ies of the information to 50 percent of patients who request it.
That’s not a request many EHRs can easily accommodate,
Rahman says. There isn’t a big green button on an EHR that will
collect the patient’s information, burn it to a CD, eject the CD,
and have the CD ready for pick up, he says.
NorthShore offers patients an electronic portal they can use to
access their records almost as soon as the data enters the EHR.
But NorthShore had difficulty tracking who requested information, data needed for calculating performance against the stage
1 criteria, Smith says. In order to ensure it met the meaningful
use measure, NorthShore decided not to include the portal in its
meaningful use reporting, instead tracking only those patients
who requested an electronic copy of their records outside of the
The offline requests were rare—only a couple each week—but
NorthShore still was challenged to fulfill half of the requests
within the required three-day deadline. The process became
fairly manual as well, requiring a written request to the medical records department, preparing the information, and then
producing and sometimes mailing the electronic copy of the
records to the patient.
“That one [measure] gave us the most trouble,” Smith says.
“Getting that done in three days was a challenge for us.”
Physicians have struggled meeting a similar requirement to
deliver clinical summaries to patients within three days of their
visits. The electronic and personnel processes for this task have
not been developed in most practices, meaning both vendors
and physicians needed to establish a system to get patients the
information, Rahman says.
Stage 1 is too soon to see a “big
difference” from CPOE. “Only in
the future stages... will we see the
benefits.” —Lynn Drazen
This, of course, was HHS’s motivation in writing the requirement, one of the program’s attempts to get providers started toward more patient-centered care.
Providers are finding the simplest way to meet the measure
is to hand patients their clinical summaries before they leave
the office. But doing this requires providers document their encounters and pull other information into the summaries before
the patient leaves.
Wellmont struggled with this stage 1 measure before working
with its vendor to develop a series of drop-down menus that
providers could select during or just after the patient visit. The
selections would summarize the encounter.
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