In the proposed rule for Meaningful Use Stage 3 the Office of the National Coordinator (ONC) has made significant changes to the patient engagement recommendations that are causing controversy amongst EHR vendors, Doctors, and the media. These recommendations include three measures of engagement, and providers would have to report on all three of them, but successfully meet thresholds on only two.
Some claim that these requirements are too burdensome, and that they may not be achievable giving what is achievable in the marketplace today.
Specifically the new rules would:
- Require that 25 percent of patients view, download, and transmit their personal health data
- Require that more than 35 percent of all patients seen by the provider or discharged from the hospital receive a secure message using the electronic health record’s (EHR) electronic messaging function or in response to a secure message sent by the patient (or the patient’s authorized representative).
- Require that more than 15 percent of patients to contribute patient-generated health data or data from a non-clinical setting, to the EHR.
It is true that the proposed ONC requirements are a very tall order for many providers to satisfy, particularly when many of the EHR systems they are using provide a less than satisfactory user experience for the medical staff that use them. Adding an entire new user population, namely patients and patient caregivers, to the mix make patient engagement even more difficult.
Most software products claim that their system is “easy to use.” There is even a popular Dilbert cartoon on this topic. Adding “easy to use” to your company’s marketing materials doesn’t really make anything easier. But, just because something is easy to use doesn’t mean that people will actually use it. In order to get true meaningful use of something it needs to be usable, useful and satisfying.
In order to achieve the requirements for improved engagement, Patient Portals need to present information, and workflow, to the patient, and/or caregivers, that are easily understood and are useful to the patients or the caregivers. By fully embracing a user-centered design approach Patient Engagement will increase.
There is another way to improve Patient engagement by using a widely adopted technology in the business to consumer sector—Personalization. Personalization, involves using technology to present information in a way that can accommodate the differences between individuals.
An example of the most common form of personalization can be seen with the selection of banners displayed by ad servers. In this form of personalization, the system makes calculations based upon your search traffic to display advertisement that it feels you would be more likely to interact with. Based upon your clicks and any other information it can obtain, the personalization engine creates a profile and uses that profile to shape the information it presents you.
What happens shortly after you “Like” something on Facebook? You start seeing ads associated with the thing you liked. That is one form of personalization.
A personalization system could also use the geo-location date that it can glean from your IP address to decide what to show you. If, for example, you live in Beverly Hills it may be more likely to display high-end products, jewelry and furs, than if your IP address is from Gila-Bend Arizona.
Personalization in healthcare records systems can take this “mass customization” to an entire new level, because instead of using predictive algorithms to determine how to present information EHRs can use the patient’s actual medical records.
Is your patient diagnosed with (ICD-10: H53.53)? The patient portal, in this case, should avoid using a color theme that has a lot of green in it!
Maybe the portal should be designed to use a bigger font when the patient has a diagnosis of an “age-related cataract.” (ICD-10: H25-H28, “Disorders of lens.”). Using the one size fits all approach view an elderly patient with visual acuity problems will not significantly use your patient portal probably because they cannot see it clearly.
The list of specific examples of customizations is probably almost as large as the number of new codes in ICD-10, but the main point of this post is to explain that by using the information we can obtain from their record we can create a “smart default” user experience that can be more engaging than just a single one size fits all standard. See also Bad Defaults.
Most personalization engines work by making guesses about potential behavior based upon past behavior and some other factors (device, location, etc.) Personalizing a patient portal would be based upon information contained within the patient’s medical record. No guessing involved!
Using this form of personalization to present an interface that is usable, useful and satisfying because it matches the detailed medical demographics of the user, is yet another way to help achieve the required increases in patient engagement for Meaningful Use Stage 3.
About the Author: Bennett Lauber is the Chief Experience Officer (CXO) for The Usability People. An executive User Experience (UX) and usability team leader with experience managing cross-functional teams responsible for designing, developing and testing healthcare, consumer, and enterprise-class data management systems for desktop, mobile and tablet devices. Member ONC HITPC Implementation, Usability, & Safety Workgroup. This article was originally published on The Usability People and is republished here with permission.