Meaningful Use: Improving Quality Care

The electronic health record (EHR) is a digital record of a patient’s health history that may be made up of records from many locations and/or sources, such as hospitals, providers, clinics, and public health agencies. The EHR is available 24 hours a day, 7 days a week and has built-in safeguards to assure patient health information confidentiality and security. (Huston, 2013)

The purpose of this paper is to discuss the electronic health record mandate. Who started it and when? I will discuss the goals of the mandate. I will discussion will how the Affordable Care Act ties into the mandate of Electronic Health Record. It will describe my own facility’s EHR and what steps are been taken to implement it. I will describe the term “meaningful use,” and it will discuss possible threats to patient confidentiality and the what’s being done by my facility to prevent Health Information and Portability Accountability Act or HIPAA violations.

EHR was created to have a technical way to securely exchange private and personal medical health information in hopes to improve the quality of care, decrease medical errors, limiting paper use, reduction of health care cost, and increasing a person access to affordable health care. A mandate was created for EHR stating that health records can be accessible to all facilities with patients having the capability to access their own health records at any time. Ameliorating the quality and convenience of care given to a patient, allow for cost saving measures, engage the patient and family to participate in their care, improve accuracy of medical diagnosis, and enhance the efficiency of the overall outcome of the patients’ health.

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: The term Meaningful use is using certified electronic health record (EHR) technology to maintain privacy and secure patient health information, by improving care coordination, population, and public health, help patients and family to be engaged in

Meaningful use is used in the EHR system, and it is used to improve quality and safety of healthcare. It improves privacy and can benefit health care management care. The facility that I work at is in the first stage of even getting an EHR system they do not receive any incentive’s, because it is a long-term care faculty. If I was working in a hospital and they wanted to have a meaningful use, they would need 14 core objectives, 5/10 from a set menu of objectives and 15 quality measures.(HEALTHIT.GOV

Meaningful use means in simple providers need to show they are using certified EHR technology in ways that can be measured significantly in quality and in quantity.

The EHRs have an automated system which may result in a suggested E/M code. Coders have to make sure this code is accurate because the clinicians are responsible for the submission of this code for the reimbursement of the facility. If the code is accurate then it could result in an increase up to tens of thousands of dollars in revenue. The common pitfalls of coding E/M services are down coding the level of care that is given to the patient. They do this because they are afraid of the risk because they do not know what code they are actually supposed to use and it is their natural instinct to do so. They don’t think about the documents that support what they have done. Another thing that is done is tied to the level of complexity of the visit. The hardest part of not knowing which code to pick is the medical decision making because it is not always so easy to pick out and hard to express in writing. Documentation is crucial to figuring out the code. If it is incomplete then the coder cannot properly decide which code to use. The doctors don’t usually think about writing the complexity of the visit, they forget to put in specific things like the images they have reviewed and the info gathered from people other than the patient. One other than that can happen is that the EHR will generate a code through the E/M calculator and it may generate one that causes an upcoding incident.

The initial investment of adopting the EHR is both costly and time-consuming, but most experts predict that the pros will outweigh the cons in the end. Meaningful use is beneficial because the providers are making better informed decisions about their patients due to the clinical guidelines and information that they are provided. Health information professionals will always be needed, just in a different capacity.

Another beneficial feature of EHR systems is that they allow different authorized professionals to access your information from anywhere at any point in time. If a patient checks into the Emergency Room, is moved to Radiology for imaging, then moved to Orthopedics for surgery and finally placed in a bed for recovery, each individual throughout that process will have access to that patient’s medical records without having to communicate with each department. This fosters an

The goal in healthcare today is to achieve better patient outcomes. Technology is changing daily that affects how patient care is provided. As the world around us continues to move into a more advanced technology based healthcare system incentives are offered to qualifying healthcare entities, provided they are utilizing approved health information technology (IT) to comply with standards set by the Centers for Medicare & Medicaid Services (CMS) (Jones, Rudin, Perry, & Shekelle, 2014). Standards such as meaningful use help ensure with the use of electronic health records (EHR) that patients are receiving quality care (Centers for Disease Control and Prevention [CDC], n.d.). This paper will define and discuss the importance and implications of meaningful use relating to healthcare. Several key points will be discussed including an overview of meaningful use, analysis, further recommendations and a conclusion.

Meaningful use refers to the adoption of healthcare management technology referred to as the electronic-health record whose primary function is enhancing the quality, efficiency, safety, as well as reduction in health related disparities. In addition, meaningful use seeks to improve the level of care coordination, public health management and population. Undoubtedly, this aspiration encompasses the increased engagement of the patients as well their families while maintaining the safety and confidentiality of the medical information of the patient. From this backdrop, this paper shall discuss the legal, ethical and financial issues that may flow from the legislation (adoption) of meaningful use.

“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

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).

Another big plus of the EHRs is that studies have shown that it has helped providers improve accuracy of diagnoses and health outcomes (Couch, 2008). For example, nurses could have reliable access to patients complete health information and have pictures which would help with whatever problem they might encounter. EHR doesn’t just keep patients medications and allergies, it also check for problems whenever a new medication is prescribed and it also alerts the nurse of potential problems (Couch, 2008). EHRs can also tell the nurse if potential safety problems occur, which helps them avoid more serious consequences for patients, which can lead to better outcomes. The EHRs can also help nurses quickly identify and correct operational problems, which compared to the paper-based setting, those kinds of problems would be more difficult to correct. It can also help