¶ … Nurses Meaningful use of data when used together with the best practice and evidence-based practice has the potential to improve health and healthcare for the population. Meaningful use of data greatly affects nurses since they are at the frontline in achieving the goals of meaningful use Mann, 2011.

This paper defines how meaningful use affects nurses and the role of nurses as relates to meaningful use. The paper is divided into four main sections -- the overview of meaningful use, which briefly defines the meaningful use program, the analysis section that describes the implications of meaningful use, meaningful use recommendations that provides evidence-based recommendations whether it is necessary to add more criteria to the program, and the conclusion section that provides a summary of the paper.

Overview of meaningful use

Meaningful use of data refers to using certified electronic health record (EHR) or electronic medical record (EMR) technology with the aim or improving the safety, efficiency, and quality of care provided while reducing health disparities. Meaningful use to some extent also means engaging the patient and their family in order to improve the coordination of patient care and achieve the overall objectives of patient care Klein, Laugesen, & Liu, 2013.

Meaningful use if defined by a set of standards that focus on paying providers when they achieve a specific criteria with the overall goal of engaging patients and their family, improving communication for better coordination of care, and reducing disparities in healthcare.

There are three major components of meaningful use that are specified. The first is the use of certified EHR systems in a meaningful way such as e-billing and e-prescribing. The second is the use of certified EHR technology to exchange health information with the aim of improving the quality of care provided. The last is the use of certified EHR technology to submit quality measures and other clinical measures for reporting purposes.

In order to achieve meaningful use, nurses and other health care providers will need to change how they document medical information. First is they will need to use a detailed criteria that is developed by the Centers for Medicare and Medicaid Services (CMS). To meet the criteria for meaningful use defined by the CMS, the nurses will need to be involved in thorough charting and documentation of patient information. At the same time, they must be flexible enough during the transition period from the manual or older computerized system to the new system since it may need them to input data into the two systems in order to manage the patient accurately, efficiently, and completely.

Requirements for meaningful use

EHRs can increase the workload of nurses since they can be time-consuming for them. However, they encourage nurses to build strong relationships with their patients in order to improve the general quality of care provided Ford, Huerta, Thompson, & Roland, 2011.

A study conducted by the University of Pennsylvania found that EHRs help nurses to improve the overall outcome of their patients. Patients also reported higher satisfaction of patients when the nurses use EHRs as a result of patient and family engagement in the care process.

In general, nurses will need to adjust their way of working in three key areas. First is that they will need to have a better view of the patient in order to understand what is missing. The interface of the EHR can offer providers with better information about tests they conduct, treatments, etc. It can also give them information on important aspects of history of important treatments that they may have missed. Electronic health records (EHRs) can reveal when there are lapses in preventive screening procedures or testing and notify the health care provider so that these important tests are not missed. To support the delivery of these notifications, the nurses will need to be keen in entering detailed information accurately and in a timely manner Damberg et al., 2012()

Secondly, the nurses will need to be more hand-on with their patients. Each patient will have a digital record of their own that includes their history, diagnosis, laboratory results, prescriptions, etc. this means that through the patient portal, the nurses will have a full overview of the patient. The nurse will therefore be able to make better-informed decisions about the patient thus, they will lead the care of the patient.

The last thing that needs to change is the collaboration between different providers. Doctors, nurses, social workers, and others in the same and other hospitals and clinics across the United States will be able to collaborate in providing care. The ultimate goal of the EHR is to give the providers one accurate and real-time picture...

This information means that the nurses and other providers need to be open to collaboration and making the best decisions for the patient.
To achieve meaningful use, the nurses will need to capture health information in a standard coded format. Secondly, the will need to track and communicate the key clinical conditions of the patient. The coordination and communication of care is also important to achieve meaningful care. This means that clinical decision support models for management of diseases and medicines will need to be a combined decision of different providers. The EHR will also be able to report all necessary measures of clinical quality and other public health information for reporting hospital performance and general disease trends.

The EHR combined with meaningful use of data will also promote decision support for the national and international health priorities. This will promote overall disease management and reporting to promote faster policy decision-making.

Analysis

The core criteria of meaningful use will have implications for different aspects of health care. The first aspect that will be affected is that of exchange of health information. Health information, defined as the secure exchange of health data between two or more authorized and consenting partners, will be facilitated largely by the EHRs. The first objective of meaningful use is to improve the quality, efficiency, and safety of care while reducing disparities in health. This can be achieved by using CPOE to enter all medication orders by any licensed health practitioner. This is expected to achieve exchange of health information since the fact that all data is entered in a standard format means it can be shared with ease. Secondly, since other data such as screening of drug-drug and drug allergies, electronic prescription, demographic and history recording will be conducted using standard formats that also promote exchange of health information Burke, 2010()

The EHR is required to be capable of electronically exchanging data. This means the EHR should be able to send data and receive data from a different system. However, there are security concerns relating to transmission of actual patient data. Therefore, the systems must be able to transmit data securely using encryption mechanisms.

The second implication of meaningful use is the reporting of measures of clinical quality. The EHR will be required to have an aggregate numerator and denominator for electronically submitting clinical quality measures. The providers submitting their data use specific templates that can be uploaded to the CMS portal to achieve this. This is essentially also part of health information exchange though in a summarized format.

A third implication of the core criteria for meaningful use is for patients to be provided with electronic copies of their health information. This will require hospitals to create electronic media with health information for each patients. This may include a CD, USB drive, memory stick, etc. This has the same security concern as sharing information between different systems. It is necessary for the information to be encrypted appropriately to ensure it is out of reach for unauthorized users. This information is required to be human readable with clinical summaries for each of the patient's visits.

Meaningful use recommendations

To achieve meaningful use, implementation of EHRs must meet the criteria defined by the CMS for meaningful use. However, one key criteria that is not included in the CMS criteria is reducing the workload for nurses. According to Damberg et al. (2012)

, it is challenging to have an excellent EMR without having complexity of information. This is because the EHR has administrative, financial, and clinical tasks. Therefore, the complexity of the EMR arises from the different tasks and scenarios within a normal working day. Administrative and financial tasks complicate routine clinical tasks since they are wide in nature -- billing codes, drug formulary, requirements for authorization, etc. It is thus challenging for the EHR to achieve the meaningful use criteria while maintaining a simplicity focus.

Simplicity of design of EHRs is important to reduce the workload on nurses. This means that the system should not have visual clutter and should provide concise display of information to accomplish the tasks of the EHR. This also minimizes the cognitive load for clinicians since it reduces their pressure by presenting information they need.

One way to achieve this is through clinical decision support mechanisms. Using the patient's history, latest and prior results, active and previous medication list, allergy list, laboratory results, and other information, the EHR can…