will most likely need to seek out best-of-breed technology, third-party service providers with certified EHR modular solutions or some combination to assist them with meeting the MU2 objectives that are not solely clinical – and are therefore outside the scope of their current clinical electronic health records (EHR) system.
Although some larger hospital systems have the advantage of enterprise-wide health information systems, they may still opt to incorporate third-party solutions to manage certain MU2 objectives – particularly when those technology solutions are certified and can be easily integrated into their existing enterprise system. By integrating solutions, they will be able to report on all MU2 measures from a single platform.
While technology will certainly continue to evolve to help hospitals of all sizes achieve meaningful use, advanced technology solutions are available today that can help hospitals to meet important MU2 objectives quickly. By implementing these existing solutions now, hospitals can spend more time focused on the MU2 objectives for which turnkey solutions do not currently exist. They will also be able to take advantage of immediate efficiencies and other benefits delivered by today’s available technology far in advance of the MU2 deadline.
For example, mobile technology that is currently available as part of a release-of-information (ROI) service will enable hospitals to meet the proposed MU2 objective that centers on patient access to information electronically/online. This mobile technology goes beyond simply allowing for the electronic delivery of the patient information. It shortens ROI turnaround times, provides tracking and reporting, and improves patient satisfaction.
The mobile technology extends ROI workflow to the point of patient care, which can make it more convenient for patients to request copies of their medical records. In addition to making the request process more convenient, the technology decreases the amount of time before the request can be acted upon by the hospital staff or third-party ROI provider.
Shortening ROI turnaround times
Today, the typical ROI process involves patients going to a specific location within the hospital to fill out a paper ROI form that includes selection criteria for clinical summaries, if that is the information sought by the patient. That form is compiled with others and manually entered into an ROI system. Once the necessary data entry and/or scanning have been completed, the request becomes actionable. An associate then begins pulling charts and printing information from various sources in order to complete the request. The request is finally delivered in a paper format.
Because much of this request process is manual, many hospitals will find the proposed four-day turnaround to complete the ROI fulfillment process for electronic/online clinical summary requests daunting. The new ROI mobile technology makes this turnaround time achievable by eliminating some of the manual steps, thereby decreasing the amount of time before the request is actionable.
One way mobile technology can expedite the ROI process is by having iPad-equipped hospital staff members use an iPad application to allow hospital patients to request their clinical summaries in their room prior to discharge. Patients complete the information request on a series of screens using touch technology. Then they sign their request digitally on the iPad – just like they sign for services at a grocery store or bank. To ensure the authenticity of the patient’s signature and to protect patient privacy, patients must produce photo identification, such as a driver’s license, which is digitally captured using the iPad camera feature. The signature on file in the patient’s medical record is compared with the signature captured on the license and on the iPad to ensure the identity of the patient.
Once the patient’s request is securely submitted on the iPad, an order for the information request is created and immediately actionable. After the requested information has been compiled electronically, an email is sent to notify the patient that the records are ready to retrieve via an electronic portal. Depending on the hospital’s internal processes, this could shave hours or days off the electronic clinical summaries fulfillment process.
Providing tracking and reporting
Providing electronic/online access to patients’ clinical summaries in a timely manner is only the first step in meeting the proposed requirements. Tracking and reporting will also be critical to ensuring MU2 incentive eligibility. With the latest mobile ROI technology, hospitals are able to begin tracking and reporting as soon as a request is submitted via the iPad application.
For patients requesting electronic delivery of clinical summaries, email addresses are gathered during the request phase. From there, the mobile technology’s certified back-end system can track whether or not the email that provides access to the information was delivered. This functionality enables hospitals to track the delivery of clinical summaries, which will help hospitals ensure that 50 percent of patients requesting electronic/online delivery receive the information within the required four days.
Because the emails that are sent to patients contain a link to download the requested information, the back-end system is also able to measure patient interaction with the clinical summaries. As soon as a patient clicks on the link to access the information, the system documents the occurrence. This tracking will allow hospitals to prove that the required 10 percent of the patients who requested electronic/online delivery did, in fact, interact with the information.
Mobile technology deployed in this way enables patients to electronically request and receive medical records beyond clinical summaries. Therefore, hospitals are able to reduce the request process turnaround times for the majority of medical record requests, making it easier to also comply with and track the MU1 objective that requires 50 percent of all patients requesting their medical records electronically to receive them within three days.
All of the information tracked within the mobile technology’s certified back-end system can be reported on directly from the system. The system’s reporting functionality also enables reports to be formatted for export into a larger enterprise system for hospitals that want to channel all reporting through a single system. In addition, a dashboard view of all activity is available, which will enable the hospital staff responsible for meaningful-use compliance to easily see at a glance whether or not the hospital is on target with MU1 and MU2 core measure requirements.
Improving patient satisfaction
Over the past few years, news outlets and government announcements have been more focused on healthcare information and technology. Consequently, patients as consumers of healthcare services are becoming more educated about the options available to them. Increasingly, hospitals are receiving inquiries from patients about the availability of electronic medical records. With patient expectations clearly shifting, hospitals that embrace mobile technology for ROI have an opportunity to improve patient satisfaction by quickly delivering electronic medical records.
There are, of course, many challenges to achieving meaningful use, including the need to understand the requirements, change/upgrade/integrate technology and adjust workflows. Although the MU2 deadline is still more than two years away, hospitals should take the opportunity to begin implementing solutions today that will ensure future compliance. This will not only alleviate last-minute stress, but it will enable them to take advantage of improved efficiencies sooner rather than later. And in the case of mobile ROI technology, hospitals will also enhance patient satisfaction and bolster their image as leading-edge, tech-savvy healthcare providers.
About the author
William Sweeney is chief technology officer, IOD Inc. Sweeney is a Microsoft Certified Systems Engineer and Cisco CCENT with more than 12 years of experience in healthcare information technology, security and healthcare service delivery. To learn more about IOD, go to www.iodincorporated.com.