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Neupert On Health

Connect Consumers with “Meaningful Use”

The current hot, behind-the-scenes, debate in HIT is around how “meaningful use” of HIT will be defined for purposes of the incentive payments provided in the HiTech portion of ARRA. Since there is a lot of money at stake and a lot of interested stakeholders, I am sure it will be an energetic debate.

Hopefully the definition of “meaningful use” will include some concept of improved health outcomes (Message to Washington - Its all about the Outcomes ).  I know this presents many challenges, and I don’t pretend to have the complete answer on how to best define “meaningful use”.

As Zeke Emanuel remarked at our IOM meeting this week, specific suggestions are much more effective than general principles in rule-making – so I’m taking to heart his recommendation. 

My simple, concrete, critically important and specific suggestion for incorporation into the definition of “meaningful use”?   Make sharing data and actionable information with consumers a required condition of “meaningful use.”  Specific and simple.  I can add lots of characteristics to it – near real time, two-way sharing, portable, and so on – but the essential point is that consumer access to their own data has to be DEFINED as part of “meaningful use.”  Consumers are the ones ultimately accountable for their health.   If we don’t include them, we will miss this historic opportunity to create a new ‘platform’ for transforming care in innovative ways.

We need to think bigger.  Folks in Washington talk about HiTech portion of ARRA as being a down payment on the future of health delivery.  I am not sure what that means myself.  But if it means we are building a platform for transforming care or creating a learning health care system – I know it must include connecting the last mile, which means incorporating the consumer and the home into the platform – by design.

The formal definition of meaningful is: full of meaning, significance, purpose, or value.

The key word for me in this definition is value.  Unless the definition of meaningful use is extended to include the consumer, real value in way of improved health outcomes or return on this huge investment will never be realized.

Posted: Friday, March 27, 2009 3:41 PM by pnblog

Comments

John Murphy said:

You cannot track outcomes, or any quality improvement for that matter, if you cannot measure it.  Measurement requires standards for comparison.  Standards require structure.  Too much of existing electronic records do not provide for structured data.  Patient records, documentation and reporting need to be captured in a structured, preferably relational, database.  It all starts with standards and the capture of structured data.  Other industries learned this decades ago.

# March 30, 2009 10:54 AM

Brian Baum said:

“Meaningful use”, “value”, “outcomes” – all powerful concepts to be sure and unfortunately, all subjective terms with varied definitions depending on the audience.  Talk to a physician about outcomes or value and the definition is likely to be far different than that provided by the average health consumer.  However, the point of view that any definition of meaningful use must include deference to the consumer is quite profound.  One could project that the only reason the collective health system, in fact health “care” itself exists, is to provide care for the health consumer.  It seems as though the future of health care must get back to the roots of the consumer.  How do we transition from a world of passive consumer participation in managing their health, to an active one?  A foundation for that transition must be information - accurate, timely, highly reliable and personalized information.  Further, that information must be available whenever and wherever the consumer needs it to ensure optimal care – be it a chronic, acute or preventive application.   This “information foundation” is the basis of the transformation of virtually every other aspect of our day to day lives, where information technology has had an impact.  If the automation of information in health care is to have true benefit, this focus is essential.  Value through the lens of the consumer is solving problems – making life easier.  Is there anything that automating personal health information may accomplish to that end?  The issue may be that from a consumer point of view the bar in health care is so low that the industry is trying too hard.  People have been “aging” since the beginning of time.  Yet to a large degree, each person experiences it as if it has never occurred before.  Can health IT, provide some relief?   Potentially help an individual “risk assess” themselves – understand of all the potential health conditions that may challenge them – which ones to pay particular attention to?  Frame proactive steps they can take to mitigate risks.  Present therapeutic alternatives to them for their conditions, allowing them to have a more informed and productive discussion with their care provider.   The foundation is information – highly personalized information.  By engaging consumers in the process, we leverage a certain market dynamic that increasingly and naturally seeks greater efficiency, services and solutions.

# April 1, 2009 8:02 AM
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