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A Physician's Perspective: Meaningful Use of Health Technology

Sep 28 2012   10:34AM GMT

Meaningful Use Stage 2: HIEs and PHRs

Posted by: DrJosephKim
EHR, hie, PHRs and patient engagement

It’s been about a month since the final rule for meaningful use stage 2 was announced by the HHS department. Two main elements will be pushed forward by stage 2:

1. HIEs
2. PHRs

Although stage 2 will begin as early as 2014, there are many states and organizations that are ahead of others in planning. Some states have several HIEs while others have none. Some leading health organizations have robust PHRs that integrate directly with the EHRs and provide patients with direct access to all their labs, radiology results, progress notes, and discharge summaries.

Let’s spend a few minutes thinking about PHRs. There once was a time when everyone thought that the PHR market was really going to explode. Everyone was jumping in. Google, Microsoft, WebMD, and many others developed PHRs. Most found that having a standalone PHR wasn’t too useful. Other companies put the PHR on a memory stick, a keychain, a necklace, or a bracelet. Some even tried to see if we could put the PHR on an implantable microchip. Concerns regarding patient privacy and information security quickly fizzled most of those ideas.

The “gold standard” approach to PHRs has been having a tethered PHR that integrates directly with the EHR. Of course, you need to have doctors and hospitals using EHRs in order to provide your patients with a tethered PHR. We’re finally getting to the point where this will become the new standard. It sure has taken us a while, hasn’t it? Groups like Kaiser, Mayo, and Partners have been offering similar services for quite some time now.

We will see add-on companies offering solutions that fill the void of current EHRs that don’t come with integrated PHRs in the next few years, between meaningful use stage 1 and stage 2. Some EHR companies will build the PHRs themselves or integrate with existing solutions. Google fell off the PHR train a while ago. Microsoft is still using HealthVault and I often wonder if/when Microsoft will launch their own EHR.

I’m still amazed it has taken us this long to get some fundamental IT adoption in health care. Motivating docs and hospitals to do this has cost us billions of dollars. We’re making progress, so let’s continue to guide the health care community in the right direction.

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