Deven McGraw, Project HealthDesign Regulatory and Assurance Advisory Group, Center for Democracy & Technology
On June 8, the Meaningful Use Workgroup of the federal Health IT Policy Committee held a hearing on patient-generated data. The purpose of the hearing was to inform the Workgroup’s consideration of possible objectives for Stage 3 of CMS’ incentive program for the meaningful use of EHRs.. Since Stage 1 of the program, the Policy Committee has signaled its interest in including patient-generated data as part of Stage 3.
Project HealthDesign was well represented at the hearing. The Workgroup heard testimony from Nikolai Kirenko, Chronology.MD co-project director and Patricia Flatley Brennan, Project HealthDesign national program director. I testified on behalf of Project HealthDesign’s regulatory and assurance advisory group.
Some of the key points of the hearing were:
- The term “patient-generated data” encompasses many different types of data, from device and sensor data (e.g., blood glucose levels or data from a pacemaker), to patient-reported data used to assess health care quality, to observations of daily living (ODLs) used by patients for better self-management and to inform their clinical care. Developing effective Meaningful Use measures and objectives that involve patient-generated data will likely require a range of approaches.
- Some high-performing health systems are already deploying models of care that include patient-generated data (including the Veterans Administration, Dartmouth, Geisinger, Partners, and the institutions participating in Project HealthDesign). However, getting other institutions and smaller ambulatory practices to adopt care models that incorporate patient-generated data may require starting with more modest, manageable steps. The objectives set for Stage 3 of Meaningful Use also should provide the foundation for adoption of more robust, patient-centered care models after the HITECH incentives have ended.
- Patient-generated data need not come directly into the provider’s EHR in order for it to be effectively utilized as part of patient care. Decisions about what to include in the EHR should preserve the role of the record in documenting and supporting clinical decision-making processes.
- Organizations that have successfully incorporated patient-generated data into clinical care have done so in accordance with specific plans. These plans document agreements between patients and clinicians about what information will be collected and how it will be used. Consequently, Meaningful Use objectives for patient-generated data will need to be structured in a way that provides flexibility for providers and patients to come up with a plan that works for their circumstances. Dr. Brennan recommended that the Meaningful Use Workgroup focus on “providing assistance, incentives, and structures” that will enable clinicians to have a way to document their use of patient-generated data in clinical decision-making.
Read the written testimonies submitted for the hearing.
The Meaningful Use Workgroup will be working over the summer to develop more specific recommendations on how to incorporate patient-generated data into Stage 3 of Meaningful Use, and members of the public are invited to participate in Workgroup calls. Learn more.