Patient Portals and Meaningful Use
Using Portals to Meet the Patient Access Objectives
By Lisa A. Eramo
THE STAGE 1 MEANINGFUL use criteria do not require that eligible providers (EPs) and eligible hospitals (EHs) create patient portals, but portals may be the best option for meeting certain stage 1 patient access and electronic communication- related provisions. Portals may also be mandatory in the near future, says Warwick Charlton, chief medical officer and vice president of general management for Intuit Health. “Meaningful use stages 2 and 3 are coming soon, and they are going to have much more patient and family engagement provisions and criteria,” he says. “These criteria will also have higher thresholds.” For now, however, portals can help providers with the
following stage 1 meaningful use requirements:
Timely online access. EPs must be able to provide patients
with timely online access to their health information (i.e.,
within four days of updating the information in a certified
EHR). This access must include—at a minimum—lab results, a
problem list, a medication list, and an allergy list. The Office of
the National Coordinator for Health IT says the purpose of this
objective is to ensure patients have the ability to access their
health information “when they see fit to do so.”
Electronic copies of health information. When patients
request an electronic copy of their health information
(including—at a minimum—diagnostic test results, a problem
list, a medication list, a medication allergy list, a discharge
summary, and procedures), EPs and EHs must be able to
provide this information within three business days. Although
ONC doesn’t specify a method by which individuals must
receive an electronic copy, it does list a patient portal as an
“acceptable mechanism.”
Clinical summaries. EPs must be able to give patients clinical
summaries for office visits within three business days of
those visits. This information must include—at a minimum—
diagnostic test results, a problem list, a medication list, and a
medication allergy list. The clinical summary may be provided
electronically, although ONC doesn’t require this in stage 1.
Electronic copy of discharge instructions. When patients
request an electronic copy of their discharge instructions, EHs
must be able to provide it at the time of discharge.
Other requirements. In general, EPs and EHs can use
portals to meet other stage 1 meaningful use criteria, such as
being able to provide patient-specific education resources. In
the ambulatory setting specifically, portals can also be used to
generate patient reminders for preventive or follow-up care—
yet another stage 1 meaningful use criteria.
The HIM Challenges for Portals
One challenging aspect of portal design is that stage 1
meaningful use criteria do not provide in-depth requirements.
Experts say this leaves many questions on the table for
providers trying to work with vendors to design portals.
“There’s discretion on the part of the EP or EH in terms of
how the provider will operationalize this, and it does prompt
more questions,” says Meg McElroy, MBA, RHIA, of Ascension
Health. For example, providers must determine what specific
types of lab results they will include for viewing in the portal.
Ultimately, this should be a joint decision made by HIM,
clinicians, and legal counsel, she says.
“These questions are hard and open for interpretation,”
says Kelly McLendon, RHIA, president of Health Information
Xperts. Because of this, and in looking ahead to future
requirements, some providers may choose to use definitions
