Adoption And Implementation Of The Electronic Health Records

In a healthcare world that operates on stringent budgets and margins, we begin to see the need for a higher capacity healthcare delivery system. This in turn puts pressure on the healthcare organizations to ensure higher standards of patient care, and compliance with the reform provisions. However, these are the harsh realities of today’s healthcare environment, a setting in which value does not always equal quality. The use of technology can help to amend some of this by providing higher capacity care without compromising quality; this can be done with the use of such technology as electronic health records (EHRs). This paper will aim to address how EHRs influence healthcare today by expanding upon topics such as funding sources, reimbursement methods, economic factors, socioeconomic factors, business influences, and cost containment.

The purpose of this discussion board is to describe the Electronic Health Record (EHR), the six steps of an EHR and how my facility implements them, describe “meaningful use” and how my facility status is in obtaining it, and to further discuss the EHR’s and patient confidentiality.

The American Recovery and Reinvestment Act (ARRA) of 2009 identified three main components of meaningful use: the use of a certified EHR in a meaningful manner, electronic exchange of health information to improve quality of care, and the use of technology to submit clinical outcomes and quality measures (Heath Resources and Service Administration, n.d.). ARRA includes many measures to modernize our nation’s infrastructure, with the “Health Information Technology for Economic and Clinical Health (HITECH) Act” being an example. The HITECH Act is an effort led by Centers for Medicare and Medicare Services (CMS) in support of electronic health records and meaningful use (Centers for Disease Control and Prevention, CDC 2016). According to Galbraith (2013), the HITECH Act aims to promote the use of EHRs by providing over $27 billion in monetary incentives for health care providers that become “meaningful users”. CMS uses these core objectives to determine if a health care provider has satisfied meaningful use and is eligible to receive financial incentives (Galbraith, 2013).

Under the provisions of the American Recovery and Reinvestment Act of 2009 (ARRA, or the Stimulus Act”), certain eligible providers are eligible for financial incentives for following and documenting “meaningful use” of a certified electronic medical record system. According to the HRSA, “in July 2010, the Centers of Medicare & Medicaid Services (CMS) published a final rule which established three phases of the EHR Incentive Program. The three stages of Meaningful Use are designed to support eligible professionals and hospitals with implementing and using EHRs in a meaningful way to help improve the quality and safety of the nation’s healthcare system.” The end point here is not that having an electronic medical record will allow for a

The American Recovery and Reinvestment Act made an investment in the year 2009 to encourage the adoption and implementation of the electronic health records (EHRs)(Cite). EHRs incentive payments were authorized through Medicare and Medicaid to clinicians and hospitals when they privately and securely used EHRs for achieving improvements in care delivery by the Health Information Technology for Economic and Clinical Health Act (HITECH). The healthcare organizations are expected to demonstrate meaningful use of EHRs. This rule of meaningful use has been implemented to strike a balance between acknowledging the urgency of adopting EHRs for improving the healthcare system and identifying the challenges that would be put forth

In 2009, the Health Technology for Electronic and Clinical Health Act (HITECH) of 1996 was expanded. This expansion included mandated guidelines for health care systems in the Unites States to continue implementing of Electronic Health Records (EHR) in health care settings by 2016 and added a provision to improve protection of patient health information through privacy and security Turk (2015) . The implementation of this program has created a debate in the medical community. In addition, many healthcare organizations and institutions have conducted research studies and surveys to evaluate the effects of the EHR on documentation of care and other aspects of the EHR. Challenges surrounding the HER include, the cost of implementing EHR’s, time spent performing documentation, and patient outcomes and safety and security concerns. Let’s further delve into a few of these challenges.

Prior to the federal mandate of EHR, research continued to show the fallacies of the healthcare system like the report published from the Institute of medicine, stating that “medical errors are the 8th leading cause of deaths in the U.S. and cost approximately forty billion dollars a year” (Overview, 2012). This was one of many indicators that healthcare needed to be reformed and in 2009, the president signed the American Recovery and Reinvestment Act or HITECH Act, which mandated that all healthcare providers must comply and begin to transition to electronic medical records (EMR) and demonstrate “meaningful use.” This act set up a timeline, which established that practices and hospitals needed to be up and running with EMR in order to continue receiving reimbursements from federal programs like Medicaid and Medicare.

In 2009, more than $30 billion dollars in incentives was allocated by congress for hospitals to institute meaningful use of electronic health records (EHRs) by 2011 (Adler-Milstein, Bates, & Jha, 2011) (Murphy, 2010). The Meaningful Use Act is a complicated principle that is part of the American Recovery and Reinvestment Act (ARRA) as well as the Health Information Technology for Economic and Clinical Health (HITECH) act.

“Go Paperless and Get Paid” is how the Office of the National Coordinator for Health Information Technology (ONC) presents the incentives for electronic health records. The United States Department of Health and Human Services (U.S. Department of HHS) distributed more than $160 billion dollars to “improve and preserve health care, health information technology, community health, and prevention initiatives” (United States Department of Health and Human Services [HHS], 2014e). Likewise, the ONC offers “Health IT Adoption Programs” through the Health Information Technology for Economic and Clinical Health (HITECH) Act, seeking to advance the American health care delivery system and to improve patient care through an unique investment towards health information technology (HHS, 2014d). Additionally, the American Recovery and Reinvestment Act of 2009 allows the Centers for Medicare & Medicaid Services (CMS) to reward eligible hospitals and professionals with monetary incentives as they implement, adopt, or upgrade and demonstrate meaningful use of certified electronic health record (EHR) technology (HHS, 2014b). The Electronic Health Records Improvement Act (H.R. 1331) introduced by the United States House of Representative Diane Black is a bill to further improve the nation’s health care adoption of health information technology.

The Health Information Technology for Economic and Clinical Health (HITECH) Act is part of the American Reinvestment & Recovery Act (ARRA) signed into law by President Obama on February 17, 2009. The HITECT Act introduced the concept of ‘meaningful use’ which incentivized the adoption of electronic health records (EHR) for the overall improvement of healthcare. This act authorized payments to qualified provider groups that meet the 'meaning use ' requirements that are paid out over five year. According to data from the National Ambulatory Medical care Survey, 57% of office based physicians’ utilized EHR system as of 2011 and 52% of this physician plan to apply for the meaningful use incentives in same year. This is a 11% increase from the year before.

The American Recovery and Reinvestment Act signed into law in 2009, includes the Health Information Technology for Economic and Clinical Health Act known as the HITECH Act. The act defined specific requirements for receiving financial incentives for ‘meaningful use’ of the electronic health record (EHR). Hospitals and providers could begin implementation of the requirements in 2011 to receive the incentives by meeting specific objectives, after 2015 failure to meet meaningful use requirements will result in penalties. Meaningful use is divided into 3 stages and each stage has objectives and requirements specific to that stage. Hospitals and providers must meet requirements for Stage 1 of meaningful use for two years before

Over the previous eight years, there has been a significant investment of private and public funds to upsurge the adoption of Electronic health records (EHRs) across the nation. The extensive adoption and “meaningful use” of electronic health records is a national priority. EHRs come in various forms and can be utilized in distinct organizations, as interoperating systems in allied health care units, on a regional level, or nationwide. The benefit of utilizing an EHR depends heavily on provider’s uptake on technology. Benefits related to electronic health records are numerous and may have clinical, organizational and societal outcomes. However, challenges in implementing electronic health records has attained some attention, the implementation

The Health Information Technology for Economic and Clinical Health (HITECH) Act, part of the American Recovery and Reinvestment Act of 2009 (ARRA), is legislation aimed at the adoption and “meaningful use” of health information technology. CMS was authorized to establish incentive programs for eligible Medicare and Medicaid providers who adopt, implement, upgrade, or “meaningfully use” certified electronic health records (EHR). The term “meaningful use” is an acknowledgement that improved health care is not the product of technology but a method to exchange and use health information to support clinical decisions at the point of care.

In 2010, Stage 1 was introduced which focused on EHR data and sharing. Healthcare providers were obligated to store health information electronically in a standardize format that allowed authorized providers and patients to easily access the info. Stage 2 began in 2014, this stage broadened the use of EHR software for health information exchange among providers which will feature enhanced integration for e-prescribing and lab results, increased sharing of patient care summaries, and continuing to encourage patients to engage in their care in order to earn the incentives. Stage 3 began in 2016 which was set out to improve outcomes. To improve the outcome of health for patients on a large scale, the quality of health information exchanged needed to be focused on, giving providers efficient and easy access to comprehensive patient data (LeGate, 2013).

This article describes The Health Information Technology for Economic and Clinical Health Act’s (HITECH) “meaningful use” objective to create a nationwide system of Electronic Health Records (EHRs) in order to improve patient safety, quality of care, privacy and security. The authors point out that during the first two years of an EHR implementation, clinicians and hospitals must meet certain requirements in order to qualify for federally funded incentive payments totaling up to $107,750 per clinician. This incentive is meant to ease the financial challenges smaller practices might face as the United States works toward a more technically collaborative information care system, EHRs promise to provide.