What is CMS Proposing?

Drop the requirements in the 2014 reporting period for:
1.       Patient electronic copies of medical records within three business days
2.       Electronic copies of discharge instructions at time of discharge
3.       The “menu” requirement for “Timely Access” on the Eligible Provider list

And replace all three of these with a core requirement of patient online access.

Eligible Professional (EP) Objective: Provide patients the ability to view online, download and transmit their health information within 4 business days of the information being available to the EP.

EP Measures: (Note: You must pass TWO measures for this objective)
1.       More than 50 percent of all unique patients seen by the EP during the EHR reporting period are provided timely (within 4 business days after the information is available to the EP) online access to their health information subject to the EP's discretion to withhold certain information.
AND
2.       More than 10 percent of all unique patients seen by the EP during the EHR reporting period (or their authorized representatives) view, download or transmit to a third party their health information.

Hospital Objective: Provide patients the ability to view online, download and transmit information about a hospital admission.

Hospital Measure: (Note: You must pass TWO measures for this objective):
1.       More than 50 percent of all patients who are discharged from the inpatient or emergency department (POS 21 or 23) of an eligible hospital or CAH have their information available online within 36 hours of discharge.
AND
2.       More than 10 percent of all patients who are discharged from the inpatient or emergency department (POS 21 or 23) of an eligible hospital or CAH view, download or transmit to a third party their information during the EHR reporting period.

The following will probably receive comment: The “unique patient” item in the EP Measure. For example, if a patient sees the provider three times in the reporting period, and in two of the instances the data is available within 4 business days, but in the third instance the data wasn’t available for the patient until six business days had elapsed, do you count the patient or not? The “within 36 hours of discharge” item in the hospital measure.

BOTTOM LINE - These changes will drive every facility to own or outsource a patient portal or PHR and to connect their EHR system to the portal so records are automatically available. Will this reduce patient HIM department requests for medical records?  Depends on two things:
1.       How well the facility advertises the portal, and gets patients to use it (instead of requesting copies of records in the traditional ways).  The requirement that 10 percent of patients actually access their records means that providers must actively persuade patients to go to the portal.
2.       How much information is actually available on the portal, and in what  format.  CMS did specify a minimum set of data that must be available – and it’s not the entire record (watch for a later blog post on this).  So patients will likely still request their records in traditional ways, depending on the patient’s reason for the request, and the health information they need.

Read the rule for yourself and utilize the tips below to speed you on your way:
1.       The pdf version of the rule (pre Federal Register) can be found by clicking here.
2.       The new proposed objective for “Access” starts on page 91 for EPs or page 144 for hospitals.
3.       The list of required record data for online access (if you want to get ahead of our next blog post) starts on page 97 for EPs or page 145 for hospitals.
4.       If you prefer the table form for reviewing the requirements, that starts on page 156.
5.       And the actual rule verbiage (not the comments and table mentioned above) is on page 406 for EPs or page 414 for hospitals.