hospital using patient portal cms 2016

How do patients use patient portals to improve clinical outcomes?

2016 Program Requirements. CMS is renaming the EHR Incentive Programs to the Promoting Interoperability (PI) Programs to continue the agency’s focus on improving patients’ access to health information and reducing the time and cost required of providers to comply with the programs’ requirements. CMS is also in the process of finalizing ...

Do patients and caregivers use portals to communicate with healthcare staff?

: For an EHR reporting period in 2015 and 2016, at least 1 patient who is discharged from the inpatient or emergency department (POS 21 or 23) of an eligible hospital or CAH (or patient authorized representative) views, downloads or transmits to a third party his or her health information during the EHR reporting period.

Does patient condition influence portal use among cancer patients?

The patient must be able to access this information on demand, such as through a patient portal or personal health record (PHR) or by other online electronic means. We note that while a covered entity may be able to fully satisfy a patient's request for information through VDT, the

What is the published literature on patient portal utilization?

Mar 09, 2020 · The Interoperability and Patient Access final rule (CMS-9115-F) delivers on the Administration’s promise to put patients first, giving them access to their health information when they need it most and in a way they can best use it. As part of the Trump Administration’s MyHealthEData initiative, this final rule is focused on driving ...

What percentage of patients use patient portals?

Is meaningful use still in effect 2020?

What is the difference between EHR and patient portal?

What is CMS interoperability and patient Access Final Rule?

Which MIPS category replaced meaningful use?

What has replaced meaningful use?

Which of the following is a benefit of patient portals?

What safeguards are included in patient portals?

What makes the patient portal different from the PHR?

What is CMS HealthCare?

What is CMS rule?

What is the CMS mandate?

When does a patient need to be seen by the EP?

The patient needs to be seen by the EP during the EHR reporting period or be discharged from the hospital inpatient or emergency department during the EHR reporting period in order to be included in the denominator.

What is EHR incentive?

The Medicare and Medicaid EHR Incentive Programs encourage patient involvement in their health care. Online access to health information allows patients to make informed decisions about their care and share their most recent clinical information with other health care providers and personal caregivers.

When do you have to take actions in EHR?

The calculation may include actions taken before, during, or after the EHR reporting period if the period is less than one full year; however, consistent with FAQ #8231, these actions must be taken no earlier than the start of the same year as the EHR reporting period and no later than the date of attestation.

Can a provider withhold information from a patient's website?

A: All information available at the time the information is sent to the patient website must be made available to the patient online. However, the provider may withhold any information from online disclosure if he or she believes that providing such information may result in significant harm.

Does CMS require growth charts?

However, because this certification capability is not required, eligible professionals and hospitals do not need to generate and make growth charts available in order to meet the objective.

What is CMS' role in protecting patient information?

CMS is taking additional steps to provide payers and patients opportunities and information to protect patient data and make informed decisions about sharing patient health information with third parties. For instance, as part of this final rule a payer may ask third-party application developers to attest to certain privacy provisions, such as whether their privacy policy specifies secondary data uses, and inform patients about those attestations. CMS is also working with payers to provide information they can use to educate patients about sharing their health information with third parties, and the role of federal partners like the Office for Civil Rights (OCR) and the Federal Trade Commission (FTC) in protecting their rights.

When will CMS report CAHs?

Public Reporting and Information Blocking: Beginning in late 2020, and starting with data collected for the 2019 performance year data, CMS will publicly report eligible clinicians, hospitals, and critical access hospitals (CAHs) that may be information blocking based on how they attested to certain Promoting Interoperability Program requirements. Knowing which providers may have attested can help patients choose providers more likely to support electronic access to their health information.

What is CMS data exchange?

Payer-to-Payer Data Exchange: CMS-regulated payers are required to exchange certain patient clinical data (specifically the U.S. Core Data for Interoperability (USCDI) version 1 data set) at the patient’s request, allowing the patient to take their information with them as they move from payer to payer over time to help create a cumulative health record with their current payer. Having a patient’s health information in one place will facilitate informed decision-making, efficient care, and ultimately can lead to better health outcomes. These payers are required to implement a process for this data exchange beginning January 1, 2022 (for QHP issuers on the FFEs, plan years beginning on or after January 1, 2022).

What is CMS 9115-F?

Overview#N#The Interoperability and Patient Access final rule (CMS-9115-F) delivers on the Administration’s promise to put patients first, giving them access to their health information when they need it most and in a way they can best use it. As part of the Trump Administration’s MyHealthEData initiative, this final rule is focused on driving interoperability and patient access to health information by liberating patient data using CMS authority to regulate Medicare Advantage (MA), Medicaid, CHIP, and Qualified Health Plan (QHP) issuers on the Federally-facilitated Exchanges (FFEs).

What is provider directory API?

Provider Directory API: CMS-regulated payers noted above (except QHP issuers on the FFEs) are required by this rule to make provider directory information publicly available via a standards-based API. Making this information broadly available in this way will encourage innovation by allowing third-party application developers to access information so they can create services that help patients find providers for care and treatment, as well as help clinicians find other providers for care coordination, in the most user-friendly and intuitive ways possible. Making this information more widely accessible is also a driver for improving the quality, accuracy, and timeliness of this information. MA organizations, Medicaid and CHIP FFS programs, Medicaid managed care plans, and CHIP managed care entities are required to implement the Provider Directory API by January 1, 2021. QHP issuers on the FFEs are already required to make provider directory information available in a specified, machine-readable format.

What is patient access API?

Patient Access API: CMS-regulated payers, specifically MA organizations, Medicaid Fee-for-Service (FFS) programs, Medicaid managed care plans, CHIP FFS programs, CHIP managed care entities, and QHP issuers on the FFEs, excluding issuers offering only Stand-alone dental plans (SADPs) and QHP issuers offering coverage in the Federally-facilitated Small Business Health Options Program (FF-SHOP), are required to implement and maintain a secure, standards-based (HL7 FHIR Release 4.0.1) API that allows patients to easily access their claims and encounter information, including cost, as well as a defined sub-set of their clinical information through third-party applications of their choice. Claims data, used in conjunction with clinical data, can offer a broader and more holistic understanding of an individual’s interactions with the healthcare system, leading to better decision-making and better health outcomes. These payers are required to implement the Patient Access API beginning January 1, 2021 (for QHP issuers on the FFEs, plan years beginning on or after January 1, 2021).

When is the provider directory API required for MA?

MA organizations, Medicaid and CHIP FFS programs, Medicaid managed care plans, and CHIP managed care entities are required to implement the Provider Directory API by January 1, 2021. QHP issuers on the FFEs are already required to make provider directory information available in a specified, machine-readable format.

How many beds are critical access hospitals?

Critical Access Hospital: Hospitals with less than 25 beds and at least 35 miles away from another general or critical access hospital.

What is an inpatient patient?

Inpatient: A patient who is admitted to a hospital to undergo treatment. The survey asks about “patients who receive inpatient care provided by your hospital”. Inpatients refer to patients who receive inpatient care from respondent hospital. Please refer to Appendix Table A1 to review the applicable questions.

What is the AHA IT supplement?

hospitals. ONC funded the 2019 AHA IT Supplement to track hospital adoption and use of EHRs and the exchange of clinical data.

What is an EHR 2015?

2015 Edition Certified Electronic Health Record (EHR): An EHR that meets certification criteria requirements established by the U.S. Department of Health and Human Services. These criteria establish the required capabilities, standards, and implementation specifications that health information technology needs to meet in order to become certified under the ONC Health IT Certification Program. Certified health IT products can be used for participation in CMS quality reporting programs and State Promoting Interoperability Programs.

How many hospitals have EHR?

Although nine in 10 hospitals possess certified EHR technology that provides them with the technical capability to transmit their health information electronically, only three-quarters of hospitals reported that they had enabled this functionality in 2019. Previous research has found that, although many hospitals and ambulatory practice groups have technology that is capable of connecting patients with their medical record online, not all providers fulfill patient requests to get an electronic copy of their record or enable patients to access their health information electronically (5-6).

What is a non-federal acute care hospital?

Non-federal acute care hospital: Hospitals that meet the following criteria: acute care general medical and surgical, children’s general, and cancer hospitals owned by private/not-for-profit, investor-owned/for-profit, or state/local government and located within the 50 states and District of Columbia.

Who was asked to participate in the AHA survey?

The chief executive officer of each U.S. hospital was invited to participate in the survey regardless of AHA membership status. The person most knowledgeable about the hospital’s health IT (typically the chief information officer) was requested to provide the information via a mail survey or secure online site. Non respondents received follow-up mailings and phone calls to encourage response.

What is EHR incentive?

The Medicare and Medicaid EHR Incentive Programs encourage patient involvement in their health care. Online access to health information allows patients to make informed decisions about their care and share their most recent clinical information with other health care providers and personal caregivers.

Can a provider withhold information from a patient's website?

However, the provider may withhold any information from online disclosure if he or she believes that providing such information may result in significant harm.

Can a patient opt out of health information?

A: A patient can choose not to access their health information, or “opt-out.” Patients cannot be removed from the denominator for opting out of receiving access. If a patient opts out, a provider may count them in the numerator if they have been given all the information necessary to opt back in without requiring any follow up action from the provider, including, but not limited to, a user ID and password, information on the patient website, and how to create an account.

Does CMS require growth charts?

However, because this certification capability is not required, eligible professionals and hospitals do not need to generate and make growth charts available in order to meet the objective.

What are the benefits of patient portals?

Background: Patient portals have demonstrated numerous benefits including improved patient-provider communication, patient satisfaction with care, and patient engagement. Recent literature has begun to illustrate how patients use selected portal features and an association between portal usage and improved clinical outcomes.

What are the objectives of the patient portal study?

Objectives: This study sought to: (1) identify patient characteristics associated with the use of a patient portal; (2) determine the frequency with which common patient portal features are used; and (3) examine whether the level of patient portal use (non-users, light users, active users) is associated with 30-day hospital readmission.

Lessons From More Than A Decade In Patient Portals

Many of us look forward to a time when the experience of interacting with our health care providers will be as consumer-friendly and technology-enabled as, for example, using an ATM or Uber.

Early Implementation And Growth Of Patient Portals

In the late 1990s and early 2000s, the earliest adopters of patient portals began offering electronic tools for patient-centered communication, often “tethered” to their integrated electronic health record system.

Lessons Learned

From more than a decade of experience engaging patients online, we offer four key lessons.

Moving Forward

Within 10 years, Kaiser Permanente’s patient portal has become a cornerstone of how we deliver care. According to our research, patients using the portal reported feeling:

Why are patient portals important?

While the evidence is currently immature, patient portals have demonstrated benefit by enabling the discovery of medical errors, improving adherence to medications, and providing patient-provider communication, etc. High-quality studies are needed to fully understand, improve, and evaluate their impact.

How does a patient portal improve patient engagement?

Patient portals may enhance patient engagement by enabling patients to access their electronic medical records (EMRs) and facilitating secure patient-provider communication.

What are the inputs and outputs of a patient portal?

The inputs are the material (eg, hardware and software) and nonmaterial (eg, leadership) components that facilitate or impair the establishment or use of the portal. Processes include the interactions of the users with the portal. Outputs comprise the results of the implementation or the use of the portal. Through the analysis, we identified 14 themes within these three categories, shown in Textbox 1.

How does patient involvement improve quality of care?

Promoting patient involvement in health care delivery may lead to improved quality and safety of care [14,15] by enabling patients to spot and report errors in EMRs, for example [6]. Some patients recognize the role of patient portals in their health care, reporting satisfaction with the ability to communicate with their health care teams and perform tasks such as requesting prescription refills conveniently [3,16]. Portal use may reduce in-person visits, visits to emergency departments, and patient-provider telephone conversations [3,8-10,12,16]. Despite the potential of portals, already used in the ambulatory setting for some time, implementation in the inpatient setting has only recently gathered momentum [17-19]. The inpatient setting presents additional challenges for implementing patient portals [18,20]. Clinical conditions leading to hospitalization are often acute and the amount of medical information generated during this time can be extensive, which may overwhelm patients [20] and challenge information technology to rapidly display this information.

How does EMR help patients?

Hospitals and other health care organizations can facilitate patient access to their EMR information through patient portals. Patient portals can provide secure, online access to personal health information [1] such as medication lists, laboratory results, immunizations, allergies, and discharge information [2]. They can also enable patient-provider communication using secure messaging, appointments and payment management, and prescription refill requests [2,3].

What are barriers in portals?

Barriers: factors that hinder widespread adoption or portal use

What is portal design?

Portal design: umbrella term for all design-related aspects of the portal including portal interface, content, features, and functions

What is a patient portal?

A patient portal is a secure online website, managed by a health care organization, that provides patients access to their personal health information [1-3]. Portals were developed to provide patients with a platform through which to claim ownership over their health care. For patients that adopt health care portals, usage of the portal has been shown to positively impact health outcomes [1]. Despite their introduction in the late 1990s to augment patient engagement [2], widespread adoption of patient portals was not seen until 2006 [2,4]. As of 2018, a reported 90% of health care organizations offer patients portal access, with the remaining 10% reporting plans to adopt this tool [5].

What are the most commonly studied patient portal metrics?

Patient use was the most commonly studied patient portal metric, analyzed in 90% (78/87) of studies. Super user designations were only found in 24% (21/87) of studies, making this the least commonly studied metric. Table 2identifies the frequency with which each metric was included in each study, with totals for each metric [6-10,18,22-102]. There were 32 different combinations of study metrics, identified in Table 3, with the two most common metric combinations being patient use/adoption, frequency, and intensity (n=9) and patient use/adoption alone (n=9). The majority of studies (53/87, 61%) analyzed three or fewer metrics, with 3.11 as the average number of metrics reported. The definitions of these 271 metrics are summarized by study in Multimedia Appendix 1.

What is portal use?

Portal use by providers, care teams, or other staff. This use could be in terms of adoption, frequency, intensity, duration, or super user, per below; patient utilization grouped by provider practice/specialty also implies provider/practice adoption.

What are the coding purposes of super user?

For coding purposes, use/adoption, frequency, duration, intensity, and super user (or similar user stratification) were considered a priori themes from which to extract definitions; provider use emerged as a theme inductively. Super user, in this context, is synonymous with high utilizer and should not be confused with the information technology standard definition implying a user with elevated privileges. All metrics were coded as binary, indicating the presence of a measure for and/or definition of each respective metric. These data were coded and recorded in a spreadsheet containing the article citation information and columns for themes of interest for both portal use metric definitions and MU criteria. Extractors’ working definitions of metric types are summarized in Table 1.

How does portal utilization affect health outcomes?

Numerous studies have investigated the relationship between patient portal utilization and health outcomes, specifically indicating a link between increased portal use and increased rates of patient engagement [6-9]. Notably, engaged individuals more actively participate in the management of their health care [10] and report enhanced patient satisfaction [11], a finding increasingly critical in patients with chronic diseases [12]. Patient portal utilization has been linked to “significant decreases in office visits…, changes in medication regimen, and better adherence to treatment” [13], along with improved chronic disease management and disease awareness [8,9]. Interestingly, even the content of patient messages was recently found to be associated with estimated readmission rates in patients with ischemic heart disease [14]. In these ways, patient portals have been cited as essential components of the solution to the cost and quality health care crisis in the United States [2].

Can portal utilization be meaningful?

Understanding how patient portal use has been defined and operationalized may encourage more consistent, well-defined, and perhaps more meaningful standards for utilization, informing future portal development.

Is there a systematic review of patient portal utilization?

Despite widespread portal interest and adoption, as well as comprehensive reviews on patient engagement with portals [2], no review has systematically assessed measurements investigating patient portal utilization. Currently, measurement of patient portal use varies widely, with inconsistent conceptual definitions serving as a consistent limitation to robust analysis [20]. Understanding how patient portal use has been defined and operationalized, both previously and currently, will encourage consistent and well-defined utilization of patient portals. Further, standardization of patient portal measurements will provide a basis from which to systematically analyze how to continue developing patient portals best suited to consumer needs.