Are you ready for a Meaningful Use Stage ?
According to Center for Medicare and Medicaid Services (CMS), around 3500 optometrists have attested for Electronic Health Records (EHR) incentives. In the coming years the incentives will decline and penalty be put on those practitioners who fail to attest to Meaningful Use for EHRs. The biggest question in everyone’s mind is that are you ready for Meaningful Use Stage 2 requirements in 2014?
Stages of Meaningful Use
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.
The purpose of stage 1 is to capture the health data in a coded format. Stage 2 applies data to patient care and further the exchange of information between providers and other healthcare entities. The stage 3 known as exact measures are still in the opening stages will focus on Clinical Decision Support (CDS) application during point of care to improve the healthcare results and equip patients with self management tools.
Which stage the practice is following depends on when the practice was installed and was first attested to using the EHR system. Through 2013 all practices using a new or existing EHR system are in stage 1. The difference is the amount of time required to attest. In 2014 practices that have attested to using the EHR in 2011 or 2012 will be required to follow stage 2 Meaningful Use criteria. Practice that are attesting to meaningful use of EHRs in 2013 and 2014 are considered under the updated stage 1 Meaningful Use criteria and will be required to report on stage 2 in 2015. CMS recently launched an online calculator, practitioners can enter data reg...
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...an for more than 30% of unique patients.
• More than 20% of all scans and tests ordered by practitioner resulting in an image should be incorporated into the EHR. Every optometrist would require to report this.
• Structured data should be entered into the EHR for first degree relatives for more than 20% of all the patients.
• Submitting specific information related to a case from CEHRT to specialized registry.
• Submitting cancer case information from CEHRT to a cancer registry.
With Stage 2 Meaningful Use the amount of data collected on patient’s increases as well as its use for coordinating and communicating care with the patient and other providers.
The result is that the volume of data and its management is a burden on the provider and his/her staff. Eventually, as EHR use becomes usual, patients will begin to recognize enhanced healthcare results.
Similar to Global Positioning Systems (GPS) provide drivers with directions, detours, alternative routes, and alerts, Clinical Decision Support (CDS) systems provide health care professionals with guidance for important decisions associated with patient care. These systems have many capabilities including synthesizing patient information, suggesting diagnostic tests, providing alerts for life-threatening situations, recommending treatment options, and providing relevant evidence and best practices. Nonetheless, just as GPSs, CDS systems are not usually perfect as evident in the ongoing evolution of their design specifications and functionalities. Some of the major issues that are still evolving for CDS systems include alert fatigue and integration of evidence-based practice (EBP) resources and clinical guidelines. One of the major areas that can benefit from the adoption and integration of clinical decision support systems is community health nursing. These systems can be used together with evidence-based medicine to help improve the quality of health and patient care in community health nursing.
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).
“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.
“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.
Electronic Health Record (EHR) is a digital collection of patient health information instead of paper chart that captures data at the point of collection, supports clinical decision-making and integrates data from multiple sources in any care delivery settings. The health record includes patient’s demographics, progress notes, past medical history, vital signs, medications, immunizations, laboratory data and radiology reports. National Alliance for the Health Information Technology defines EHR 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
The objectives of meaningful use will take form in three stages, to be rolled out over a five year period. Stage one took place between 2011 and 2012 which involved data capture and sharing. Within this stage the criteria focused on electronically obtaining health data in a standardized format, using health information to track clinical conditions, instigating the reporting of public health information and clinical quality measures, and finally using these materials to involve patients and their families in their healthcare.
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.
The EHR is a computerized health record that will take place of the paper chart. The health care information will be available to all health care providers at anytime, anywhere. The record will contain medical history, diagnosis, medications, immunization, allergies, diagnostics and lab results; from past doctors, emergency department visits, school, pharmacies, and out patient laboratories and facilities (Department of health and human services, 2014). Health care providers will be able to access evidence-based tools to aid in decision-making. EHR will also streamline workflow, and support changes in payer requirements and consumer expectations. In 2004, “the HHS secretary, Tommy Thompson appointed David Brailer as the national health information coordinator to provide: leadership for the development and nationwide implementation of a interoperable HIT infrastructure, with the goal of establishing electronic health records...
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).
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).
Effective health care targeted processes that demonstrate desired outcomes. It is important to adopt the process of various techniques and identify the prevented techniques for the influence of changing associated system. Some techniques are involved in assessment of performance and tools for the quality of improvement. Health care provides multiple factors to determine the quality and ensure the safety of the change practices which increase challenges for patients. The patient actively engages in the development of evidence based on critical knowledge and core health care system strengths.
Introduction Clinical Decision Support Systems: Decision support systems use a software containing knowledge and theories from various fields to support complex decision-making and problem-solving. A working definition; "Clinical Decision Support systems link health observations with health knowledge to influence health choices by clinicians for improved health care". (Proposed by Dr. Robert Hayward of the Centre for Health Evidence) It allows decision makers to build and look for the implications of their judgments.