CQM Application Paper

Implementing immunizations into the clinics can be challenging for the facility and the staff. There are several methods that have been implemented to monitor the methods used by the staff to give the immunizations to the patients in the clinics. There have been several obstacles and challenges that the staff and leaders have faced. As with any changes that take place in patient care within an organization methods must be set up to monitor those changes. Changes promote challenges not just to staff leaders but the organization as a whole. Communication with any changes can be challenging for

Healthcare providers have a moral and ethical obligation not to do harm to patients. Mandatory vaccination could prevent harm from being done to patients by preventing the spread in influenza. “Nursing is the protection, promotion, and optimization of health and abilities,

One of the biggest impacts on the healthcare industry is the transition from a fee-for-service model to a value-based payment model. This transition is emphasizing the importance of utilizing data captured electronically in EHRs, HIEs, and other clinical and business systems to improve patient care. Payers are implementing payment incentives and penalties based on performance in defined quality and safety metrics through programs such as Blue Cross’ Pay for Performance (P4P) or CMS’ Value-Based Purchasing (VBP). These programs, along with other factors, are resulting in a growing that utilizes data analytics and business intelligence to provide healthcare leaders and physicians with insight into their quality and safety metric status.

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).

This Stage 1 started from 2011-2012, its objective dealt with data capture and sharing, these sheets are providing these services to assist professionals and hospitals understand the requirements of each objective and demonstrate meaningful use success. This stage also allows qualified providers to receive their payment after fulfilling nine core objectives and one public health objective. The second stage of the Meaningful Use is Stage 2 started in 2014; it dealt with the advanced clinical processes. This Stage introduces new aims and measures, as well as higher entries; it also required health care providers to prolong EHR capabilities to a greater portion of their patient populations. The last stage of the Meaningful Use is Stage 3, this Stage it still in a building phase. Its objective will be focusing on improving quality, safety, efficiency, and leading to improved outcomes. Even though the details of this program have not been finalized, Meaningful Use Stage 3 will work to make the program easier to understand. It will provide the professionals (EPs) and hospitals the ability to exchange and use information between electronic health records, and improve patient outcomes. Based on the current timeline, healthcare providers have the choice to begin Stage 3 Meaningful Use in 2017 but are not permitted to use it until

A significant investment to encourage the adoption of electronic health records (EHRs) by healthcare providers was made by the American Recovery and Reinvestment Act of 2009. The EHR Incentive Program, which financially rewards providers for using EHRs and meeting all CMS program requirements, was launched by CMS in the year 2011. All healthcare providers (private or public) are required to adopt and demonstrate ‘meaningful use’ of electronic health records for maintaining their existing Medicaid and Medicare reimbursement levels (Cite). A set of penalties for healthcare providers who fail to meet the deadline have already been defined by the U.S. government. Healthcare providers failing to introduce EHR systems by the year 2015 will experience a one percent reduction in Medicare reimbursements in that year, a two percent reduction in the year 2016, a three percent reduction in the year 2017, followed by a reduction of up to a 95 percent reduction in reimbursements over a period of

In today’s seemingly ever-changing world of healthcare regulation, medical professionals are burdened with many compliance requirements. On October 14, 2016, the Department of Health and Human Services released its final rule implementing the Quality Payment Program as part of the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). Starting January 1, 2017, clinicians who are reimbursed by the Centers for Medicare and Medicaid Services(CMS) are required to participate in the Quality Payment Program (QPP). (Centers for Medicare & Medicaid Services, 2016) The QPP replaced the Sustainable Growth Rate formula with the new payment structure in which clinicians are rewarded for delivering high quality care. There are now two pathways for

In July 2010 CMS Centers of Medicaid and Medicare services published a final rule which established three phases of the EHR Incentive Program. The Medicare and Medicaid EHR Incentive Program provides financial incentives for the “meaningful use” (MU) of certified Electronic Health Record technology to improve patient care. 36$ billion was authorized.

In addition to the core elements, providers will have to choose any five of the ten additional tasks to implement in 2011-2012. Some examples of these might be clinical lab results, patient appointment reminders and drug-formulary checks. This gives the providers a chance to choose their own path toward full EHR implementation and meaningful use. Legislation ties payments to the achievement of advances in health care processes and outcomes. The regulations are specific as to when providers will have to use particular functions in order to be considered meaningful users. The meaningful use rule acknowledges the urgency of adopting the electronic health record and recognizes the challenges it will pose on all providers.

Cerner integrates patient information throughout all of the departments within a hospital setting. This program also has the ability to expand into other health care facilities within a community, such as long term care, hospice, and home health (Cerner, 2015). Cerner offers community hospitals solutions in their “Software as a Service” model. Cerner will host the software program, provide upgrades, and monitor performance to ensure stability. This will allow community hospitals to have a predictable cost for the software (Cerner, 2015). Another advantage of this system is the “Smart Room”. Wireless devices such as infusion pumps, and vital sign monitoring devices can access the system. This allows for instant documentation of this information into a patient chart and will alert if abnormalities are noted. Bar code scanners and carts are available as well. These items improve patient safety (Cerner, 2015). Cerner is capable of CPOE, electronic prescription transmitting, and has the ability to capture data and immunization statuses to meet reporting regulations.

Cerner optimize clinical and financial outcomes. These solutions are currently licensed by approximately 9,300 facilities

1) My hospital initiated this program back in 1999. We also participate in the Statement Immunization Information System (SISS) program. We use this system to check or update vaccination records for our patients. All of our charting is done electronically. This is beneficial because any member of the healthcare team can access a patient’s record from anywhere in the hospital. Any information updated on our end can then be accessed by another provider whom also uses an EHR system. This allows each member of the healthcare team to collaborate, reduce medical errors, minimize medication interactions, and decrease medical costs. All of our patients, are educated on the EHR system that we use from the moment they check in on admission. Throughout their stay, they are instructed on how to access it and how to use it. Upon discharge, they are given an EHR packet and are encouraged to capitalize on all that the program has to offer from the comfort of their own homes.

b. What will the new system accomplish? What functions will it perform? Which organization goals will it support?

“There are over 1.7 million patient records stored in the voluntary GE Medical Quality Improvement Consortium (MQIC). No other solution can compete with Centricity EMR capability to support the quality improvement initiating and that provides information for successful with performance related pay programs. It also shows Meaningful Use. A healthcare facility may customize their own Centricity EMR based on the practice particular needs and objectives” (Wikipedia, GE Healthcare, 2016).

Nurses will often be the individuals that, “address these concerns and offer advice of what to expect and how to prevent or respond to side effects,” (Batenburg et al., 2011, p. 5). It is vital that the nurse be aware and educated regarding the most current and most up-to-date research findings in regards to immunization practices. Wallstein et al. (2012) believes that “aggressive educational campaigns” regarding the correct use of antipyretics should be targeted towards physicians and nurses. The information and data gained from this study will help determine appropriate practice and guide nurses to provide accurate evidence-based information to parents.