The federal government has taken deliberate steps to ensure that EHR systems are strong, secure, and able to communicate with each other. “Certification” is a way to enforce standards. Hospitals, doctors and other eligible practitioners can earn incentive fees under the meaningful use program, by adopting certain standards and earning certification. EHRs are certified after passing tests of their functionality, reliability, security, and compliance with the standards. Certification provides assurance to purchasers and other users that an EHR system offers the necessary technological capability, functionality, and security to help them meet the meaningful use criteria established. Providers and patients must also be confident that the EHR systems they use are secured, can maintain data confidentiality, and can work with other systems to share information. Certification of EHR systems is an important step in ensuring that meaningful use requirements are met and that the benefit of improved patient care is realized. Certifying Bodies The Certification Commission for Healthcare Information Technology (CCHIT) is a private, non-profit organization formed to certify EHRs against a minimum set of requirements based on functionality, interoperability, and security. It was founded in 2004 by three industry associations: the healthcare Information and Management Systems Society, the American Health Information Management Association, and The Alliance for Health Policy and Systems Research. In 2005 CCHIT was awarded a three-year, $7.5M government contract to assist with developing certification criteria and inspection processes for EHR systems. The U.S. Department of Health and Human Services has partnered with the CCHIT to certify EHR pr... ... middle of paper ... ...tion requirements. Similarly, the systems analysis, or define phase, is the deliverable which defines the system’s requirements. This includes taking the deficiencies in the existing system and addressing them with specific proposals for improvement. These proposals can be to ensure that the new EHR has all the necessary requirements to qualify for certification and help to narrow down vendor selection. Incorporated into the SDLC is a maintenance phase in which constant upkeep and evaluation is needed to ensure an operational system that is properly maintained, supported and secured. During this phase, system users should be kept up-to-date about the latest modifications and procedures. It is therefore important to know that your vendor has a good standing reputation and plans to provide continuous support for your software throughout the product’s lifecycle.
The federal government has taken a stance to standardized care by creating incentive programs that are mandated under the Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009. This act encourages healthcare providers and healthcare institutions to adopt Meaningful use in order to receive incentives from Medicare and Medicaid. Meaningful use is the adoption of a certified health record system that acquires or obtains specified objectives about a patient. The objectives or measures are considered gold standard practices with the EHR system. Examples of the measures include data entry of vital signs, demographics, allergies, entering medical orders, providing patients with electronic copies of their records, and many more pertinent information regarding the patient (Friedman et al, 2013, p.1560).
The U. S government passed the American Recovery Act in 2009 that established incentives and penalties to promote EHR use. From this legislation the Meaningful Use Program for EHR’s s was created. Through The Meaningful Use Program the U.S. government is able to support the adoption and use of EHR technology to enhance and revolutionize health care. The goal of the program is to increase EHR adoption, improve quality, safety, reduce disparities, and improve public health (hmsa , 2012).
“Meaningful Use” implemented in July, 2010, set criteria’s for physicians and hospitals to adhere, in order to qualify for certain financial incentives and to be deemed meaningful users (MU) of the EMR. Meaningful use in healthcare is defined as using certified electronic health record to improve quality, safety, efficiency, and reduce mortality and morbidity. There are 3 stages of meaningful use implementation. The requirements for the 3 stages are spread out over a period of 5 years. MU mandates that physicians meet 15 core objectives and hospitals meet 14 core objectives (Hoffman & Pudgurski, 2011). The goal is to in-cooperate the patient and family in their health, empower autonomy to make decisions while improving care in all population.
Unfortunately, the quality of health care in America is flawed. Information technology (IT) offers the potential to address the industry’s most pressing dilemmas: care fragmentation, medical errors, and rising costs. The leading example of this is the electronic health record (EHR). An EHR, as explained by HealthIT.gov (n.d.), is a digital version of a patient’s paper chart. It includes, but is not limited to, medical history, diagnoses, medications, and treatment plans. The EHR, then, serves as a resource that aids clinicians in decision-making by providing comprehensive patient information.
According to the National Alliance for Health Information Technology (2008) and the American Health Information Management Association (AHIMA) (2012), the personal health record (PHR) is defined as the individual lifelong electronic health records. Its features are electronic, readily available, personal control, standardization, resource sharing, and portability. Although the PCEHR is currently being implemented in several countries of the world, it still has many controversial disadvantages. Hoy, Yoshihashi, & Bailey, 2012) mention that some of the ideal functions of PHR, include patient controlled, longitudinal record, interoperable and resource sharing, portability, automated input of clinical reports, as well as the integration of clinician workflow. "The PCEHR is aimed to be a secure electronic summary of people's medical history stored and shared in a network of connected systems from a central electronic hub (Australian Nursing Journal, Aug. 2012; Kerai, Wood, &Martin, March 2014)”. The Australian Government has clear legal provisions on PCEHR implementation, including the conditions of participation, target participants, methods and procedures of registration, informed consent, security requirements, penalties for violation of privacy and mitigation strategies (Australian Nursing Journal, Aug. 2012; Australia Government ComLaw, 2012; Williams, 2013; Wilson, 2012). However, The Australian (2013, September 17) notes that the Australia government has invested 1 billion on the project, but only 0.6% of people actually using this program registered at about 65 million electronic health record conditions.
Meaningful Use (MU) is defined as a healthcare provider’s usage of certified EHR technology in a way that can be measured largely in quality and in quantity. By establishing meaningful use using an Office of the National Coordinator (ONC) certified EHR program; healthcare providers can collect stimulus money, as arranged through the HITECH act of 2009. MU is designed to improve healthcare quality, efficiency, safety, and help to reduce health disparities. Also this helps to maintain privacy and security of patient healthcare information. (EHR Incentives & Certification, 2014)
This paper will identify the use of Electronic Health Records and how nursing plays an important role. Emerging in the early 2000’s, utilizing Electronic Health Records have quickly become a part of normal practice. An EHR could help prevent dangerous medical mistakes, decrease in medical costs, and an overall improvement in medical care. Patients are often taking multiple medications, forget to mention important procedures/diagnoses to providers, and at times fail to follow up with providers. Maintaining an EHR could help tack data, identify patients who are due for preventative screenings and visits, monitor VS, & improve overall quality of care in a practice. Nurse informaticists play an important role in the adaptation, utilization, and functionality of an EHR. The impact the EHR could have on a general population is invaluable; therefore, it needs special attention from a trained professional.
It is hoped that meaningful use will also bring an acceleration in medical data research. EHR’s are now being used to measure Physician’s quality of service in the workforce through the Physician Quality Reporting System (PQRS). This program rewards by reimbursement to individuals who, through the EHR tracking, can prove they meet “care-quality measures.” The goal is to force the act of certifying EHR’s. Eventually, programs like PQRS will require certification, therefore anyone using these services must comply in order to maintain costumers/patients. In order to maintain efficiency and variety in the healthcare system, EHR systems need to be diverse. The full potential is reached when information can be shared through integration. This is known as Interoperability within the healthcare IT system. Because records and patient information can be so easily lost in transit or translation through either fax, mail, etc., Interoperability is one of the primary motivations for healthcare information technology or EHR
Over the years, healthcare facilities have acted like a storehouse for patients’ medical records, uninterested and unable to distribute clinical data to anyone beyond their organization. The EHR, started in the 1960s under the name of "computerized-based patient record" (CPR), became known as "electronic medical records" (EMR) in the 1990s and today it is known as electronic health record (EHR).The target of the Department of Health and Human Services (HHS) is to incorporate the EHR and use it in a "meaningful" way to improve the quality, efficiency, and safety of patient care delivery; to engage patients in their personal health record; and to improve care coordination. Equally important, the "meaningful use" of the EHR system intends to build a bridge to other systems by creating an interoperability of health information while implementing quality care throughout. However, this interoperability can only be accomplished when the receiving system and the user fully understand how to apply these exchanges.
These issues manifest themselves in two ways. First, the criteria set out for Stage 1 Meaningful Use overlooked EHR vendors' lack of incentives or requirements to design their EHR systems in such a way that makes them able to easily transfer patient data to other providers ...
Health information opponents has question the delivery and handling of patients electronic health records by health care organization and workers. The laws and regulations that set the framework protecting a user’s health information has become a major factor in how information is used and disclosed. The ability to share a patient document using Electronic Health Records (EHRs) is a critical component in the United States effort to show transparency and quality of healthcare records while protecting patient privacy. In 1996, under President Clinton administration, the US “Department of Health and Human Services (DHHS)” established national standards for the safeguard of certain health information. As a result, the Health Insurance Portability and Accountability Act of 1996 or (HIPAA) was established. HIPAA security standards required healthcare providers to ensure confidentiality and integrity of individual health information. This also included insurance administration and insurance portability. According to Health Information Portability and Accountability Act (HIPAA), an organization must guarantee the integrity, confidentiality, and security of sensitive patient data (Heckle & Lutters, 2011).
For instance, the “meaningful use” aspects of the law must be evaluated by the ONC and demonstrated as effective, so that the incentives provided by the Centers for Medicare and Medicaid Services (CMS) may be obtained. “Meaningful Use” has been established in three stages, each stage has certain core objectives with deadlines for implementation and use. Furthermore, these specific requirements must be able to be performed properly for a two year period to gain acceptance and advancement to the next stage. For example, computerized physician order-entry (CPOE), clinical decision support, capturing patient information, and being able to exchange as well as integrate patient information from other sources, must be met and proven reliable in order to advance into “meaningful use” stage two. Final implementation of the new or updated EHR systems must be completed by 2015 in order to receive incentives. If interoperability has not been met, fines will be imposed on the eligible practice or professional until the new EHR is
The systems planning phase is the first phase completed in the SDLC. It encompasses evaluating the feasibility and the cost of the system, identifying the risks involved with implementing the system, and determining the responsibilities of each of the team members. To begin the planning phase, a systems request is submitted to the IT department, detailing the problems and changes to be made in a system. (Rosenblatt, 2014). It is important to note that the request may be a large, significant request, or it can be a smaller, more minor request; however, each request should be addressed using the systems development life cycle. After the request has been made, a feasibility study is conducted that determines the costs and benefits of the new or improved system. The study then recommends a strategy that is best for the system in terms of technical, monetary, and time factors.
Ragavan, V. (2012, August 27). Medical Records Pals Malaysia : 17 Posibble Reasons How Electronic Medical Records (EMR) Might Support Day-to-Day Patient Care. Retrieved from Medical Records Pals Malaysia: http://mrpalsmy.wordpress.com/category/emr/
For the purpose of our report we have chose the Department of Health and Ageing’s eHealth system. This choice differs slightly from the instructions of the assignment as eHealth is not a current information system - i.e. it is still being designed and implemented. The key motivation behind decision was we assumed management would much rather a report on a new and upcoming system than one they would most probably already know about. If we have to write a report to management, they don’t need analysis of their current systems, they should know them – so we have decided to why to provide some analysis on a system currently being implemented.