Meaningful Use Stage 1 encouraged physicians to implement an EHR in order to capture discrete and some unstructured healthcare data with the future goal of sharing this across the industry. Stage 2 reimbursement (preliminary) will be based on the patient taking an active role in the sharing of this data. This is contrary to the way patients have been trained.
In most clinic scenarios, the patient visits the physician when they are sick. They explain what is wrong and the physician makes a diagnosis, scribbles on a clipboard, and writes a prescription. The patient leaves the office, fills the prescription, and goes home to heal. Nowhere in this scenario does anyone encourage the patient to learn about their disease, download their results, or become more active in managing their health.
Patients DO NOT KNOW better. Meaningful Use Stage 2 makes a huge assumption. In order for MU Stage 2 to work, the patient needs to give a damn about their health and treatment. Today, this doesn’t happen until patient issues become chronic.
Going forward, patients need to be trained to be more proactive about managing their health. The physicians and their staff will need to spend time teaching them about the benefits of managing their health. Physicians will spend more time with patients who are finding answers on the internet. Clinic staff will answer more questions based on this patient search for knowledge. None of this time is reimbursable.
A physician’s response to Ashish Jha’s article paints a picture of Fed Fatigue (see my recent blog) by the physicians. Meaningful Use Stage 2 piles onto this. In order to see reimbursements, the physicians will have to drive patient education on top of everything else. This will take time. This will take materials. This will incur costs. This will drive more physicians out of medicine.
When it is over, it also has the potential to change the practice of medicine. Patients who take a proactive role in their health can save the industry a lot of money. To get the most out of this, patients should be taught to do this while they are young. We teach our children to save money. We teach our children manners, we teach our children to read, write, and get along with others. We do NOT teach our children to care about their health. Moreover we do not teach them to proactively manage their health and information related to their health.
If this is going to work, a lot of teaching will be crucial. It needs to start in the schools. It needs to happen at home. It needs to happen!
