Legal and Ethical Issues in Nursing Informatics

¶ … Healthcare incentive program

Nursing Informatics/Meaningful use

Meaningful Use Program

Overview of Meaningful Use program

Meaningful use is basically an enticement program available for healthcare providers and hospitals for attaining the aims as per the Centers for Medicare and Medicaid Services (CMS). The healthcare providers and hospitals should ensure that they are making use of certified EHR technology visibly represented in methods. From 2015 and onwards, healthcare providers and hospitals will be penalized for nonconformity with these regulations (Halimi, Brandes, & Bassi, 2012). Meaningful Use (MU) incentive program was started back in 2011. CMS started coordinating the monetary incentives to the participants of the program, fulfilling the requirements as per MU. The criteria were developed by a panel of experts known as National Quality Forum. The development of the criteria was to incorporate, promote and support EHR systems which enhanced patient's care whilst keeping privacy and security of EHR systems intact. The basic aim is to integrate the overall adoption of new healthcare technology by the entire healthcare industry and healthcare providers for the patient's and consumer's benefits. For receiving the EHR incentive payment, the healthcare providers needs to validate their usage of EHR's by fulfilling the criteria of MU and its objectives (Thurston, 2014).

How Electronic Health Records (EHRs) are important to healthcare system?

Electronic health records (HER's) needs to be incorporated for redesigning the healthcare system. Due to EHR's, care services are improved as well as it supports evidence-based practice. EHR system can furnish data for investigating patient populations, deal with chronic disease and guarantee preventive care applications which paper documentation wasn't able to achieve. The technology is destined to become the basis of clinical practice in future. EHR is a clinical tool which is quite low priced, competitive and lifesaving all in one (Thurston, 2014).

Electronic health record (EHR's) facilitates high quality and low priced healthcare by backing up the doctors and enhancing the healthcare results. The price of implementing this is around $20 million to $100 million, which depends on the size of the hospital, which in turns indicates that just 2% of the hospitals have incorporated this facility. The financial incentive is dispatched from federal Health Information Technology for Economic and Clinical Health (HITECH) Act (Halimi, Brandes, & Bassi, 2012).

In the words of Gale, Hartley and Croll (2014), HITECH19 has stated the three fundamental requirements for being an EHR user:

Using certified HER technology in a constructive way, which includes electronic prescribing as well finalized by the secretary

Using certified EHR technology which is connected in a way that facilitates exchange of information for enhancing the healthcare's value for instance boosting coordination.

Information should be submitted on clinical quality basis which are again finalized by the secretary employing certified EHR technology.

Goals of Meaningful Use Program

The HITECH Act's goals in formulating MU are to:

Boost the efficacy, safety and value of healthcare whilst cutting down discrepancies

Uphold EHR's security and discretion

Enhance the care coordination

Involve families and patients in care

Progress of Meaningful Use

The program is working along fine. In a span of just five years, EHR's has been adopted at an increased pace. From April 2014, 73% of the professionals (383,072 from527,200) as well as 91% (4,561 from 5,011) have taken part in the voluntary program and collected a whopping amount of $23.7 billion in Medicare EHR incentive program in case valid cases of adoption, implementation and up gradation of EHR system or meeting the MU criteria (Jones, Murphy, Novak, & Sarnowski, 2014).

Meaningful Use Criteria

The hospitals and eligible professionals (EP's) have to demonstrate the usage of certified electronic health records (EHRs) in order to receive the incentive imbursement given for Medicare EHR Incentive Program under Centers for Medicare & Medicaid Services (CMS). Hospitals and eligible professionals which are eligible for this incentive program don't need to demonstrate their usage of EHR during the initial year, but should adopt, apply and modernize to an EHR for collecting the incentive imbursement from their respective States (healthit, n.d.).

Summary of Meaningful Use Criteria and Objectives:

For being eligible for the MU criteria, the hospitals and EP's should accept the certified EHR technology and ensure that certain objectives are being met. The hospitals and eligible professionals must facilitate certified HER in their systems for collecting the incentive reimbursement via Medicare HER Incentive Program under CMS (healthit, n.d.).

In case of stage-1, MU criteria consist of:

Collecting health data electronically in a proper format

Making use of that information for tracking vital clinical data

Using that data in care coordination procedures

Attempting to involve family members and patients in healthcare

Enforcing reporting clinical quality appraisal along with public health data

In case of stage-2, the focus is centered on:

Health information exchange (HIE)

Making use of lab work and e-prescribing

Patient controlled information

Transmission of vital patient data to numerous settings

Implications for Nurse Practitioners

The incompetent and inefficient paper-based silo method of delivering care to a well-organized, structured and interoperable data system powered by EHR, the role of the healthcare providers has become crystal clear, especially in case of nurse practitioners (NP's). In case of their duties, NP's are known to affect the price and quality of health care. Hence, they can drive the usage of advanced healthcare facilities for quality, security and efficacy of healthcare services (Jones, Murphy, Novak, & Sarnowski, 2014).

Most of the fundamental objectives of MU ensure that EHR facilitates effective healthcare for instance, demographics, vital signs, allergies and list of medications. Apart from that, various fundamental objectives consist of making use of advanced capabilities to understand the real importance of EHR's in healthcare industry and its value for the entire society. With the help of such systems, the doctors are able to take better informed healthcare decisions and commit fewer mistakes. Most of the objectives of MU allow the nurses to enter data in a well-organized manner, noting down the information in a notepad isn't feasible to meet the primary goals. For instance, keeping a list of active medication, keeping a list of allergy, saving vital signs, weight, height, smoking habits and advanced directives. Saving this key health data is vital as it can be sent to other end users and helps in successful healthcare via evidence-based care. Apart from that, documentation which was saved prior can be shown again on next visit, ensuring a patient history instead of dealing once again all over again (Halimi, Brandes, & Bassi, 2012).

According to Recovery Act of 2009, some financial incentives were assimilated for healthcare providers as well as Nurse practitioners for implementing the usage of EHR's after HITECH Act was put in effect. The program guarantees incentive payments in both cases of Medicare and Medicaid program (Jones, Murphy, Novak, & Sarnowski, 2014).

Implications for patients and healthcare

The healthcare industry will be completely revolutionized totally by meaningful use by transforming the method of documenting medical data. As the criteria have been ordained by CMS, the participants will have to ensure thorough and detailed documentation and charting of patient care. The healthcare professionals need to be patient during this period and ensure that they reveal patient information accurately. Meaningful use will change the way healthcare is given by healthcare professionals which consists of:

Providers will have a better view of what's missing. The interface of EHR's is designed as such that it facilitates availability of information about screening tools, tests and cures on the spot. It can also outline lapses in medical treatment and inform the physician in order to take medically informed decisions

More hands-on patients. With the help of patient portals and online features, patients can view their own lab results, records and list of medication. Hence, the patients will become more knowledgeable about their own care.

More collaboration between providers. The end goal of EHR is to outline a clear and real time condition of patient's health which will be available to hospitals, health providers and clinics in USA. With this information on fingertips, the physicians can take better medical decisions on the basis of patient's history (Simmons, 2013).