Patient engagement via mHealth will be key to Stage 3 Meaningful Use

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With the Meaningful Use Stages 1 and 2 rules focused on electronic health records, healthcare industry observers are starting to look ahead to Stage 3 and its implications for mHealth.

Emerging mobile technologies hold enormous promise for healthcare, especially in the area of patient engagement, and that is where Stage 3 comes into play, according to a Jan. 21 blog by Chuck Parker, executive director of Continua Health Alliance, posted on the HIMSS website.

"While Stages 1 and 2 of Meaningful Use are primarily concerned with EHR implementation and clinical measures, the proposed measures for Stage 3 take on patient engagement," writes Parker. "If ONC's recommendations come to pass, Stage 3 will encourage medical practices and hospitals to enlist their patients to use health devices and apps, and to accept patient-generated data into EHRs."

Parker predicts that practices and hospitals embracing Stage 3 will "discover a new capacity to bring about positive outcomes through timely, targeted interventions, both at the individual and population levels." Nevertheless, he cautions that  "underlying the presumption of mHealth's success is the notion of connectivity between systems and devices" and "unless personal health devices work together with minimal effort, patients are unlikely to stick with mhealth tools, and the momentous opportunity for connected health will be lost."

On September 4, 2012, the Department of Health and Human Services released the Meaningful Use Stage 2 and the Standards & Certification Criteria Final Rules, expanding on the Stage 1 criteria with a focus on encouraging the use of health IT for continuous quality improvement at the point of care and the exchange of information in the most structured format possible. Patient engagement is an important focus of Stage 2, which includes measures that require patient activity.

However, as an October 2012 Information Week article notes, the word "mobile" is mentioned only once in the 672 pages of the Meaningful Use Stage 2 regulations. The article quotes Pam Matthews, senior director of regional affairs at HIMSS, in a mHIMSS post as saying how mobile technology could help meet Meaningful Use requirements for more patient engagement and data exchange: "Yet in the final rule they remained silent on mobile. HIMSS supports the development of guidelines to achieve transitions of care through patient-centered mobile interfaces. We encourage consideration of including mobile health technology in future stages of meaningful use."

Stage 3 is planned for final rulemaking in early 2014 with Stage 3 starting in 2016. But, the American College of Physicians and HIMSS are among an increasing number of high-profile groups calling for changes to the proposed Meaningful Use Stage 3 rules recommended by the ONC's Health IT Policy Committee in November. This week, the American Medical Association, the American Hospital Association and the College of Healthcare Information Management Executives have shown skepticism in their comments on the proposed criteria. The AMA called for an outside evaluation of the program, and CHIME called the Stage 3 thresholds "unrealistic."

To learn more:
- read the HIMSS blog

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