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. Implementing Meaningful Use Assignment Paper
Include three to five references, including your textbook.
Prepare this assignment according to the guidelines found in the APA Style Guide
This assignment uses a rubric.
Implementing Meaningful Use
“Meaningful use” is a term applied in health care to outline the minimum requirements for using electronics health records (EHR). In fact, meaningful use is the deliverable approach targeted at boosting the use of EHR in patient care by improving communication between provider to provider, provider to insurance, and patient to provider. The primary purpose of meaningful use is to promote EHR adoption and use in supporting the continued development of standardized data exchanges, improving patient-centric preventive care, and collaboration between public and clinical health care. In essence, demonstrating meaningful use is an indication of the adoption, implementation and upgrade of certified EHR technologies (Davis, 2020). This paper discusses the expected gains from meaningful use, three stages involved, and challenges at each of the three stages.
Meaningful use pursues five main objectives. The first objective is to make improvements in the reduction of health disparities while improving efficiency, safety and quality. The second objective is to increase patient engagement. The third objective is to make improvements in care coordination. The fourth objective is to make expand public and population health. The final objective is to ensure adequate security and privacy protection for personal health information (Penner, 2017).
Meaningful use came into being through the Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009. This legislation introduced programs intended to encourage the adoption of EHR and use three stages to implement meaningful use in EHR systems. Between 2011 and 2015, a reimbursement program was implemented to encourage EHR adoption. The program targeted facilities that demonstrated meaningful use of EHR by offering them financial incentives. During this period, showing meaningful use acted as the basis for reimbursement. However, the policy changed since 2015 when facilities that did not show proof of meaningful use would be subjected to penalties in the reimbursement. From 2015, the facilities that did not show proof of meaningful use in EHR were subjected to Medicare reimbursement payment adjustments that start at 1% in the first year, before reaching a maximum annual adjustment at 5% (Harrington, 2021).
The smooth adoption of EHR has been facilitated by the three stages of meaningful use. The break down into three stages makes it more feasible to implement EHR as intended while lessening the likelihood of providers being overwhelmed by the requirements. The first stage is the adoption of certified EHR technologies. This is intended to targeted certified EHR technologies for promotion and implementation. Successfully passing through this stage requires that the facilitate demonstrate that the EHR technology electronically captures clinical data with the patients given the ability to access a digital copy of their own health records. In this first stage, the requirements for successful completion are that the EHR system must be able to provide electronic clinical summaries for patients at the end of each office visit, computerize provider order entry (CPOE), and a digital copy of the health information to the patients (Hersh & Hoyt, 2018).
It is evident that this first stage focuses on promoting certified EHR technologies adoptions. The requirements established for this stage are for capturing clinical data electronically and ensuring that patients have access copies of their own health information in electronic format. The implementation of this first stage faces seven significant barriers/challenges. The first challenge is financial barriers. The adoption of certified EHR system is an expensive and technically challenging endeavor as the system must be purchased, installed and maintained. The second challenge is clinician/provider resistance. There is a lack of expertise, exposure and experience among clinicians/providers to produce and meet the technology requirements. The third challenge is workflow changes as the route of information flow changes. The fourth challenge is the reduced interaction between providers and patients. The fifth challenge is usability issues in terms of the system being intuitive and organized such that users can find what they are looking for with minimal hassle. The sixth issue is interoperability concerns and difficulty in integrating with other systems, especially when they are from different vendors and use different formats. The final challenge is privacy concerns and HIPAA compliance (Wager, Lee & Glaser, 2022).
The second stage is the expansion of the EHR system with the intention of improving care coordination. This stage builds up on the previous stage by shifting from initial EHR adoption to placing emphasis on meaningful use. The primary focus is on meeting the integral needs of the system to improve care coordination by expanding the ability to exchange patient information. In this second stage, the requirements for successful completion are that the EHR must be able to maintain an up-to-date problem list of active and current diagnoses, chart and record vital signs changes, report ambulatory clinical quality measures to the states and CMS, implement a clinical decision support system (CDSS), and have the ability to exchange key clinical information (Hersh & Hoyt, 2018).
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It is clear that this second stage focuses on expanding on the gains made in the first stage and encourages the use of certified EHR technologies. In addition, it emphasizes capabilities in exchange of patient information and care coordination. Besides that, it introduces more rules for patient engagement, requirements for care coordination and more clinical decision support, as well as increasing the thresholds of criteria compliance. The implementation of this second stage faces three significant barriers/challenges. The first challenge is longer reporting periods and higher thresholds as it pushes providers to take more notes as a routine habit, and this requires that they modify the workflow accordingly. The second challenge is the requirement for patient exchanges as it grades providers for what their patients will do on their own time with regards to patient portal adoption. The third challenge is health information exchange as not all facilities use EHR so that it becomes difficult to meet this requirement (Wager, Lee & Glaser, 2022).
The third stage is the use of more advanced technologies to improve health outcomes. this stage builds up on the previous two stages and finalizes on meaningful use by undertaking targeted measures to improve health outcomes for patients. It expands the EHR system capabilities by introducing new technologies such as patient portals, e-prescriptions and system securities. In this third stage, the requirements for successful completion are that the EHR system should record smoking status of patients, record patient demographics, conduct drug-to-drug and drug allergy checks, maintain an active medication list, provide e-prescriptions (eRx), and protect the electronic health information (Hersh & Hoyt, 2018).
It is apparent that this third stage focuses on using certified EHR to improve health outcomes by carrying out coordinated care through case reporting, clinical data registry, health information exchange. Also, it improves health outcomes by implementing patient provider access, CPOE, clinical decision support, e-prescribing, and protected health information. The implementation of this third stage faces three significant barriers/challenges. The first challenge is the high threshold of patient engagement. This places the burden on providers and yet it is the patients who use the portal. Providers cannot coerce patients to use the patient portal. The second challenge is clinical quality measures as the EHR system is always being optimized. The third challenge is health information exchange as it requires that providers rely on the capabilities of their certified EHR systems, and yet not all patients use the system so that capturing their data is difficult (Wager, Lee & Glaser, 2022).
One must accept that meaningful use is intended as an incentive for EHR adoption and leveraging to derive the associated benefits of EHR while minimizing harms. Meaningful use pursues the objectives of: improving reduction of health disparities, increasing patient engagement, improving care coordination, expanding public and population health, and ensuring adequate security and privacy protection. The implementation of meaningful use is conducted in three stages. The first stage promotes the adoption of EHR technologies. This stage faces challenges from financial barriers, clinician/provider resistance, workflow changes, reduced interaction between patients and providers, usability issues, interoperability concerns, and privacy concerns. The second stage encourages the use of certified EHR technologies. This stages faces challenges from longer reporting periods, requirement for patient exchanges, and health information exchange. The third stage focuses on using certified EHR to improve health outcomes by carrying out coordinated care. This stage faces challenges from high threshold of patient engagement, clinical quality measures, and health information exchange. Overall, these challenges must be addressed to ensure successful implementation of meaningful use.
References
Davis, N. (2020). Foundations of Health Information Management (5th ed.). Elsevier, Inc.
Harrington, M. K. (2021). Health Care Finance and the Mechanics of Insurance and Reimbursement (2nd ed.). Jones & Bartlett Learning, LLC.
Hersh, W. R., & Hoyt, R. E. (Eds.) (2018). Health Informatics: Practical Guide (7th ed.). Informatics Education.
Penner, S. J. (2017). Economics and Financial Management for Nurses and Nurse Leaders (3rd ed.). Springer Publishing.
Wager, K. A., Lee, F. W., & Glaser, J. P. (2022). Health Care Information Systems: A Practical Approach for Health Care Management (5th ed.). John Wiley & Sons, Inc.
Implement Meaningful work Rubric
Three Stages
28 points
Criteria Description
Three Stages
- Target
28 points
The essay substantially and thoughtfully describes the three stages of meaningful use and their measures.
- Acceptable
25.76 points
The essay clearly and thoughtfully describes the three stages of meaningful use and their measures.
- Approaching
24.64 points
The essay clearly describes the three stages of meaningful use and their measures.
- Insufficient
22.4 points
The essay vaguely describes the three stages of meaningful use and their measures.
- Unsatisfactory
0 points
The essay does not adequately describe the three stages of meaningful use and their measures. Implementing Meaningful Use Assignment Paper
collapse Implementing Meaningful Use assessment
Implementing Meaningful Use
28 points
Criteria Description
Implementing Meaningful Use
- Target
28 points
The essay skillfully and thoughtfully explains the challenges and barriers faced by facilities in implementing each stage of meaningful use.
- Acceptable
25.76 points
The essay clearly and thoughtfully explains the challenges and barriers faced by facilities in implementing each stage of meaningful use.
- Approaching
24.64 points
The essay clearly explains the challenges and barriers faced by facilities in implementing each stage of meaningful use.
- Insufficient
22.4 points
The essay vaguely explains the challenges and barriers faced by facilities in implementing each stage of meaningful use.
- Unsatisfactory
0 points
The essay does not explain the challenges and barriers faced by facilities in implementing each stage of meaningful use.
collapse Thesis, Position, or Purpose assessment
Thesis, Position, or Purpose
5.6 points
Criteria Description
Thesis, Position, or Purpose
- Target
5.6 points
The thesis, position, or purpose is persuasively developed throughout and skillfully directed to a specific audience.
- Acceptable
5.15 points
The thesis, position, or purpose is clearly communicated throughout and clearly directed to a specific audience.
- Approaching
4.93 points
The thesis, position, or purpose is adequately developed. An awareness of the appropriate audience is demonstrated.
- Insufficient
4.48 points
The thesis, position, or purpose is discernable in most aspects but is occasionally weak or unclear. There is limited awareness of the appropriate audience.
- Unsatisfactory
0 points
The thesis, position, or purpose is not discernible. No awareness of the appropriate audience is evident.
collapse Development, Structure, and Conclusion assessment
Development, Structure, and Conclusion
6.4 points
Criteria Description
Advances position or purpose throughout writing; conclusion aligns to and evolves from development.
- Target
6.4 points
The thesis, position, or purpose is coherently and cohesively advanced throughout. The progression of ideas is coherent and unified. A convincing and unambiguous conclusion aligns to the development of the purpose.
- Acceptable
5.89 points
The thesis, position, or purpose is logically advanced throughout. The progression of ideas is coherent and unified. A clear and plausible conclusion aligns to the development of the purpose.
- Approaching
5.63 points
The thesis, position, or purpose is advanced in most aspects. Ideas clearly build on each other. Conclusion aligns to the development of the purpose.
- Insufficient
5.12 points
Limited advancement of thesis, position, or purpose is discernable. There are inconsistencies in organization or the relationship of ideas. Conclusion is simplistic and not fully aligned to the development of the purpose.
- Unsatisfactory
0 points
No advancement of the thesis, position, or purpose is evident. Connections between paragraphs are missing or inappropriate. No conclusion is offered.
collapse Evidence assessment
Evidence
4 points
Criteria Description
Selects and integrates evidence to support and advance position/purpose; considers other perspectives.
- Target
4 points
Comprehensive and compelling evidence is included. Multiple other perspectives are integrated effectively.
- Acceptable
3.68 points
Specific and appropriate evidence is included. Other perspectives are integrated.
- Approaching
3.52 points
Relevant evidence that includes other perspectives is used.
- Insufficient
3.2 points
Evidence is used but is insufficient or of limited relevance. Simplistic explanation or integration of other perspectives is present.
- Unsatisfactory
0 points
Evidence to support the thesis, position, or purpose is absent. The writing relies entirely on the perspective of the writer.
collapse Mechanics of Writing assessment
Mechanics of Writing
4 points
Criteria Description
Includes spelling, capitalization, punctuation, grammar, language use, sentence structure, etc.
- Target
4 points
No mechanical errors are present. Skilled control of language choice and sentence structure are used throughout.
- Acceptable
3.68 points
Few mechanical errors are present. Suitable language choice and sentence structure are used.
- Approaching
3.52 points
Occasional mechanical errors are present. Language choice is generally appropriate. Varied sentence structure is attempted.
- Insufficient
3.2 points
Frequent and repetitive mechanical errors are present. Inconsistencies in language choice or sentence structure are recurrent.
- Unsatisfactory
0 points
Errors in grammar or syntax are pervasive and impede meaning. Incorrect language choice or sentence structure errors are found throughout.
collapse Format/Documentation assessment
Format/Documentation
4 points
Criteria Description
Uses appropriate style, such as APA, MLA, etc., for college, subject, and level; documents sources using citations, footnotes, references, bibliography, etc.,
- Target
4 points
No errors in formatting or documentation are present. Selectivity in the use of direct quotations and synthesis of sources is demonstrated.
- Acceptable
3.68 points
Appropriate format and documentation are used with only minor errors.
- Approaching
3.52 points
Appropriate format and documentation are used, although there are some obvious errors.
- Insufficient
3.2 points
Appropriate format is attempted, but some elements are missing. Frequent errors in documentation of sources are evident.
- Unsatisfactory
0 points
Appropriate format is not used. No documentation of sources is provided. Implementing Meaningful Use Assignment Paper