The American Recovery And Reinvestment Act

Several years ago, a mandate was ordered requiring all healthcare facilities to progress from paper charting and record keeping to electronic health record (EHR). This transition to electronic formatting has pros and cons associated with it. I will be describing the EHR mandate, including who initiated it, when it was initiated, the goals of the EHR, and how the Affordable Care Act and the Obama administration are tied into it. Then I will show evidence of research and discuss the six steps of this process as well as my facilities progress with EHR. Then I will describe meaningful use and how my facility attained it. Finally, I will define HIPAA law, the possible threats to patient confidentiality relating to EHR, and how what my facility

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.

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.

Under the provisions of the American Recovery and Reinvestment Act of 2009 (ARRA, or the Stimulus Act”), certain eligible providers are eligible for financial incentives for following and documenting “meaningful use” of a certified electronic medical record system. According to the HRSA, “in July 2010, the Centers of Medicare & Medicaid Services (CMS) published a final rule which established three phases of the EHR Incentive Program. The three stages of Meaningful Use are designed to support eligible professionals and hospitals with implementing and using EHRs in a meaningful way to help improve the quality and safety of the nation’s healthcare system.” The end point here is not that having an electronic medical record will allow for a

In efforts to reform the United States healthcare system and create a nationally unified data exchange system the federal government has established an incentive program to eligible professionals and hospitals. The federal government has turned to certified electronic health record (EHR) technology to help facilitate the process of broadening health IT infrastructures. The federal government views EHR system used in meaningful ways as the key to reforming the healthcare systems. Meaningful use of the EHR systems can also improve the overall quality of healthcare, insure patient safety, as well as reduce the cost of healthcare to individuals (Bigalke & Morris, 2010, p. 116).

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.

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).

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 U.S. Department of Health and Human Services (HHS) states that in order to realize meaningful use of the EHR technology, healthcare providers are obliged to apply the technology in a approach that enriches quality, safety, and efficiency of healthcare delivery; ebbs healthcare inconsistencies; involves patients and families; enriches care coordination; expands population and public health; and guarantees sufficient privacy and security guards for personal health information. (U.S Department of Health and

The Institute of Medicine sponsored a discussion paper on evaluation of return on investment. What the paper says is that it is difficult to quantify the value of an electronic health record in business. The paper does state that those institutions that did get a significant return on investment(including Kaiser Permanente and the VA) reported the advantages occurred over about a decade. The investment in the EHR allowed the HCOs to free up storage space and costs, reduce costs associated with never events, improve compliance, reduce the costs of repeat testing and many other measures of success (IOM). We are left with a vague definition of how to measure the effectiveness, role and purpose of the electronic health record, however, an EHR can be considered effective and fulfilled its purpose if the quality of care improves, the cost of care decreases, and the HCO is able to run more

Electronic health records is a major component in the United States health care system. It has been proven to improve health care quality by saving time and reducing

One of the main components for the HITECH is the Medicare and Medicaid EHR Incentive Programs. These programs give incentive payments to eligible professionals, hospitals, and critical access hospitals (CAHs) that implement or upgrade to a certified EHR (Wager 8). An additional incentive is received if we can demonstrate “Meaningful Use” of interoperable electronic medical records. The concept of electronic health records-meaningful use (EHR-MU) [8] implements the provisions of the ARRA (American Recovery and Reinvestment Act) of 2009 that provide these type of incentives.

The American Reinvestment and Recovery Act (ARRA) introduced by President Obama in 2009 included goals to improve economic efficiency by increasing technology in healthcare (Hoffman & Podgurski, 2009). The goal of the ARRA was to computerize the health records of all Americans by the year 2014 and it dedicated 19 billion dollars to the promotion of healthcare technology to meet this goal (Hoffman & Podgurski, 2009). The Health Information Technology for Economic and Clinical Health (HITECH) Act, which is a part of the ARRA, provided an opportunity for healthcare organizations to receive financial incentives for meeting certain levels of meaningful use through adoption and use of health information systems and an electronic health record (EHR) (McGonigle & Mastrian, 2012). The enactment of the ARRA and the HITECH Act have led to healthcare organizations and providers entering the technology market in search of a system to meet the needs of their practice organization and patients with the capability of qualifying for the government proposed incentives. As demand was placed on the technology suppliers, a large variety of health information systems became available and are still being created for purchase. With so many options available in the health information technology marketplace, it is imperative that current purchasing entities fully evaluate systems for effective implementation using a reliable and comprehensive approach.

As of May 19th, 320 health care providers (including 283 physicians and 37 hospitals) have received a total of $75 million in Medicare incentive payments for demonstrating meaningful use of electronic health records. The relatively slow start was perhaps to be expected—to qualify for this first round of incentives, practices were required to not only meet certain EHR requirements, but also sign up for the payments within the first two weeks they were available. Many practices simply weren 't that far in the process.

These four measures that define meaningful use laid out the framework for healthcare reform, emphasizing the importance of the EHR in healthcare delivery through financial incentives, while giving significant weight to the security of the protected health information of the individual patient. Through Medicare and Medicaid incentives, a healthcare provider could receive over $100,000 for complying with the rules of HITECH, but non-compliant providers would receive a 1% decrease in funding, with that percentage increasing each subsequent year (Hudock & Wagner, 2009). Not only are the bonus incentives granted, but the government would also reimburse the provider for implementing the EHR, recouping nearly the entire amount that they paid to enforce the system. Failure to do so would result in a cut in funding, and penalties for non-compliance to the standards would result in financial sanctions of up to $1.5 million per calendar year (Ouellette, 2015). With the number of Medicare eligible patients steadily increasing every year, it became essential to become compliant with the standards outlined in the HITECH Act, and the implementation of an EHR became a priority issue to be carried out in an immediate fashion.