While many of the new CMS objectives address patient engagement, the most challenging Stage 2 objective calls for physicians to "provide patients the ability to view online, download, and transmit their health information within four business days of the information being available to the [provider]." If that weren't enough, physicians have to prove that more than 5 percent of all unique patients seen during their EHR reporting period actually do this.
"This is the first time that patient action will be required for a provider to achieve meaningful use," notes Jim Tate, president of EMR Advocate, Inc., an EHR consultancy.
To accomplish this objective, providers will have to convince patients to engage in their care, and though it's not required that a practice use a portal to do this, experts agree it's the best way.
But many providers are still left wondering: What does educating patients about the portal entail? And are there tactics to improve the rate of use among patients — and prove use to CMS?
While portal use is higher at the practice of Kevin Spencer, an Austin, Texas-based family physician who works in ten-doctor Premier Family Physicians, the burden of proof is stressful.
"We have almost 18,000 patients on the patient portal who exchange information on the continuity of care document, and we have to prove 5 percent of people are doing it," he says. "That's a pretty tall order."
Spencer says his practice will have a much easier time than many, as about half of its patients are already enrolled in the portal. To get patients on board, the practice employs a number of tactics. For example, front-desk staff members tell patients about the portal when they call in to ask questions or request refills, letting them know it will be easier and faster to send a secure message to the office via the portal. Getting patients on the portal kills two birds with one stone, and will help the practice fulfill CMS' "secure messaging" objective when it's time to attest.
"If you call with a question to a physician's office, most of the time, the person who will be able to answer your question is not going to be able to answer the phone," says Spencer. "But if you get a portal question at 10, 11 at night, those questions get answered more quickly. And it prevents misinformation from being relayed. You're not telling one person who's telling the patient."
Another bonus: The practice's vendor, Greenway Medical Technologies, is upgrading the portal to include a way for the practice to know that patients are opening messages.
But while Spencer has the advantage of living in Austin, where "50 percent of the population is under 35," he worries about practices in parts of the country where patients are less familiar with portals or broadband access is a problem.
For those practices, and any other that struggles with portal enrollment, Jason Fortin, senior adviser for Impact Advisors, suggests identifying patients who will get the most use out of a portal, such as those with a chronic condition.
"They are the ones who will presumably get the most value, who are most engaged in their health issues," says Fortin. "It might be hard to get young, healthy patients to use the portal because the value proposition for them isn't there."