More than a year or so of squabbling is (sort of) over and today HHS announced its criteria for the first phase of meaningful use. Essentially the 25 criteria for qualifying for “meaningful use” (in other words who qualifies for the money) have been changed to 15 with a further 5 from a menu of 10. The details are here, and it looks like most of the percentages needed to qualify have been relaxed but not eliminated. The Dogs have clearly had a minor victory in that there are patient communication requirements in both the mandatory and optional criteria.
The most impressive part of the announcement (you can see it here) which included HHS Sec Sebelius, CMS head Berwick (not wearing his Che Guevara T Shirt) & ONC Director Blumenthal, was the two Reginas. First, Surgeon General Regina Benjamin explained how thrice her clinic was destroyed by nature, and how the second time she realized that while she had thought she couldn’t afford electronic records for her patients, she then realized that she couldn’t afford not to have them.
The other Regina was our friend Regina Holiday who made (to me) a surprise appearance and told the 73 Cents story in a heartfelt and powerful way. She’s really become the poster child for why access to health data matters to ordinary people, and we need to get her from the world of webinars, Health 2.0 Conferences and HHS announcements onto Oprah and the 6 O’Clock News right now.
And I’ll be suggesting that when I interview David Blumenthal in a little under 30 minutes.
And here's the 3mins audio of Regina Holiday at MU announcement
Categories: Matthew Holt
Dear Pete –
I disagree. Regina Holliday’s story is extremely relevant to EHRs and health IT more generally because she is able to articulate the importance of a complex and convoluted subject in a way that most people “get”.
Yes, hospital administrators will charge for patient access to data if they are able to. But FYI the new Meaningful Use rules (as well as the modifications of HIPAA released yesterday) address the amount they are able to charge, and the time period in which info must be made available to the patient. As a result of these changes, hopefully no patient will be facing a $0.73 per page charge/30 day wait for his/her record in the future!
The bigger point, though, is (as you put it) that hospitals don’t want to share data. That’s exactly the problem we need to address. And one way to do it is by mobilizing patients to demand otherwise. Most patients are totally unaware of the kinds of difficulties Regina and her husband faced until they are stuck in a health crisis, with little leverage and low emotional and financial reserves. Many may not even think to ask for their records—though doing so can save their lives.
By all means, let’s help Regina get on Oprah or any other platform that will let her help move the majority of Americans to think differently. We need to harness stories like Regina’s to help change the system through consumer demand.
Regina Holiday’s $0.73 story and EMR’s are largely orthogonal. Hospital administrators will charge patients for records in any format as long as they are allowed to because there are liability and competitive issues that can make having patient records floating around seem unattractive. This is not cost-based pricing, but punitive pricing. If Holiday’s hospital had wanted to share the records they would have, electronic or paper.
We have to be careful not to confuse business and technology issues.