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
Here is the link:
Penner, S. J. (2017). Economics and financial management for nurses and nurse leaders (3rd ed.). New York, NY: Springer Publishing. ISBN-13: 9780826160010
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
Implementing Meaningful Use
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Implementing Meaningful Use
As healthcare organizations continue to integrate health information technology into healthcare delivery, laws and guidelines aimed at supporting the implementation of such technologies are continuously being developed. For example, the Health Information Technology for Information and Clinical Health (HITECH) Act of 2009 prioritized the effective use of Electronic Health Records (EHR) technology by ensuring that it can help healthcare organizations to provide quality, safe, and efficient healthcare services (McGonigle & Mastrian, 2017). The HITECH Act established Meaningful Use to direct the implementation of interoperable EHR and ensures that healthcare organizations achieve quality, safety, and efficiency. The Centers for Medicare & Medicaid Services (CMS) is the entity that is charged with the responsibility of enforcing Meaningful Use and ensuring its compliance by organizations (Agency for Healthcare Research and Quality, 2022). The Medicare and Medicaid EHR Incentive Programs, created by the CMS, supports eligible hospitals and providers to implement Meaningful Use. Under these programs, eligible hospitals and providers are able to earn financial incentives when they follow the outlined stages for effective implementation and meet the desired measures in every stage (Penner, 2017). The purpose of this assignment is to describe stages of meaningful use and their measures including an explanation of the challenges and barriers faced by facilities in implementing each stage of meaningful use.
Stages of Meaningful Use and Their Measures
The Medicare and Medicaid EHR Incentive Programs require eligible participants to implement Meaningful Use in three stages. The specific objectives aligned with Stage 1, 2, and 3 are capturing and sharing of data, advanced clinical processes, and improved outcomes respectively (Agency for Healthcare Research and Quality, 2022).
Stage 1: Data Capture and Sharing
Stage 1 of Meaningful Use is the initial phase where eligible participants are expected to start the EHR implementation process. The incentive programs require providers to prove their capability to electronically produce copies of medical records whenever patients need them. Additionally, at stage 1, facilities should be in a position to print summarized copies of patients’ visits at the end of those visits.
The CMS has set specific measures that are used to determine whether providers have achieved stage 1 objectives or not. These measures include structured data entry of patient demographics, the use of computerized physician order entry (CPOE) for medication orders, recording patients’ smoking status and vital signs, updated patients’ problem and medication lists, and the ability to produce a clinical summary for patients at the end of every visit (Penner, 2017). For example, an organization that uses CPOE to make at least 30% of all medication orders and transmitting at least 75% of all medication prescriptions electronically is believed to be meeting the objectives of the first phase of meaningful use (Agency for Healthcare Research and Quality, 2022). Data gathering and sharing are the primary focus of the first stage of meaningful use.
Additional measures set for meeting stage 1 of meaningful use combine multiple metrics most of which require providers to ensure and maintain a structured data entry. These measures include allowing patients to access their health information electronically, medication reconciliation, and the provision of patient-specific education resources through the EHR technology (Penner, 2017). Eligible providers should also have the capacity to submit various clinical quality measures to the CMS. These are measures related to hypertension management, screening, preventive care, and immunization status (Agency for Healthcare Research and Quality, 2022). Meeting these measures gives healthcare organizations the capacity to transfer data to EHR and share patients’ health information.
Stage 2: Advanced Clinical Processes
The primary focus of the second phase of meaningful use implementation is the advancement of clinical processes through the creation of new standards aligned with the priorities of the National Quality Strategy. This stage encourages the utilization of the certified EHR technology to promote continuous quality improvement during healthcare delivery and when exchanging health information among healthcare providers (Penner, 2017). The EHR incentive program expects eligible hospitals and providers to develop clear standards that direct patients as they access their health information electronically. Building upon stage 1 measures, stage 2 of meaningful use lays emphasis on improving performance in relation to the management of high-priority health conditions by using clinical decision support. Besides, the nature of information exchange that is taking place on the certified EHR technology in stage 2 should be more structured than that of stage 1.
The CMS uses a number of measures to determine when an eligible provider or hospital has met stage 2 objectives of meaningful use implementation. An example of a measure related to CPOE is the capacity to use CPOE to make more than 30% of radiology orders, more than 30% of laboratory orders, and more than 60% of medication orders. Additionally, providers must be able to generate at least one report for specific conditions suffered by patients and be in a position to use the eMAR to track more than 10% of medication orders. Eligible providers must have the capacity to use the EHR to record patients’ smoking status for more than 80% of patients aged 13 years and above (Agency for Healthcare Research and Quality, 2022). An organization that meets these measures is able to provide more advanced clinical procedures when compared to those performed in stage one of meaningful use implementation.
Stage 3: Improved Outcomes
The primary focus of stage 3 of meaningful use is on the improvement of healthcare outcomes. Precisely, providers must be able to demonstrate that they have the capacity to provide quality and safe healthcare services to patients and that the care that they offered to patients or populations improved their health (Penner, 2017). For example, a provider should be able to prove that the care that it offers to children with asthma reduces the rates of hospital admission for that specific population. Under stage 3 of meaningful use, providers and hospitals have a unique responsibility of optimizing primary care through the use of health information technology. They should also be in a position to enhance their EHR capabilities and explore linkages with other providers in the community (Centers for Medicare & Medicaid Services, n.d.; Penner, 2017). Such providers have the capacity to provide population-focused health care that is supported by the increased integration of health information technology.
The CMS utilizes numerous measures to establish whether facilities have met the objectives of the third stage of meaningful use. One of these measures is the ability to conduct a security risk assessment on the EHR software to ensure maximum protection of patients’ health information. Providers should also demonstrate that they are using EHR in the prescription of more than 80% of all the allowed medication prescriptions. They should also prove that they are able to use CPOE to make not less than 80% of medication orders, more than 60% of orders for diagnostic images, and lab orders of not less than 60% (Agency for Healthcare Research and Quality, 2022). They should also allow patients to access their health information electronically such as by activating the patient portal feature. Moreover, the CMS establishes whether eligible participants have reached stage 3 of meaningful use when they are able to send messages to patients and demonstrate increased patient engagement and care coordination. The facilities should also be able to generate summaries of patients’ care records and prove that they meet the requirements for electronic reporting (Penner, 2017). Meeting these measures gives healthcare organizations the capacity to use the EHR technology to provide care that improves both patient and population outcomes.
The Challenges and Barriers Faced By Facilities in Implementing Each Stage of Meaningful Use
Facilities usually experience some challenges in implementing each stage of meaningful use. According to the Agency for Healthcare Research and Quality (2022), the challenges experienced by facilities as they strive to optime their health information technology during the implementation of meaningful use are usually the same. The main difference is witnessed in the magnitude of the challenges which increase in complexity from stage 1 to stage 3. The common challenges and barriers include; the inability to implement new models of care due to strict reimbursement rules, additional costs involved in improving services from one stage to another, complex administrative structures and staffing patterns as a facility transitions from one stage to another, and limited management experience (Penner, 2017). Facilities need to work in collaboration and prepare proper plans to be able to mitigate these challenges and barriers.
Conclusion
When creating the Medicare and Medicaid EHR Incentive Program, the CMS’ ultimate goal was that eligible participants will reach the third stage of meaningful use. The measures that the CMS has set for each stage guides participants to comply with the requirements of every stage of meaningful use implementation. Incentives are available for participants who meet the required measures of meaningful use at different stages.
References
Agency for Healthcare Research and Quality. (2022). Electronic health records and meaningful use. https://www.ahrq.gov/ncepcr/tools/pf-handbook/mod17.html
Centers for Medicare & Medicaid Services. (n.d.). Stages of promoting interoperability programs: First year demonstrating meaningful use. https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/Downloads/Stages_ofMeaningfulUseTablepdf.pdf
McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.
Penner, S. J. (2017). Economics and financial management for nurses and nurse leaders (3rd ed.). New York, NY: Springer Publishing. ISBN-13: 9780826160010.