Meaningful use is the fifth stage of implementing EHR. Meaningful use refers to using the health records in a purposeful way to achieve the goals patient focused healthcare, population health, improving quality, and safety in healthcare. There are three stages of meaningful use which is regulated by the Centers for Medicare and Medicaid Services (CMS). The first is to make sure you actually have an electronic record system, the second stage is providing patients with access to their own medical records with care coordination, and the third is improving healthcare outcomes (How to Implement EHRs). This fifth stage is an incentive program and is such an important part of the plan that Medicare can actually penalize clinicians and hospitals
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).
Stage 1: This stage is primarily for meaningful use of an EHR in a clinical setting. The EHR technology the physician uses must meet at least 15 requirements and 5 “menu” criteria that are listed in the HITECH Act. The EHR used must be able to store patient demographic information, an e-prescribing with drug interaction alert content, and contain patient’s insurance information.
Meaningful Use and the EHR Many new technologies are being used in health organizations across the nation, which are being utilized to help improve the quality of health care. Electronic Health Records (EHRs) play a critical role in improving access, quality and efficiency of healthcare ("Electronic health records," 2014). In order to assist in expanding the use of EHR’s, in 2011 the Centers for Medicaid and Medicare Services (CMS), instituted an EHR incentive program called the Meaningful Use Program. This program was instituted to encourage and expand the use of the HER, by providing health professionals and health organizations yearly incentive payments when they demonstrate meaningful use of the EHR ("Medicare and Medicaid," 2014).
The Health Information Technology for Economic and Clinical Health Act (HITECH) was put into place as part of the American Recovery and Reinvestment Act of 2009, and was signed and made a part of law in February 2009. It sponsors the adoption and meaningful use of health information technology. (www.healthcareitnews.com). There was $22 billion and of this $19.2 billion was supposed to be used as a method to increase the use or the Electronic Health Records by the doctors and healthcare facilities. (www.hitechanswers.net).
“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.
The interpretation of quality health care varies with each person. Some place emphasis on the ability to access various treatments without interference. Others value the feature of being able to simply select one’s provider. Quality health care, according to the Institute of Medicine (2001), can be defined as care that is “safe, effective, patient-centered, timely, efficient and equitable” (p. 3). Furthermore, it should account for, in detail, a patient’s medical history, and improve overall patient well-being.
“An electronic health record (EHR) is a digital version of a patient’s paper chart. EHRs are real-time, patient-centered records that make information available instantly and securely to authorized users.” (healthit.gov) The EHR mandate was created “to share information with other health care providers and organizations – such as laboratories, specialists, medical imaging facilities, pharmacies, emergency facilities, and school and workplace clinics – so they contain information from all clinicians involved in a patient’s care.” ("Providers & Professionals | HealthIT.gov", n.d., p. 1) The process has proved to be quite challenging for providers. As an incentive, the government began issuing payments to those providers who “meaningfully use certified electronic health record (EHR) technology.” (hhs.gov) There are three stages that providers must progress through in order to receive theses financial incentives. Stage one is the initial stage and is met with the creation and implementation of the HER in the business. Stage two “increases health information exchange between providers.” ("United States Department of Health and Human Services | HHS.gov", n.d., p. 1) Stage three will be the continuation and expansion of the “meaningful use objectives.” ("United States Department of Health and Human Services | HHS.gov", n.d., p. 1) The hospital, where I work, initiated the HER mandate many years ago. In this paper, I will discuss the progression and the challenges that my hospital encountered while implementing the EHR mandate.
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)
Healthcare is a dynamic, ever-changing environment. The complex circumstances around daily conversations that encompass life-threatening decisions are critical. In order to deliver high quality care, individuals must be able to communicate effectively. In the perfect world of communication, everyone receives the exact same information and is able to respond the exact same way. Unfortunately, communication breakdown is a prevalent issue among hospitals. On any given day of the hospital arena, multiple interactions take place. Some of the dialogue is planned, and some is not. While hospital departments are living in different silos within the same organization, the cultures may vary among the employees. Hospital leadership fosters the importance of collaboration within the organization and depends on the employees to ultimately drive the process. In order to overcome communication barriers in the workplace, conversations must occur. Engaging in daily face-to-face meetings with employees increases positive work culture, morale and overall productivity.
The American Recovery and Reinvestment Act was created to stimulate medicine and adopt as well as “meaningfully” use electronic health records within and across health organizations. This was to help improve patient outcomes and accountability, aid in coordination of care, promote effective health management across organizations, and align incentives with good patient and population outcomes.
The NHS Outcomes Framework has five standard domains which is set out to improve the quality and outcome of care and services that is being delivered to the patients and service users (National Quality Board, 2011). As such, this project plan is focused on domain 2 as it has been mentioned before, is based on improving the quality of people with long term conditions. Nurses will give cardiac discharge advice to patients on self care, thus identifying how to improve and manage their condition so that they can continue with their normal lifestyle. Furthermore patients will be advised on how to overcome stress and depression which will help them in maintaining the activities of living (DoH, 2013).
The EHR is defined as “an electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be created, managed, and consulted by authorized clinicians and staff across more than one healthcare organization” (Fahrenholz, C. G. & Russo, R., 2013b). The Office of the National Coordinator for Health Information Technology (ONC) has published a list of required items an EHR must have to satisfy the complete EHR definition. According to the ONC, the EHR must include, for both ambulatory and inpatient systems: computerized provider order entry, demographics, a problem list, a medication list, a medication allergy list, clinical decision support, transitions of care, data portability, clinical quality measures, authentication, access control and authorization, auditable events and tamper resistance, audit reports, amendments, automatic log-off, emergency access, end-user encryption, integrity, drug-drug and drug-allergy interaction checks, vital signs, body mass index and growth charts, electronic notes, drug-formulary checks, smoking status, image results, family health history, patient list creation, patient-specific education resources, electronic prescribing, clinical information reconciliation, incorporation of lab tests and values/results, immunization information, transmission to immunization registries, transmission to public health agencies-syndromic surveillance, automated measure calculation, a safety-enhanced design, a quality management system and be able to view, download and tra...
Studies have implied that, healthcare professionals who practice clinical features through EHR were far more likely provide better preventive care than were healthcare professionals who did not. (page 116). From 2004, EHR has initiated, even the major priority of President Obama’s agenda is EHR (Madison & Stagger, 2011). Health care administration considers EHR as the introduction of advanced technology which can improve patient satisfaction are can increase the financial incentives of the healthcare organization. Studies have pointed out that the federal policy is proposed to transform all medical records into EHR (Hebda & Calderone, 2010).
The purpose of the Electronic Health Record is to provide a comprehensive, standardized and universal digital version of a patient 's health records. The availability of a patient 's digital health record provides health information and data for critical thinking and evidence based decision-making, aggregates patient data for quality assurance and research. The Electronic Health Record has been, "identified as a strategy for effectively and efficiently coordinating and maintaining documentation of patients health histories and as a secure method of providing more informed clinical decision making" (MNA, 2006).
Question 1: Describe and diagram the existing process for reporting and identifying major public health problems, such as a flu pandemic.