Latest Health IT Developments Focus on Engaging Consumers in Their Own Health and Wellness

Deven McGraw, Proje­ct HealthDesign Regulatory and Assurance Advisory Group, Center for Democracy & Technology

It’s a little too early to take a victory lap, but the stars seem to be aligning for a significantly changed health care system – one that actively engages patients as partners in achieving health and wellness – within the next few years. What are the reasons for our optimism?

1. On November 2, the Centers for Medicare and Medicaid Services (CMS) released the final rule governing Accountable Care Organizations (ACOs) established under the new Medicare Shared Savings Program. Under this rule, providers in ACOs who can deliver care to Medicare beneficiaries at costs below what Medicare typically pays will be able to share a fairly significant portion of the savings. More than half of Medicare beneficiaries are treated for five or more chronic conditions a year. As a result, achieving savings for this population will depend in part on how well they are actively engaged in managing their health and wellness, such as through the use of personal health records (PHRs) and other technologies that assist patients in self care and in engaging with their clinical care teams more regularly. The Project HealthDesign grantee teams are already providing examples of how such technology can be leveraged to make a difference in individual and population health outcomes.
   
   
2. The Health IT Policy Committee has recommended that Stage 2 of meaningful use require health care professionals and hospitals to provide patients the capability to electronically view — and securely download on demand — relevant portions of their health information. This could significantly increase the demand for PHRs, applications or devices that help individuals securely store, share and make use of their personal health information. Although the official criteria for Stage 2 have not yet been set, the Obama Administration has already implemented this “Blue Button” capability  for My HealtheVet and MyMedicare.gov. I am also hearing that vendors of certified electronic health record products are already building this capability into product updates.
   
   
3. The Office of the National Coordinator for Health IT (ONC) rolled out its consumer engagement and education initiative in September. As part of that initiative, health care organizations are encouraged to “take the pledge” to provide patients with “secure, timely, and electronic access to their health information” and to encourage them to use the information to improve their health and their care. In the legislation that created the CMS EHR Meaningful Use Incentive Program, Congress also included a provision that amended HIPAA to require health care entities to provide patients with electronic copies of their health data if that data is stored electronically; entities are also required to send a patient’s copy to another provider or the patient’s PHR upon request. We expect the regulations to implement this provision to be finalized early next year.

Early in 2012 we will know more about whether these optimistic predictions will bear fruit, so stay tuned.

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