Charleston Area Medical Center ( Camc )

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 study measured whether each hospital had implemented basic EHRs in the years before and after the HITECH Act. Results showed that the annual rate of EHR adoption for eligible hospitals increased from 3.2 percent before the act to 14.2 percent afterward. Ineligible hospitals also saw an increased from 0.1 percent to 3.3 percent. These results show increased EHR adoption was directly correlated to the HITECH Act.

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).

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

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.

Meaningful Use engages patients and families in their health care, improve care coordination, improve population and public health and maintain privacy and security ("CMS," 2015, para. 1). Healthcare providers must show CMS that they are using their EHRs in ways that can positively affect the care of their patients. To do this, providers must meet all of the requirements established by CMS for this program and be able to demonstrate Meaningful Use of their EHRs to receive incentive reimbursement. The Meaningful Use program is divided into 3 stages which span 2011 (data capture and sharing), 2013 (advanced clinical processes) and 2015 (improved outcomes).

I think the strategic mission should be revised. The Medical Center is in an older urban area with smaller shops and businesses. The community is trending towards a predominantly elder population. There has also been a decline in compliance with T.J.C. standards. Staffing supports new program development and the physician staff is in abundant supply. There are also major issues that need to be addressed, such as shortages in clinical staff, non-interfacing information technology systems, antiquated facilities and infrastructure, and a shift to its financial mix. Careful assessment of the aging person's

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.

Hence, EHR 's are inherently complex amalgamations of diverse subsystems targeted toward varied users. The stakeholders are the users and must have a role in implementing any IT or EHR system into its work flow. An EHR can be customized to accommodate any environment depending on the level of expertise of the vendor and how long they have been in the business of creating an optimum system that 's customized to fit the organizations needs. For the most part, EHR 's must be designed for efficient, error free use. Ideally, an EHR is a system that encompass all the subsystems that make a hospital meet "meaningful use" criteria to acquire incentives for adopting EHR into practice. In the next five years, EHR adoption will no longer be a luxury, it will be a "MUST". EHR 's and other health information technology will be a necessity to practice medicine (econsultant.com, 2010). Rather than purchase several standalone systems, it would behoove one , in my opinion , to purchase an EHR that would satisfy all the needs of the stakeholders, the physician , nurses and other hospital staff and all parties involved in the tertiary practice too. Although LWMS 's budget is not large enough to accommodate the full cost of implementing an EHR,

Anita Ground also stresses on the huge importance of this planning stage by using a concept of system life cycle. It consists of feasibility study, analysis, design, programming, implementation, and lastly maintenance (Ground, 2011, VA TMS training material). The analysis phase in particular would coincide with what the author Yoshihashi is presenting in figuring out office strategy and researching EHR options. Identification of stakeholders and system requirement would play a critical role in EHR adoption (Ground, 2011). Stakeholders would include patients, family, clinicians, billing, registration, and coding as well as the external users such as Centers for Disease Control (CDC) and Centers for Medicare and Medicaid Services (CMS). Bottom line is that the new system being purchased would need to provide meaningful use to the clinic based on the current certification standards.

The author, Judy Murphy, focuses mostly on how the government played a huge role in the adoption of EHRs into the medical world. Murphy brings up George Bush’s statement in his 2004 State of the Union address and Obama’s push to make that happen, but this is just scratching the surface of government interventions. The author discussed the money allocated by the acts such as “The Stimulus Bill” or “The Recovery Act” to help fuel the economy and rescue a struggling health care industry. She states how acts were passed, and how there were rules set in place to be followed by hospitals and providers around the United States. The article describes how the government is basically forcing these facilities to adopt EHRs by using a reward

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

The ARRA includes the Health Information Technology for Economic and Clinical Health (HITECH) Act, which pursues to improve American Healthcare and patient care through an extraordinary investment in Healthcare IT (HIT). The requirements of the HITECH Act are precisely designed to work jointly to provide the necessary assistance and technical operation to providers, enable grammatical relation and organization within and among states, establish connectivity in case of emergencies, and see to it the workforce is properly trained and equipped to be meaningful users of certified Electronic Health Records (EHRs). These computer software products are designed collaboratively to intensify the footing for every American to profit from an electronic health record (EHR) as part of a modernized, interrelated, and vastly improved grouping of care delivery.

Electronic health records (EHR’s) have many advantages, but there are plenty of disadvantages. EHR’s were created to manage the many aspects of healthcare information. Medical professionals use them daily and most would feel lost without it. Healthcare organizations were encouraged to adopt EHR’s in 2009 due to the fact that a bill passed known as The Health Information Technology for Economic and Clinical Health Act (HITECH Act). “The HITECH Act outlines criteria to achieve “meaningful use” of certified electronic records. These criteria must be met in order for providers to receive financial incentives to promote adoption of EHRs as an integral part of their daily practice”, (Conrad, Hanson, Hasenau & Stocker-Schneider, 2012).

When implementing a new EHR, departments need to have a plan in place when the system causes change to the process and design within the organization. Often times, regulations and policies need to be changed to coincide with a new system in place, such as a new EHR program (University of Scranton, 2017). A way to mitigate this situation is to start at the federal level’s regulations and work down the scope from there. This will guarantee that mandatory rules are still being followed and there is successful transition into future policies. Additionally, funding will be crucial to the organization’s ability to have a new EHR system. Each department needs to ensure they are properly tracking funds and that they can afford to upgrade.