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Patient-generated data standards: Stage 3 meaningful use?

The Health IT Policy Committee put patient-generated data on the agenda when it included a provision in its stage 3 meaningful use request for comment that would require providers to accept electronic information from their patients. This could be a tough lift for a number of technical and workflow reasons, but regulators continue to signal that this is the direction into which EHR policy should head.

Patient-generated data can play an important role in improving health care, said Doug Fridsma, M.D., Office of the National Coordinator for Health IT chief science officer, during a February 12 Google+ Hangout. Rather than looking at patients as people who interact with the health system, they should be viewed as integral parts of that system. Therefore, patients should be able to interact directly with the same electronic record their providers use, Fridsma said.

“What I don’t want is two separate but equal systems: one that’s geared toward providers and EHRs and one that’s geared toward consumers,” Fridsma said. “We need to make sure that a healthy health care system has room for both those communities. We have not succeeded if the patient is seen as a separate participant in the health care system.”

He acknowledged that there is still a lot of work to be done to reach this point. Patients need to be more engaged in their own care, policymakers and vendors need to figure out how best to present physicians with patient-generated data, and the industry must agree on a set of technical standards for allowing patients to interface with their records. Fridsma said that patients should not have to learn SNOMED codes just to update their problem lists.

Clearly there is a lot to be considered before every EHR system in every doctor’s office has the capability to accept patient-generated data. Furthermore, some physicians are leery of trusting data offered by patients. But it’s worth keeping an eye on. Vendors offering patient portals and personal health records are probably watching developments closely. If patients can interact directly with their doctor’s EHR system there is less of a need for these additional systems.

It will be interesting to see how much of the HIT Policy Committee’s initial proposal (the measure in the request for information said that providers must offer 10% of their patients the option to submit self-generated data) makes it through to the final stage 3 rules.

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