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Update: AHRQ Project to Develop a Health Information Rating System

Posted on January 9, 2013 | No Comments

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Implementation Briefs
Key Developments

By Lara Cartwright-Smith


Previous implementation briefs have addressed the electronic health record (EHR) incentive programs enacted by the HITECH Act, part of ARRA.[1] These programs financially incentivize adoption of EHR technology that meets standards of interoperability and accessibility, among other criteria, and incentivize providers to use the technology to engage with patients and improve patient care. Among other goals, the EHR incentive program is intended to improve patient engagement in their health care, which will allow better communication, decision-making, and self-management.

Many of the “meaningful use” measures, as they are called, address the use of EHRs for patient engagement. For example, Stage 1 Meaningful Use standards required participating providers to “provide patients with an electronic copy of their health information,’’ which under Stage 2 Meaningful Use became “the ability to view online, download, and transmit health information” as a core objective.[2] Under Stage 2, providers must also give patients a clinical summary of each visit and use secure electronic messaging to communicate with patients on relevant health information.[3] Furthermore, providers are required to use certified EHR technology to “identify patient-specific education resources and provide those resources to the patient.”[4]

These requirements for individuals to have electronic access to health information are aimed at achieving higher quality and more efficient health care through more engaged patients who use information to make better decisions, both with respect to health care and day-to-day self-management of their health. However, realizing this goal will require not only that the information is available to consumers and patients but that they use the information in a meaningful way to influence their decisions and behavior.

AHRQ Project to Develop a Health Information Rating System

On October 5, 2012, the Agency for Healthcare Research and Quality (AHRQ) announced a proposed project entitled “Development of a Health Information Rating System (HIRS).”[5] Comments are due December 4. The project’s ultimate goal is to develop “a reliable and valid rating system to assess the understandability and actionability of heath education materials.”[6] In other words, it will create a method for clinicians to determine how easily patients can understand and act on health education information that is provided through EHRs. The project has four main tasks:

1. develop a valid and reliable Health Information Rating System (HRIS);

2. create a library of patient health education materials;

3. review EHRs’ patient education capabilities and features; and

4. educate EHR vendors and users.

AHRQ has already created a draft HRIS, which will be assessed by Abt Associates for construct validity (determining whether users understand the materials and know what actions to take) and then made publicly available with instructions for users.


The proposed HRIS will give providers and EHR vendors a system to rate the understandability and actionability of health education materials that may be included in EHRs. This project represents another step in the direction of truly meaningful use of electronic health information by making that information accessible and useful for individuals at all levels of health literacy.

[1] E.g.,;
[2] Medicare and Medicaid Programs; Electronic Health Record Incentive Program – Stage 2 Final Rule, 77 Fed. Reg. 53968, 54007 (Sept. 4, 2012).
[3] 77 Fed. Reg. 54129.
[4] Id.
[5] Notice: Agency for Healthcare Research and Quality Agency Information Collection Activities: Proposed Collection; Comment Request. 77 Fed. Reg. 60997 (Oct. 5, 2012).
[6] 77 Fed. Reg. 60998.

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