As part of the 2014 Certified EHR Technology, Indian Health Services is creating a personal health record (PHR) that will allow patients to access their medical information online.

Depending on how they are used, Electronic Health Records (EHRs) can provide a wealth of benefits for both providers and their patients, such as providing accurate, timely information and empowering patients to become more active in their personal health. By demonstrating meaningful use of a certified EHR, health practitioners promote the use of technology as a means of improving health care in the United States.

Under the Health Information Technology for Economic and Clinical Health (HITECH) Act, eligible professionals (EPs) and eligible hospitals (EHs) can qualify for Medicare or Medicaid EHR incentive payments by demonstrating meaningful use of certified EHR technology through successfully meeting specific objectives.

The Indian Health Service (IHS) is pleased to report that, as of May 2013, EPs and EHs across all of Indian Country have received more than $69 M in EHR incentive payments. With the requirements for Stage 2 of meaningful use going into effect for FY/CY 2014, EPs and EHs will have the opportunity to collect even more EHR incentive money.

Looking to the Future

Based on numerous requirements from the Centers for Medicare and Medicaid Services (CMS), the Office of the National Coordinator (ONC), and the National Institute of Standards and Technology (NIST), the Office of Information Technology (OIT) is updating its RPMS EHR software. In order to achieve 2014 certification, the RPMS EHR will have to demonstrate more than 40 requirements successfully, and almost every package will have to be modified.

With internal testing taking place during in the next couple of months, IHS’s goal is to have the RPMS EHR certified this summer to meet the various 2014 criteria. OIT is close to selecting an Authorized Testing and Certification Body who will provide consultative services and administer the certification test.

Once certification is achieved, all RPMS EHR users will need to upgrade to the 2014 certified version. In particular, all EPs and EHs, regardless of their stage of meaningful use, will need to upgrade to the 2014 certified version of the EHR prior to beginning their reporting period for CY/FY 2014. Using the 2011 certified version of RPMS EHR will not be allowed for anyone participating and attesting to MU for CY/FY 2014, even for those who are only participating in Stage 1. However, EPs and EHs will only have to demonstrate meaningful use for a 90-day period in 2014, regardless of whether they are in Stage 1 or Stage 2, to allow time to implement the new technology.

Personal Health Records

As part of the 2014 Certified EHR Technology, IHS is creating a personal health record (PHR) that will assist patients in accessing some of their medical information via a web browser. By using the PHR, which is a secure portal, patients will be able to view, download, and transmit demographic information, medications, lab results, problems, vital signs, immunizations, and other visit-related information. Such availability will help address one of the major focal points of meaningful use by encouraging patient engagement.

Before using the PHR, the patient will need to create a PHR account. Once this account has been established, the patient will be prompted to validate his or her identity at the clinic or hospital. To assist with this process, a PHR registrar at each health care facility will validate the patient’s identity and link his or her PHR and medical record accounts using a PHR administrative application. Because the PHR also interfaces with the Master Patient Index (MPI), the PHR registrar will be able to link the patient with multiple RPMS EHR accounts. Once the PHR and RPMS EHR accounts are linked, patients will be able to view their health information online. If the patient receives care in more than one place, he or she will be able to see information from each facility with the same PHR account.

The information available to patients will come from the Consolidated Clinical Document Architecture (CCDA), which will be used by the Health Information Exchange. Since the CCDA will be updated with changes within 24 hours of each patient visit, patients will be assured timely access to their most recent medical record information.

In addition to permitting patients to view their health information online, the PHR will help promote secure communication and facilitate the transmission of key clinical information between patients and their providers.

Making an Impact

Integrating the use of an EHR with the daily operations of physicians and hospitals represents an excellent opportunity for health IT to demonstrate its value in affecting the quality of patient care. Whether by improving the accuracy of documentation, measuring the effectiveness of specific objectives, or engaging patients in their personal health needs, these important initiatives support IHS’s goal to “ensure that comprehensive, culturally acceptable personal and public health services are available and accessible to American Indian and Alaska Native people.”