Meaningful Use

In 2009, the U.S. Government passed The Health Information Technology for Economic and Clinical Health (HITECH) Act, as part of the American Recovery and Reinvestment Act of 2009, to promote the adoption and meaningful use of health information technology (Mangalmurti, Murtagh and Mello 2060). The HITECH Act authorizes grants and incentives to promote the “meaningful use” of electronic health records (EHR) by providers (2060). The effect is a high commitment to a technology-led system reform, urging a renewed national commitment to building an information infrastructure to support health care delivery, consumer health, quality measurement and improvement, public accountability, clinical and health services research, and clinical

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.

Modern communications capabilities open up a world of possibilities for all types of medical practices to develop deeper connections with their patients and to manage health care remotely. The HIPAA Privacy Rule gives patients the right to obtain copies of their medical records, treatments and protected health information or PHI. These requirements go further if medical providers want to receive reimbursement from Medicare and Medicaid -- patients must be able to access their records online, download copies and transmit the information to third-party providers. Most medical practices are finding it necessary to develop patient portals where patients and physicians can interact, share information and perform important functions such as practices billing patients and accepting payments online. HIPAA 's rules require that these patient portals have strong security and privacy protections to prevent unauthorized access of these confidential PHI records.

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).

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

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

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.

For over 10 years, all areas of industry have been investing in informational technology (IT). IT offers faster and more proficient care especially for the healthcare industry. Health information technology (HIT) is making significant changes in how care is being delivered and addressed for patients and healthcare workers. HIT includes electronic health records (EHR), personal health records (PHI), electronic prescribing and more. The potential list is endless. HIT provides for more accurate and efficient documentation, prescriptions, and education. The Obama administration came up with an answer to help in HIT by instituting the meaningful use. This paper will discuss the overview of meaningful use, its’ core criteria, and recommendations for additional criteria.

The American health care system is in the midst of a paradigm shift as it transitions away from a paper documentation system towards a total electronic world. The electronic health record is revolutionizing the way health care practitioners, organizations and patients utilize patient information resulting in more efficient and accurate care, which implies better patient outcomes. In an effort to expedite the adoption of the electronic medical record, the United States government implemented an act entitled Meaningful Use which outlines three stages required by all health care systems and providers. The United States government provided financial incentives to ensure that these stages were met. It is imperative that the health care leaders are familiar with the requirements of Meaningful Use and create a timeline to ensure meeting all expectations. This paper will address the history of meaningful use implementation, meaningful use goals, and careful considerations for the health care leaders.

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.

An Electronic Health Record is a computerized form of a patient’s medical chart. These records allow information to be readily available to authorized providers during a patient’s encounter with the healthcare system. These systems do not only contain medical histories, current medications and insurance information, they also track patients’ diagnoses, treatment plans, immunization dates, allergies, radiology images and lab tests/results (source). The fundamental aspect of EHRs is that they are able to share a patient’s information quickly across service lines and even between different healthcare organizations. Information is at the fingertips of lab techs, primary care physicians, pharmacies, clinics, etc. The

Legislation such as the Health Information Technology for Economics and Clinical Health (HITECH) Act promoted meaningful use of electronic health records (EHR) to provide better patient outcomes (CDC, n.d.). Meaningful use is regulated by CMS and National Coordinator for Health IT (ONC) and is based on five goals including: improving quality, safety, efficiency and reducing health disparities, engage patients and families in their health, improve care coordination, improve population and public health,

“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

EHR in its simplest form is a digital version of a patient’s paper chart. EHRs have been defined as “real-time, patient-centered records that make information available instantly and securely to authorized users”[19]. It can allow patient information to be more easily shared between clinicians in different organisations, such as between ???, thus improving patient safety and clinicians’ decision-making.[20, 21] EHR can be combined with an electronic prescribing system, which can provide clinical decision support to physicians in the form of highlighting tests that are abnormal and advising on the ordering of specific drugs for the patient.