John Sherard

As a concerned physician with job responsibilities including implementation of EHR in a large medical system I am requesting a change in one of the MU (Meaningful Use) criteria. I am specifically referring to the MU stage 2 core 7 measure related to availability of the EHR online. The specific portion of this MU criteria I am asking to be changed is the part that requires "more than 5% of all unique patients seen by the EP (Eligible Provider) during the EHR reporting period (or their authorized representative) view, download, or transmit to a third party their health information. There are two reasons this 5% rule should be eliminated. First, it not only arbitrarily assumes 5% or more of patients will want to, but actually requires 5% or more of patients to use this method of seeing their records. Patients should not be coerced into choosing this and EP's should not be placed in a position where they are encouraged to coerce their patients into this. Second, a recent study finds that this MU criterion does not have its intended consequences. Published in the November 21, 2012 edition of the Journal of the American Medical Association is the article, "Association of Online Patient Access to Clinicians and Medical Records With Use of Clinical Services." This article finds that patients use more services, including office visits, telephone calls to the office, after hours clinic visits, emergency department visits, and hospitalizations when they use online access to their EHR. This study suggests online access to patient records may in fact be detrimental in terms of both care and costs. I ask that the 5% rule regarding patient use of online access be waived and that any requirement for any percent of patient to access their records online be waived.