Who’s Ready for VDT Meaningful Use Requirements?

November 17, 2015 - When the Centers for Medicare and Medicaid Services (CMS) issued the final rule for the EHR Incentive Programs in 2015 through 2017, it modified Stage 2 patient engagement objectives that require patient action. This was one of the major changes in the latest set of meaningful use requirements.

The threshold for Patient Electronic Access — the capability to view, download or transmit (VDT) health information — decreased from 5 percent of patients in the previous Stage 2 rule to one single patient during the 2015 and 2016 reporting periods for both eligible providers and eligible hospitals in the Modified Stage 2 rule.

Although the threshold is dropping significantly for now, it reverts back to the prior level in 2017, so it's still constructive to look at general VDT capabilities across the nation. The Health IT Dashboard, maintained by the Office of the National Coordinator for Health IT, allows the user to view the percentage of hospitals in each state that reported the capability for patients to electronically VDT their personal health and medical information. The dashboard uses data collected from a 2014 American Hospital Association survey of non-federal acute care hospitals.

To get a look at the most advanced states in regard to VDT, HealthITInteroperability.com filtered within the dashboard view for states in which more than 75 percent of hospitals reported having the specified patient engagement capability.

Here’s a look at the performance of states in that category.

AHA’s survey found that 64 percent of hospitals nationally had electronic VDT capabilities for patients as of 2014.

The states that exceeded 75 percent of hospitals with this capability:

• Vermont – 100 percent
• Massachusetts – 91 percent
• Alabama – 87 percent
• Arkansas – 86 percent
• New Hampshire – 83 percent
• North Dakota – 82 percent
• South Carolina – 82 percent
• Florida – 81 percent
• Virginia – 81 percent
• Delaware 80 percent
• Maryland – 78 percent
• New Jersey – 77 percent
• Wisconsin – 76 percent

To offset the possibility that states with relatively few hospitals achieved high percentages, we cross-referenced the most populous states (based on U.S. Census Bureau data) and pulled those results. Here’s how the 10 most populous states fared on the VDT measure (population rank in parentheses):

• Florida (3) – 81 percent
• Illinois (5) – 75 percent
• New York (4) – 71 percent
• North Carolina (9) – 70 percent
• Michigan (10) – 70 percent
• Pennsylvania (6) – 69 percent
• Ohio (7) – 68 percent
• Georgia (8) – 66 percent
• Texas (2) – 64 percent
• California (1) – 52 percent

The bottom six states for the VDT measure (reported at less than 50 percent) are as follows:

• Missouri – 20 percent
• Nevada – 33 percent
• Oregon – 38 percent
• Washington – 42 percent
• Arizona – 43 percent
• Hawaii – 43 percent

In its final rule, CMS explains that removal of the 5 percent threshold for Measure 2 from the Stage 2 VDT objective will allow “for the necessary time for providers to work toward patient education and the availability of resources, as well as allowing the industry as a whole time to develop a stronger infrastructure supporting patient engagement.”

The one-patient VDT requirement for eligible providers and hospitals applies in 2015 and 2016 reporting periods. For 2017 reporting, this measure increases to more than 5 percent of unique patients seen by the eligible provider, or more than 5 percent of unique patients discharged from the inpatient or emergency department of an eligible hospital.