Hospitals Must Seek Patient Input on EHRs to Achieve 'Meaningful Use': PwC

In a new PriceWaterhouseCoopers report on hospitals' implementation of electronic health records, the consulting firm found that providers need patient feedback on EHRs for meaningful use steps to be successful.

The Health Research Institute of consulting firm (PwC) PriceWaterhouseCoopers has released a new report called "Putting Patients Into 'Meaningful Use'" that says hospitals need to take steps to incorporate patient feedback for meaningful use implementation to be worth the investment.

PwC's Health Research Institute provides analysis on various issues affecting the health care industry.

HHS (the U.S. Department of Health & Human Services) announced Stage 2 standards for meaningful use in January 2011 requiring hospitals to allow 80 percent of patients to access their EHRs within 36 hours of discharge from the facility. In addition, at least 20 percent of patients must be allowed access to EHRs, including test results. The Stage 2 requirements take effect in October 2012. HHS is currently seeking public comment on the Stage 2 requirements.

In the survey, for which PwC announced results on Feb. 23, the firm interviewed 1,000 consumers and 3,000 health care executives in the fall of 2010 about stage 2 meaningful use requirements. PwC was interested in consumer feedback on health reform and how they would use health care.

The patient could be considered "forgotten" as a user of EHRs, according to Bruce Henderson, director and national leader of PwC's EHR-HIE practice.

Of consumers PwC interviewed, 13 percent of consumers said their doctors or hospital had not asked for their input about EHRs, though 56 percent of them were willing to talk to their doctor about them and learn how to use the technology.

"I think you can't start engaging and communicating with patients soon enough," Henderson told eWEEK. "It's going to contribute to a much higher level of adoption by the patient."

Health care professionals need to engage patients on their expectations for EHRs if hospitals are going to get a better return on their investment as far as meaningful use of health records, Henderson said.

When patients are engaged in the process of EHR adoption, they'll believe that their health care is working better for them, he said.

Despite the federal push for adoption of electronic records, only 14 percent of consumers surveyed are accessing EHRs from doctor's offices, with 30 percent not seeing a need to do so, PwC reports.

Although patients are consulting with those with similar conditions online, they're still mostly turning to doctors offline, according to a recent report by the Pew Internet & American Life Project.

In its survey, PwC also found that barriers to electronic access as well as social and educational barriers have led to a gap in expectations as far as what patients and physicians want out of EHRs.

Physicians believed 45 days was a reasonable amount of time to make test results available electronically, but patients expected access to this information within 30 minutes, PwC reports.

A fragmented health care industry, including the way applications are configured, contributes to this gap in time, according to Henderson.

"Our industry is very highly fragmented, so in addition to the need for electronic health records, there's an equal need for the ability to move that data across our fragmented industry into a single location, into a single patient record," he said.

"The expectation is driven by wanting to make better, faster decisions for diagnosis and treatment, better in the context that I have a better, more complete picture available to me than I've ever had before," Henderson said.

For hospitals to improve the amount of patient engagement regarding meaningful use of EHR platforms, organizations could allow patients to use iPads at the point of care, Henderson suggested.

The workflow of a doctor's office also needs to change from the paper chart days, with a nurse practitioner helping doctors navigate the next steps, he said. "When two parties enter the exam room together, they'll have a bidirectional purpose for an exchange," he explained. "They'll accomplish so much more and probably faster than in the past."