Using Patient Portals to Achieve Meaningful Use Stage 2
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1 Introduction A patient portal is a secure application accessible via the Internet that allows patients to interact with their healthcare provider. The patient portal allows patients to view parts of their medical record (chosen by the healthcare provider) and communicate with their provider through secure messaging. To meet the 2014 requirements of the Centers for Medicare & Medicaid Services (CMS) Electronic Health Record (EHR) Incentive Program, often referred to as Meaningful Use, healthcare providers must have a patient portal installed. The requirements for how actively the provider and patients use the portal are dependent upon the Stage of Meaningful Use in which the provider is participating. For, the provider must interact with the patients using the portal. For Meaningful Use Stage 1 in 2014 and beyond, patients must have the ability to view their information through the portal, but there are no requirements that patients must be able to interact with the provider through the portal. However, it is recommended that providers begin to foster interaction with patients online as soon as possible. Patient Portals in Meaningful Use CMS believes that healthcare providers are in the best position to encourage patients to take a more active role in their healthcare by using Health Information Technology (Health IT) such as a patient portal or personal health record (PHR). The information below provides details about each EHR Incentive Program (Meaningful Use) measure that requires a patient portal, along with a checklist to review individual requirements. To demonstrate Meaningful Use, providers must meet the thresholds for the measures (or qualify for an exclusion). There are no partial incentive payments failure to meet any of the requirements results in no payment, and possible subjection to a penalty. A Patient Portal is required in order to meet the Core Measures for. The Patient Portal may also help to meet a menu measure and several additional measures because it encourages patients to populate their health information online. It also allows providers to exchange clinical information with their patients electronically. Patient Portal Measures * For those providers and hospitals still attesting to Stage 1 in 2014: You are required to use a patient portal to provide discharge instructions/clinical summaries to 50% of your patients electronically Healthcare Information and Management Systems Society (HIMSS) 1
2 Overview of Objectives In there are 17 Core Objectives. Eligible Providers must meet ALL 17 Core Measures. Patient Portal REQUIRED Patient Portal HELPS In Meaningful Use Stage 3 there are 6 Menu Objectives. Eligible Providers must meet AT LEAST 3 Menu Objectives. There are no measures that require a Patient Portal; however, the Patient Portal may help you to meet the requirements. Patient Portal HELPS 2014 Healthcare Information and Management Systems Society (HIMSS) 2
3 Core Objectives: Patient Portal Guidance Core Objective 3 Record the following demographics: preferred language, sex, race, ethnicity, date of birth. Patient Portal HELPS Comment: You are not required to have the patient record this information. However, providing the patient the ability to record the information and have it available in the EHR may help you to meet this measure. Core Objective 3 Checklist Can the patient enter Demographics into the patient portal? Preferred language Ethnicity Gender Date of birth Race Is the patient recorded information available in the EHR, and can you update the patient s record using this information? Do you have a report/dashboard monitoring that more than 80% of your patients have demographics recorded? 2014 Healthcare Information and Management Systems Society (HIMSS) 3
4 Core Objective 7 Provide patients the ability to view online, download and transmit their health information within four (4) business days of the information being available to the EP. Patient Portal REQUIRED Core Objective 7 Checklist Measure 1 Are you able to easily provide User Name / Passwords to your patients? Is information available to patients within 4 business days? Is the information provided through a secure channel that is encrypted and integrity-protected? Is the following information available? Patient name Provider s name & office contact information Current and past Problem List Procedures Laboratory test results Current medication list and medication history Current medication allergy list and medication allergy history 2014 Healthcare Information and Management Systems Society (HIMSS) 4
5 Measure 2 Vital signs (height, weight, blood pressure, BMI, growth charts) Smoking status Demographic information (preferred language, sex, race, ethnicity, date of birth) Care plan, including goals & instructions Known care team members, including the PCP Do you have a report/dashboard monitoring that information was provided to 50% of your patients within 4 business days? Is the portal easy to use? Does the portal provide patients instructions on how to download and transmit information? Can patients view, download and transmit to a third party? Do you have a report/dashboard monitoring that 5% of your patients access the information? 2014 Healthcare Information and Management Systems Society (HIMSS) 5
6 Core Objective 8 Provide clinical summaries for patients for each office visit Patient Portal HELPS Core Objective 8 Checklist Is the Clinical available to patients within 1 business day for office visits? Is the following information available? Patient Name Provider s Name & contact information Date and location of the visit Reason for the visit Current problem list Current medication list Current medication allergy list Procedures performed during the visit Immunizations / Medications administered during the visit Vital signs taken during the visit (or other recent vital signs) Laboratory test results List of diagnostic tests pending Clinical instructions Future appointments Referrals to other providers Future scheduled tests Demographic information maintained (sex, race, ethnicity, DOB, language) Smoking status Care Plan information, including goals & instructions Recommended patient decision aids (if applicable to the visit) Do you have a report/dashboard monitoring that Clinical Summaries were provided within 1 business day to 50% of your patients seen for office visits? 2014 Healthcare Information and Management Systems Society (HIMSS) 6
7 Core Objective 12 Using Patient Portals to Achieve Use clinically relevant information to identify patients who should receive reminders for preventive/follow-up care and send these patients the reminders, per patient preference. Patient Portal HELPS COMMENT You are not required to send Education resources electronically. However, the ability to send Education resources electronically may help you meet this measure. Core Objective 12 Checklist Can you identify patients who should receive reminders for preventive/follow-up care? Can you electronically select, sort, access and create patient lists by date and time, by communication preference and at least 1 of the following? Problems Demographics Medication Laboratory tests and values/results Medication allergies Can you record patient preference for receiving messages (mail, phone or secure messaging)? Can you send a reminder, per patient preference? Do you have a report/dashboard monitoring that more than 10% of your patients were sent a Reminder? 2014 Healthcare Information and Management Systems Society (HIMSS) 7
8 Core Objective 13 Using Patient Portals to Achieve Use clinically relevant information from Certified EHR Technology to identify patient-specific education resources and provide those resources to the patient. Patient Portal HELPS Core Objective 13 Checklist Can you electronically send Education resources? Do you have a report/dashboard monitoring that more than 10% of your patients received Education resources? 2014 Healthcare Information and Management Systems Society (HIMSS) 8
9 Core Objective 17 Using Patient Portals to Achieve A secure message was sent using the electronic messaging function of CEHRT by more than 5 (five) percent of unique patients (or their authorized representatives) seen by the EP during the EHR reporting period. Patient Portal REQUIRED Core Objective 17 Checklist Can a patient send a Secure message to the EP? Do you have a report/dashboard monitoring that more than 5% of your patients have sent at least one secure message? (Stage 2 only) 2014 Healthcare Information and Management Systems Society (HIMSS) 9
10 Menu Objectives: Patient Portal Guidance Menu Objective 4 Record patient family health as structured data. Patient Portal HELPS COMMENT You are not required to have the patient record this information. However, providing the patient the ability to record the information and have it available in the EHR may help you meet this measure. Menu Objective 4 Checklist Can the patient enter Family Health History into the patient portal? Is the patient recorded information available in the EHR and can you update the patient s record using this information? Do you have a report/dashboard monitoring that more than 20% of your patients have Family History recorded? 2014 Healthcare Information and Management Systems Society (HIMSS) 10
11 Final Comments The key to success is having a Patient Portal that contains the information patients want AND is easy for patients to use. If you can t get meaningful information to the portal, or your patients don t use the portal, you won t meet the measures. Checklist for Success Can I send meaningful information to the portal? Can I easily provide Activation Information to patients? If a patient forgets their User Name / Password, can they easily retrieve it? Is the patient portal easy to use for patients of all ages? Is it easy for a patient to download & transmit information? If a patient has a question about information on the portal, is there someone they can call? Is the portal available on mobile devices? Is the portal available in multiple languages? This document is provided for general information purposes. Nothing in this document should be construed as legal advice, and you should obtain your own appropriate legal and other advice on this subject matter. All Meaningful Use charts in this document come from the Centers for Medicare & Medicaid Services (CMS) website at Healthcare Information and Management Systems Society (HIMSS) 11
12 Acknowledgements Using Patient Portals to Achieve HIMSS Meaningful Use Patient Portal Workgroup This review was developed by the members of the HIMSS Ambulatory HIE Toolkit Task Force s Meaningful Use Patient Portal Workgroup. Special thanks to Heather Marney for serving as primary author on this review. Steve Bouck Solution Synergy, LLC Steve.Bouck@solutionsynergy.net Sonia Fischer Radiation Management Associates sfischer@rma-1.com Heather Marney Children s Healthcare of Atlanta Heather.Marney@choa.org Eric Renaux Network Performance Healthcare erenaux@networkperform.com Authors Kristy Carberry NEOS Technologies KCarberry@neostechnologies.com Mare Henderson Novant Health marehenderson@me.com Matt Reid American Medical Association (AMA) Matt.Reid@ama-assn.org Charles Stewart RioOne Health Network C.Stewart@dhr-rgv.com Mari Greenberger, MPPA Director, Informatics mgreenberger@himss.org Jessica Hout Senior Manager, Interoperability & Standards jhout@himss.org HIMSS Staff Julie Moffitt Program Manager, Informatics jmoffitt@himss.org Joyce Sensmeier, MS, RN-BC, CPHIMS, FHIMSS, FAAN Vice President, Informatics jsensmeier@himss.org HIMSS is a global, cause-based, not-for-profit organization focused on better health through information technology (IT). HIMSS leads efforts to optimize health engagements and care outcomes using information technology. The inclusion of an organization name, product or service in this publication should not be construed as a HIMSS endorsement of such organization, product or service, nor is the failure to include an organization name, product or service to be construed as disapproval. The views expressed in this white paper are those of the authors and do not necessarily reflect the views of HIMSS Healthcare Information and Management Systems Society (HIMSS) 12
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