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Meaningful Use

How mobile technology helps meet MU

By Robert Oscar T

he Health Information Technology for Economic and Clinical Health (HITECH) Act enables eligible healthcare professionals and hospitals to qualify for Medicare and Medicaid incentive payments when they adopt certified electronic health record (EHR) technology and use it to achieve meaningful use (MU). This objective entails measureable benchmarks that providers must meet to qualify for the incentive payments. Currently, many physicians are searching for ways to meet MU objec- tives as quickly and cost effectively as possible. During Stage 1 (2011 and 2012), providers must meet certain mandates, and 80 percent of patients must have re- cords in the certified EHR technology. Scheduled to begin in 2013, Stage 2 involves quality assurance of advanced clinical processes at the point of care and the electronic exchange of information. Scheduled to begin in 2015, Stage 3 requires improved outcomes in quality, safety and efficiency of clinical decision support and patient self-management tools. As of yet, EHRs do not require a Web interface or smart- phone applications for mobile devices, including cell phones or tablet PCs. However, the possibility is growing, especially in today’s patient-centric environment, as more physicians embrace smartphone technology to help streamline adminis- tration and improve patient care. A number of mobile medi- cal apps now enable physicians to quickly and easily gather information, access reference material, connect with other physicians and join online collaborative discussions. Likewise, a growing number of patients have begun to embrace new mobile technologies for self-management of care. According to a survey by Accenture, 90 percent of American patients surveyed prefer using the Internet, email and/or mobile devices to better manage their health and/or complete certain health-management-related tasks, such as scheduling doctor appointments and ordering prescription refills. Researchers also found that 83 percent of patients want to access personal medical information from the Web, and 72 percent want to be able to book, change or cancel doctor appointments and request prescription refills online.

The meaningful-use challenge

The American Hospital Association (AHA) and the College of Healthcare Information Management Execu-

22 September 2012

tives (CHIME) have formally expressed significant doubts about both the timing and the content of the proposed rule, implementing Stage 2 of the EHR incentive program. They warned that the requirements for Stage 2 were not feasible, especially because more than 80 percent of hospi- tals haven’t even attained Stage 1 MU due to the high bar set and market factors, such as vendor capability. The AHA warned that elements of the proposed rule would “stand in the way of a successful program to support widespread adoption by all hospitals.”

The AHA expressed particular concern with the pro- posed objective of providing patients with the ability to access, download and transmit their protected health information via patient portals, citing various security is- sues. Not only did the AHA claim that the objective goes “well beyond” current technical capabilities, but the AHA also found several security issues and cited other various potential flaws or problems.

The patient portal measure poses a serious challenge for most eligible providers because patients who currently receive healthcare through Medicaid or Medicare plans are less likely to have Internet access at home. The Affordable Care Act of 2010 (ACA) is expected to expand Medicaid benefits to an additional 22.4 million Americans by 2014. Recent data shows that a number of Medicaid recipients – in particular, people of color and of low-income populations – are adopting mobile technology at a rapid pace and are increasingly using mobile tools to access the Internet. This data suggests that mobile-friendly versions of patient portals could help close the online access gap for Medicaid patients. What’s more is that physicians can play a proactive role in addressing these issues by adopting mobile apps that are designed specifically for their workflow, as opposed to tra- ditional hospital information systems, which were designed originally for hospital operations staff and function in rigid steps. Real-world interactions with patients are rarely linear, often jumping from one workflow to another. In order for this type of rigid functionality to become more efficient, it would require the kind of flexibility and mobility that new technology provides. For now, most mobile phones on the market meet only about 40 percent of the security requirements required


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