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.

Comments

• Anonymous
  March 30, 2009
  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.

• Anonymous
  April 01, 2009
  The comment has been removed