NUR 621 Electronic Health Records Incentive Programs Essay

NUR 621 Electronic Health Records Incentive Programs Essay

Implementing Meaningful Use

The success of healthcare organizations in the modern world depends largely on the use of health information technologies. Health information technologies enable healthcare organizations to achieve goals including safety, quality, and efficiency in patient care. Healthcare providers play a pivotal role in ensuring the successful implementation of technologies in their institutions. They explore the existing evidence to determine the need and relevance of different health technologies in addressing their needs. Healthcare organizations have to abide by the developed regulations that guide the use of health information technologies. In doing it, they ensure the meaningful use of data to enhance care outcomes for their diverse populations. Meaningful use is an incentive program that was adopted to enhance the utilization of electronic health records in healthcare organizations. The program provides incentives to the healthcare providers for ensuring sustained and continuous improvements in the use of electronic health records. The meaningful use aims to ensure safety, efficiency, and quality in healthcare. Healthcare organizations have to meet the stated core and menu objectives and develop clinical quality measures for safety and quality. Therefore, this paper examines the meaningful use and its associated challenges and barriers experienced by organizations in its implementation.

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Stages of Meaningful Use

The implementation of meaningful use occurred in three stages. The first stage, stage 1 happened between 2011 and 2012. It provided the basis for the implementation of the entire process of meaningful use. It also provided the basis of the requirements that healthcare providers and organizations needed to achieve for the successful use of electronic health records (Jarmai& Vogel-Pöschl, 2019). Stage 1 of the meaningful use led to the adoption of strategies that would facilitate the sharing and capture of electronic health data. Healthcare organizations were required to meet the set and core objectives. The set core objectives were 15, 10 menu sets, and 25 objectives. Healthcare organizations needed to meet at least 20 of the 25 meaningful objectives for them to receive incentive payments (Jarmai& Vogel-Pöschl, 2019). They were also expected to achieve the entire 15 core objectives and at least five of the menu set objectives.

Examples of the essential core objectives that healthcare organizations were expected to achieve included recording demographic information of the patients, using computerized physician order entry systems, electronic ordering of medications, and protecting the collected electronic health information (Jarmai& Vogel-Pöschl, 2019). The menu objectives that healthcare organizations needed to achieve included enabling patients access to their health data, submitting electronic data such as those related to immunization, and providing electronic reminders to patients for follow-up (Jarmai& Vogel-Pöschl, 2019). The quality measures that were used in evaluating successful implementation and realization of the set outcomes used in stage 1 included patient safety, efficiency in resource utilization, clinical processes, and adherence to the developed clinical guidelines.

The implementation of stage 2 of the meaningful use was between 2012 and 2018. The aim of stage 2 of meaningful use was to expand the criteria developed in stage 1. It ensured the utilization of electronic health records in healthcare aligned with the priorities of the National Quality Strategy. The focus in this stage also extended to ensuring the continuous improvement of electronic health records uses in healthcare (Keshta&Odeh, 2021). Stage 2 of the process ensured healthcare organizations meet the developed clinical process objectives. Healthcare providers and institutions were also expected to meet the clinical process objectives to ensure efficient and safe use of electronic health records to improve health outcomes (Keshta&Odeh, 2021). Healthcare organizations were evaluated based on their ability to achieve 5 menu objectives and 14 core objectives.

The examples of core objectives that were to be achieved included automatic tracking of medications, electronic messaging, enhancing patient access to their electronic data, downloading and transmitting electronic health data, and recording the family and patient history electronically. Examples of core objectives included electronic recording and charting vital signs, use of computerized provider order entry for medication, laboratory, and medication orders, recording behavioral data such as smoking for patients aged 13 years and above, and undertaking medication reconciliation (Keshta&Odeh, 2021). The measures for evaluating healthcare organizations in this stage included the elimination of disparities in the use of electronic health records, using electronic health records to reduce disease burden, protecting data integrity, and efficiency in care coordination and communication.

The implementation of stage 3 of meaningful started in 2019 to the present. This stage aims to ensure the utilization of certified electronic health records technology (CEHRT) by healthcare organizations. It strengthens the efficiency and effectiveness of electronic health records use in healthcare to achieve optimum outcomes for diverse patient populations (Rathert et al., 2019). Healthcare providers are required to achieve set measures such as electronic health records reporting for 90 days and utilization of the 2015 CEHRT edition in their care process. Healthcare organizations are also required to achieve the set objectives that support the use of electronic health records in patient care (Rathert et al., 2019). The examples of set objectives include the protection of data integrity, electronic prescribing and clinical decision support, and increased patient access to their electronic health records. Stage 3 also requires healthcare organizations to report at least six quality-related measures about their services and engage in activities that enhance interoperability in meaningful use (Rathert et al., 2019). The measures for evaluating healthcare organizations in this stage include efficiency improvement, patient safety, and reduction of disparities in the use of electronic health records in healthcare.

Challenges and Barriers

Healthcare organizations have and continue to experience challenges in the implementation of the above stages of meaningful use. Healthcare providers experienced the challenge of intense pressure to use electronic charting in the implementation of stage 1. They experience challenges in balancing patient needs and the requirements of implementing the requirements for stage 1 of meaningful use. Stage 1 also gave the provision of enabling patients to have access to their electronic data, which was challenging for healthcare providers caring for minors (Colicchio et al., 2019). Providers experienced ethical dilemmas related to protecting the privacy and confidentiality of minors’ data in their practice. Patients also had a low understanding of the importance of shared information, which increased the risk of ineffective use of health information technologies. Healthcare organizations also found it expensive to fund the projects that could ensure the realization of the set core and menu objectives (Colicchio et al., 2019). They incurred costs related to system purchase, maintenance, upgrade, and training their staff on achieving the desired outcomes.

Healthcare providers also experienced the challenge of increased workload in the implementation of stage 2 of meaningful use. Stage 2 increased the need for reporting of electronic data for at least 80% of the patients seen by the healthcare providers. There was also the challenge of ensuring the integrity of electronically stored information (Colicchio et al., 2019). Stage 2 of meaningful use expanded the provisions of having patients access their electronic data, which increased the risk of loss of data confidentiality and privacy. Healthcare providers were also expected to transmit electronic information on referrals and transition of care, which raised concerns about the confidentiality and privacy of patient information. Healthcare organizations also experienced the challenge of a lack of the needed expertise in the implementation of some requirements (Colicchio et al., 2019). An example can be seen from the need for public health reporting, which was a challenge in most organizations due to lack of the experts in this aspect of reporting.

Healthcare organizations also experience challenges in the implementation of stage 3 of meaningful use. The challenges include those associated with health information exchange and patient access to their electronic health data. Healthcare organizations have to adopt systems that will minimize data integrity issues, which can be costly. Patient engagement may also increase the risk of data loss due to the ineffective use of systems by the patients (Colicchio et al., 2019). Healthcare organizations also have to incur costs in building the desired competencies in their staff, hence, the economic challenge of stage 3 implementation.

Conclusion

Meaningful use has benefits such as improved safety, quality, and efficiency in healthcare. Health care organizations have the responsibility of ensuring the adoption of robust systems that will minimize the risks of data loss in the use of electronic health records. Healthcare providers should develop the needed competencies to support the realization of the goals of meaningful use. Most importantly, healthcare institutions should implement anticipatory measures to minimize the challenges and barriers to meaningful use.

References

Colicchio, T. K., Cimino, J. J., &Fiol, G. D. (2019). Unintended Consequences of Nationwide Electronic Health Record Adoption: Challenges and Opportunities in the Post-Meaningful Use Era. Journal of Medical Internet Research, 21(6), e13313. https://doi.org/10.2196/13313

Jarmai, K., & Vogel-Pöschl, H. (2019).Meaningful collaboration for responsible innovation.Journal of Responsible Innovation. https://www.tandfonline.com/doi/abs/10.1080/23299460.2019.1633227

Keshta, I., &Odeh, A. (2021).Security and privacy of electronic health records: Concerns and challenges.Egyptian Informatics Journal, 22(2), 177–183. https://doi.org/10.1016/j.eij.2020.07.003

Rathert, C., Porter, T. H., Mittler, J. N., & Fleig-Palmer, M. (2019). Seven years after Meaningful Use: Physicians’ and nurses’ experiences with electronic health records. Health Care Management Review, 44(1), 30–40. https://doi.org/10.1097/HMR.0000000000000168

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Write a 1,200-1,500-word essay describing the electronic health records incentive programs, also known as meaningful use. It offers financial incentives and was designed to improve quality, safety, and efficiency of care through the use of electronic health records.

Describe the three stages of meaningful use and their measures.
Explain the challenges and barriers faced by facilities in implementing each stage of meaningful use.
Include three to five references, including your textbook.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.