Rethinking Stage 3 Meaningful Use to address key care disparities

The Consumer Partnership for eHealth (CPeH) is a non-partisan group made up of more than 50 consumer, patient and labor organizations and led by the National Partnership for Women & Families, a group that has been working in health information technology policy since 2005. According to Healthcare IT News, CPeH recently published a plan aimed at reworking some of the core focuses of Meaningful Use for the upcoming Stage 3.

The news source reported that the CPeH plan is the result of a year-long review of research as well as collaborations with experts studying health disparities and how they relate to electronic health records, IT and Meaningful Use. By removing these, CPeH believes that patient health outcomes will improve on a broader scale. The plan itself has been submitted to the Health IT Policy Committee, the federal board created in conjunction with the American Recovery and Reinvestment Act of 2009.

The current situation for Stage 3
Stage 2 Meaningful Use is set to begin its reporting period for doctors and physicians on Jan. 1, 2014. Stage 3 Meaningful Use is slotted to begin in 2016, giving providers only two years to attest to Stage 2 Meaningful Use, whereas the community had from 2011 to 2014 to attest to Stage 1. This has some members of the health IT community concerned about potential drops in meaningful users over the coming few years.

While Stage 1 set the groundwork and Stage 2 is prepared to advance the clinical processes, the Centers for Medicare and Medicaid Services (CMS) has made clear that Stage 3 will place its onus on the end goal of Meaningful Use: the patients. Among its stated focuses are improved quality, safety and efficiency - all leading to improved health outcomes - as well as decision support, patient-centered health information exchange (HIE), patient access to EHR software and management tools, and data collection that will work to improve general population health. Each of these steps places patient care at its center. But, as the CPeH believes, it is missing a big part of the picture.

Inside the CPeH plan
CPeH recognizes Stage 3 Meaningful Use as an opportunity to change healthcare for the better. But it also sees room for improvement.

"It's impossible to achieve better health outcomes and significantly reduce healthcare costs without tackling health disparities, which are a pervasive and costly problem," said Debra Ness, president of National Partnership for Women & Families. "We have the chance to leverage Stage 3 of the Meaningful Use program to make significant progress in addressing disparities. We must not squander this opportunity. CPeH has created a bold, yet achievable, path forward for including criteria in Stage 3 that will begin to reduce disparities and, in doing so, help us achieve patient- and family-centered care, better outcomes and lower costs for everyone."

Currently, the Joint Center for Political and Economic Studies estimates that the combined cost of health disparities and premature death in the U.S. between 2003 and 2006 was approximately $1.24 trillion. And as CPeH argues, as cited by Healthcare IT News, the country's diversity is growing, and health disparities are likely to increase exponentially alongside it.

As Ness put it, every American deserves an equal opportunity at healthy living. And policy makers should realize that the current health IT plan, while an improvement, does not ensure that.

CPeH pointed out that today's Meaningful Use program only requires basic data collection on race, ethnicity and gender. However, the new plan proposed by CPeH calls for more intensive data collection that includes disability status, sexual orientation and gender identity, all of which would help recognize, track and address disparities.

Healthcare IT News expounded more on the CPeH plan, which shows promise and may successfully bring coordinated care equally to a wider group of patients.

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