One of the big challenges that meaningful use participants face is the integration with others and the ability to properly share that clinical information to make it all happen.

Some additional suggestions for how to improve the patient-centered nature of the draft definition issues by ONC (for more detail see http://ixcenterblog.org/archives/718):
* Certainly, some of the elements should be moved up — earlier in the timeline (e.g., secure messaging, patient access to self-management tools & decision support, and electronic reporting on experience of care).
* The access to electronic information needs to be “timely” (a word that should be added); timely applies both to the speed at which it is made available and the ability to get information targeted to the consumer’s particular moment in care.
* Incorporation of data generated by the consumers themselves beyond just what can be uploaded from electronic monitoring devices (per the 2013 criterion).
* There should be more attention to consumer information tools (beyond just narrowly definted personal health records) and more clarity around the kinds of tools that consumers need — not just self-management tools but also decision support tools and tools that facilitate effective & efficient communication to improve the infrastructure for participatory medicine.