Home Forums Discussions General Discussion Providing a patient with a copy of records - MU

There has been some past discussion here (I couldn't find the thread) about what CMS is looking for us to be able to provide to patients as a part of Meaningless Use (sorry, but that is what MU is starting to mean to me). Their site now describes the following:

"a minimum level of information is defined in the certification process. All EHR technology is certified for the purposes of this program (according to ?170.304(f)) to provide:

Problem List
Diagnostic Test Results
Medication List
Medication Allergy List."

Of course they would "encourage" us to be able to provide more if asked.

Actually it was discussed at ACUC of using the patient summary or CCR as the form to give patients.

So the father of a patient of mine sent me an email asking if I was using a certified EHR, and if so, could I upload info to the HealthVault that he's created for the child. I told him what EHR I am using and asked which certification he was referring to, since in my head there's been a million of them popping up. In his response, he includes the following:

"The only EHR certification that matters is for Meaningful Use Stage 1 (MU-1). (MU-2 is coming but wont be here for a while)
.... Amazing Charts V6 is certified for MU-1, and
their certification process including HealthVault...this means that Amazing Charts can produce a standard summary care
record for [patient] (in either CCR or CCD format) that can be
electronically exchanged with [patent]'s HealthVault.
After [patient ] sees the specialist, we will import the Clinical Summary record of the specialist encounter to [patient]'s HealthVault and then share it back with you. (Or he could send it directly to you through a Clinical Messaging service)

Since Amazing Charts is MU-1 certified, you will be able to import the specialist's clinical summary record of her encounter with [patient] into your Amazing Charts EHR.

(In fact, to receive your reimbursement from the government for your purchase of Amazing Charts, you must attest that your practice knows how to share a patient's health information with a PHR like HealthVault.)"

later he goes on to say:
"MU-2 certification is on its way and will require providers to use an electronic Clinical Messaging service to exchange health records with other providers' EHRs and patients' PHRs
My company, Health-ISP, offers this standardized, CMS approved
Clinical Messaging service, that will connect with your Amazing
Charts. Or you could use Health-ISP Clinical Messaging service on a standalone basis, on the same computer as your Amazing Charts."

So... it looks like, by Jon's link, that we're going to be given 3 days to upload info at a patient's request (Do we get paid for this? Can we charge a records processing fee?)... and it sounds like this upcoming requirement of using a Clinical Messaging System (which is a subscription of sorts: "A doctor subscribing to a HISP can exchange messages with doctors, hospitals, and labs subscribing to any other HISP") is something WE the provider have to pay for? Sounds like the insurance company should pay for it. I still see nothing wrong with said specialist just faxing me a consult report.

This is all getting ridiculous.
As more of these regulations pile on, it's just more reason to opt-out... or change professions.

Well, back to actual patient-care.

or you can implement an "advanced technology fee" that patients must pay.

Is an 'advanced' fee tongue in cheek or is anyone doing this? I wonder if we are alowed to charge any fees for these MU components.

For now I am having patients purchase a thumb drive and giving them information from AC. THE VA clinic is doing the same thing. I dont have time to send all this electronic stuff everywhere...

Boondoc, I have not had a single patient yet ask for a CCD.
I suppose if they asked me for it, I would produce it and either email it to them, or burn to a CD, or save to their thumb drive.

Todd, Fortunately the CMS requirement only says that we give this information to 50%of patients who request it. Have you had patients request this information format?
If so, have you told anyone no? You only have to give to 50%, so try telling this to the next person who asks for the meaningless file...

No one has ever asked me for a summary. I have been asked for a copy of all their meds and I had a patient tell me she wished she could remember all her diagnoses so she could tell consultants. I produced those documents for those patient. It would be much more useful to me (and save a bunch of paper) if one could select whether they want the CCR to have every diagnosis (active or inactive) and every medication (active or inactive) print out. I think the way it is now is very messy and difficult for patients to understand.

Leslie, I don't think these CCD's are intended for patients to fully understand. I think the idea is that they can transport to another care provider with a complete summary of all diagnoses and all meds, both active and inactive.

I agree with you however. it's basically information overload and most of it is stuff that we as providers of healthcare ourselves do not want to see.

I send a summary of the visit and CCD after every visit to the Updox patient portal. No paper is needed for this. The patients receive my specific directions and expected follow-up. This connects them to the free patient portal that is provided by Updox. Anyone uninterested in this information, just has to ignore the email that directs them to the portal. The portal keeps a record of which items the patients have read. For some of our elderly patients who are not "connected", we send their info to their children's email. This is only done at their request and permission, of course. This improves communication all the way around.