EHR Stage 3: A Case Study

The adoption of EHR has been slower than expected (Gans 1323). With numerous systems available, it is particularly difficult for a smaller practice to identify which system best meets its needs. Other notable challenges for some practices include assumption of the capital investment as well as managerial responsibilities associated with the IT infrastructure. A common implementation challenge encountered is the lack of a universal vision and definition of EHR. Since there are multiple interpretations of the definition of EHR and attendant requirements, identifying current and future needs is a complex process for potential users. Short term limited ability systems will eventually become obsolete as there is a move toward more global EHR systems. On June 18,

To better understand where my facilities progress is concerning EHR’s, I will first explain the six step process in implementing an EHR. In the first step, an organization must assess their preparedness to initiate an EHR. This includes their

The vision of meaningful use was divided into three specific stages and each with its own set of core objectives. Stage one set the foundation for the EHR Incentive Programs by establishing requirements for electronic clinical data, including providing patients with electronic copies of their heath information (Centers for Medicare and Medicaid

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

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.

To achieve Stage 1 meaningful use of an EHR, providers must meet 15 core objectives and 5 objectives out of 10 from the menu set objectives. Providers must track the 3 required core Clinical Quality Measures (CQMs) on patients and identify at least 3 additional CQMs from the set of 38 CQMs on patients. Stage 2 requirements consist of continuations of stage 1 requirements, with heightened demands for the number of electronic transactions. Stage 2 impacts nursing, brings greater emphasis on disease management, clinical decision support, transition of care, documentation of care plans and patient access to health information (Guterl, 2012). Stage 3 is likely to follow the same format as its predecessors, with a divide between core (mandatory) and menu

The goal of meaningful use Stage 1is to motivate providers to implement EHRs, and it sets baseline criteria; hospitals must meet 14 required core objectives and 5 menu set objectives from 10 options to achieve meaningful use. Eligible professionals must meet 15 required core objectives and 5 menu set objectives from 10 options to achieve meaningful use. Stage 2 and 3 will expand on the baseline criteria. Stage 2 “emphasized care coordination and exchange of patient information,” and Stage 3 “improves healthcare outcomes.” (What is Meaningful Use?, 2017).

The decision to convert to EHR had to be probably still is long hours of research, time consuming.

Achieving MU will require general training and time, which interprets to big costs for health-care professionals. A few problems with MU are enrolment and attestation process is cumbersome for eligible providers and for those with employed faculty, incentive costs for hospitals and eligible health care providers cover only a few percent of the overall cost to implement an EHR and attain meaningful use, the majority of medical organization are within the similar relative development phases of EHR application, there is a lack of clinical predictors for whom health organizations are rival to recruit, train, and maintain, implementation plans for new applications are typically a lot lengthier than the timeline specified

A readiness assessment can assist in identifying the readiness of an organization to successfully starting an EHR, the readiness for the staff to accept, and productively by using the EHR. The results will help assess what the current state of technology is, what is needed to make a

Implementation Phase: This stage accepts that reasonable desires were produced. In the event that doctors and other key office staff are oversold on what the new framework will do, the framework is bound to be viewed as no less than a halfway disappointment. The EHR champion must help the training set reasonable desires for the effect on beginning profitability amid the early framework usage stages. Amid the usage of an EHR, rehearse profitability will at first decay, regardless of how great the framework and what the

Stage 2 is contemplation referred to as “sitting on the fence” which is characterized by not considering change in a month. Behaviors of this stage are being ambivalent; aware but not impressed by any need to change (Sare & Ogilvie 2010). In signing the ARRA legislation on Feb. 17, 2009, President Barack Obama described the need for EHR by saying, “It’s an investment that will take the long overdue step of computerizing America’s medical records, to reduce the duplication and waste that costs billions of health care dollars and (reduce) the medical errors that every year cost thousands of lives.” Since EMRs can help reduce mistakes, physicians globally should be adopting of EHRs. However, they were still ignoring the fact, having their patient

Level III evidence suggests that most clinicians that are exposed to a new EHR system must adapt to make accommodations for this new system by leaving their comfortable old system for a new unknown one (McAlearney et al.,2015). The reason that adapting to a new EHR system is very difficult for some physicians is because they apply their old comfortable methods to a new changed system instead of taking an effort to adapt to that new system with a new method that is more appropriate. Some clinicians get so frustrated with trying to adapt that they either retire early, move to other hospitals, misuse the EHR system, or just quit entirely. This process of adapting to the new system and getting comfortable with it requires change, which is naturally

In 2005, HIMSS Analytics developed the eight-stage EMR Adoption Model. The model reflects the results of more than 5,000 institutions surveyed about their level of clinical system implementation and progress toward a paperless EMR (HIMSS, 2009). To progress through each stage of the model, capabilities within each stage must be operational and all lower stages must have been achieved before a higher level will be considered achieved (HIMSS, 2009).

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.