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The Health Information Technology for Economic and Clinical Health (HITECH Act), which was passed as part of the American Recovery and Reinvestment Act of 2009, has fostered significant progress in the adoption of Electronic Health Records (EHRs) in various clinical settings, particularly through the Medicare and Medicaid EHR Incentive Programs and its focus on EHR adoption in Stage 1 Meaningful Use (CITATION gov). For instance, as a result of the Medicare and Medicaid EHR Incentive Programs, the percentage of office based physicians who have adopted an EHR system dramatically rose from 18.2% in 2001 to a staggering 78.4% in 2013 (CITATION phys data). Additionally, as of July 2013, 67% of hospitals achieved Stage 1 Meaningful Use and an additional 16% were paid for adopting EHRs (CITATION hosp data).
However, despite the $24 billion of federal spending allocated towards EHR adoption, the benefits of EHR adoption still have not been even close to fully realized (CITATION 24 b). Specifically, duplicate and unnecessary medical testing, which EHRs were set out to address, still presents a significant financial burden and, more importantly, less efficient and effective patient care from a lack of care coordination and provider communication (CITATION issue brief). In fact, a recent Boston study found that 20% of the patients transferred between hospitals underwent duplicate, unnecessary medical tests that were performed within the last 12 hours (CITATION boston).
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 ...
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...ck of EHR interoperability, there are inevitably several challenges that must be considered in order to ensure that these solutions are successfully carried out.
Medicare and Medicaid Incentive Programs – Stage 2 Meaningful Use
Although most physicians may be prepared to attest to Stage 2 Meaningful Use, several of the stakeholders that they interact with may not, which may compromise their ability to fulfill all of the Stage 2 Meaningful Use criteria and lead to Medicare reimbursement penalties as a result of factors that they have no control over. For instance, there are currently no federal incentives home health agencies or skilled nursing facilities to adopt EHRs, which presents a foregone opportunity for physicians to complete electronic summary of care documents when they perform transitions of care or referrals to these care settings (CITE narsin' homezzz).
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).
Thus, reducing administrative work gives an opportunity to clinicians to spend more time with their patients. Through health informatics, some medical procedures can be automated, saving money for the health care budget. Research by Blumenthal and Tavenner (2010) states that, “The widespread use of electronic health records (EHRs) in the United States is inevitable. EHRs will improve caregivers' decisions and patients' outcomes. Once patients experience the benefits of this technology, they will demand nothing less from their providers.
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.
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.
The Meaningful Use includes the implementation of EHR in three Stages and is mainly focused on using EHR as a new healthcare technology that is used to promote health information exchange and resulting in improved outcomes in patient care. This benefited both the providers as well as the patients.
To ease the adoption of EHRs, in addition to receiving incentive payments, CMS has established criteria for Meaningful Use in stages. Stage 1 is the easiest to obtain and stage 3 will be the most difficult.
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.
The health industry has existed ever since doctors bartered for chickens to pay for their services. Computers on the other hand, in their modern form have only existed since the 1940s. So when did technology become a part of health care? The first electronic health record(EHR) programs were created in the 1960s around the same time the Kennedy administration started exploring the validity of such products (Neal, 2013). Between the 1960s and the current administration, there were little to no advancements in the area of EHR despite monumental advancements in software and hardware that are available. While some technology more directly related to care, such as digital radiology, have made strides medical record programs and practice management programs have gained little traction. Physicians have not had a reason or need for complicated, expensive health record suites. This all changed with the introduction of the Meaningful Use program introduced in 2011. Meaningful use is designed to encourage and eventually force the usage of EHR programs. In addition, it mandates basic requirements for EHR software manufactures that which have become fragmented in function and form. The result was in 2001 18 percent of offices used EHR as of 2013 78 percent are using EHR (Chun-Ju Hsiao, 2014). Now that you are caught up on some of the technology in health care let us discuss some major topics that have come up due to recent changes. First, what antiquated technologies is health care are still using, what new tech are they exploring, and then what security problems are we opening up and what is this all costing.
Advances in technology have influences our society at home, work and in our health care. It all started with online banking, atm cards, and availability of children’s grades online, and buying tickets for social outings. There was nothing electronic about going the doctor’s office. Health care cost has been rising and medical errors resulting in loss of life cried for change. As technologies advanced, the process to reduce medical errors and protect important health care information was evolving. In January 2004, President Bush announced in the State of the Union address the plan to launch an electronic health record (EHR) within the next ten years (American Healthtech, 2012).
In 2009 President Obama, through the American Reinvestment and Recovery Act, pledged to provide incentives to the nation’s physicians and hospitals to convert to an electronic healthcare system in attempt to improve the quality of care and reduce cost (Freudenheim, 2010). By converting to an electronic system, we have the opportunity for improved communication between all healthcare providers and decreased cost to our healthcare system. The goal is to improve communication across all aspects of the service chain (Horan, Botts & Burkhard, 2010). Almost two years later, the conversion progress continues to be slow. Only one in four physician’s offices, mostly large groups, have implemented the electronic record system (Freudenheim, 2010).
The new healthcare technology that is spreading nationwide it the EHR programs that are being implemented and updated in healthcare organizations. Government policies are in place for societies protection and privacy, it also helps to create a place where healthcare information can be utilized to its fullest potential. ONC authors’ regulations that set the standards and certification criteria EHRs must meet to assure health care professionals and hospitals that the systems they adopt are capable of performing certain functions (HealtIt, 2015).
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/