You know when you’ve seen a really good movie and it ends with “to be continued” or an understanding that there will be a sequel? No matter how good the first movie is, and no matter how sure you are that the sequel can’t compare, you will still go back to the theatre, get your popcorn, and pay to see “part two.” Why? Because you’re intrigued. And if you had to do it all over again, you would likely commit to seeing part three, too!
Meaningful Use Stage 2 (MU2) feels a lot like that. Since the Health Information Technology for Economic and Clinical Health Act (HITECH) passed, the industry has focused on how to use Electronic Health Records (EHRs) to achieve advanced care coordination and delivery within the Meaningful Use guidelines. It’s really just the “sequel” to part one. Stage 1 built the infrastructure and foundation for what was to come. The suspense and build-up to Stage 2 doesn’t feel nearly as “pivotal” as Stage 1. Not because the requirements aren’t as industry shaping or influential, but because those of us in health care and Health IT have come to expect the “next big thing.” In other words, I would have been surprised if Stage 2 had not made information exchange foundational or patient engagement a staple part of communication (no matter what the percentage). My expectations were set by my previous experience.
The reality is that health care is changing…and it’s happening right before our eyes. It’s no longer a question of when, but how. Like when you know the villain will die at the end of the movie, but you keep watching anyway because you want to see how it will happen.
Quality measures take center stage
MU2 is interesting, not because it’s moving more providers onto electronic health records, but because it’s encouraging physicians and patients to start using these types of technologies differently — and arguably, even “more meaningfully” than before.
Two new core objectives in MU2 are that patients have online access to health information and that they have secure messaging communication between with their provider. This is important because patient engagement is now becoming the responsibility of providers—a real shift away from the traditional practice of medicine.
There are other important shifts as well (like the juicy parts of a movie). These include getting providers to actually share data with one another outside of their usual network and use a different electronic medical record (EMR), a Centers for Medicare & Medicaid Service (CMS) designated test electronic health record (EHR).
The Stage 2 rules move us forward on the quality side of health care requiring electronic reporting of clinical quality measures, as well as counting and analyzing in ways we have not traditionally been able to manage in clinical practice.
In short, meaningful use continues to enhance the infrastructure needed for the broader changes underway in health care reform. While EHRs alone can’t transform the cost and quality issues we have in our health care system, they remain foundational to finding the solutions that will.
Stay tuned: The promise of accountable care
Accountable care organizations that lack interoperable EHRs will likely struggle in the future. Mobile health and remote patient monitoring technologies that engage patients alongside an EHR hold more promise to reduce readmission rates and educate patients. Telehealth solutions that utilize EHR information hold promise for extending the point of care needed for so many patients.
In short, the sequel of this movie, while not as jaw-dropping and trail blazing as Stage 1, is still very much worth watching and reflecting on.
As for Stage 3?
To be continued….