DNP 805 Select a specific health care technology-related regulation, law, statute, or ethical standard that applies to informatics
DNP 805 Select a specific health care technology-related regulation, law, statute, or ethical standard that applies to informatics
DNP 805 Select a specific health care technology-related regulation, law, statute, or ethical standard that applies to informatics
The COVID-19 pandemic hit our health care system and that there is an urgent need to focus on evidence-based implementation of digital health. This gains is important since there is frequently need to focus on providing telehealth and telemedicine since patients are not being seen in the clinics. This pandemic has created a unique opportunity to create quality data which can enable the achievement of the “Learning Healthcare System (LHS)” paradigm which implies that knowledge generated within the health care systems in the daily practice is used systematically to produce the continual improvement in care. International Medical Informatics Association (IMIA) adopted an evidence-based approach toward deployment of digital health technologies during the current COVID-19 crisis. This helped all clinicians to assess patients while they are at home and not worrying to go out. The World Health Organization (WHO) defines in its web site eHealth as “the use of information and communication technologies for health care purposes.” With this, health informatics can assist IT to support patients with their practice of health. Accessing their health is important and should be done effectively and safely. It will have an overwhelming benefit for both patient experience and outcomes and of utilizing telemedicine. Studies should focus on improving access, reducing technological barriers, and policy reform to improve the spread of telemedicine.
I think it connects with GCU Christian worldview and i agree telemedicine and telehealth can support our health care industry especially right now that we are on pandemic. Some patients are still afraid to go out and see their primary doctors and they want to talk to them thru telehealth. We should have guidelines and privacy to remember at all times for ethical decisions.
References:
International Medical Informatics Association IAHSI statement to WHO on the use of informatics in pandemic situationsAccessed December 1, 2020 at:https://imia-medinfo.org/wp/statement-from-the-international-academy-for-health-sciences-informatics-iahsi-the-academy-of-the-international-medical-informatics-association-imia-to-the-director-general-of-the-who-on-the-use/
World Health Organization WHO guideline Recommendations on Digital Interventions for Health System StrengtheningAccessed march 2, 2021 at:https://www.ncbi.nlm.nih.gov/books/NBK541902/pdf/Bookshelf_NBK541902.pdf
Thank you for providing an insightful post. The COVID-19 pandemic has dramatically impacted how healthcare is delivered in regard to telehealth. Telehealth has made it possible to expand access, reduce unnecessary emergency room visits, and has also reduced disease exposure for staff and patients (Gibson & Hendrickx, 2021). One of the most significant benefits of telehealth is that patients can easily access care and get advice from a provider anywhere and anytime. As mentioned, telehealth has prevented many unnecessary admissions, enabling patients to stay and heal in the comfort of their homes. This was excellent especially during the COVID-19 pandemic because patients were treated in the comfort of their homes and created hospital space for patients with needed medical severe attention (Gibson & Hendrix, 2021). In my professional opinion, the evolution of telemedicine has been an added benefit for everyone. I used telehealth for the first time during the pandemic, which I found very helpful. The provider was able to give recommendations and even prescribe necessary medication. This also saved me a trip to the urgent care or emergency room, which is about 30 miles from me.
Reference:
Gibson, N. A., Arends, R., & Hendrickx, L. (2021). Tele-U to tele-ICU: Telehealth nursing education. Critical Care Nurse, 41(5), 34–39. https://doi-org.lopes.idm.oclc.org/10.4037/ccn2021109
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The Hospital-Based Inpatient Psychiatric Services also know as HBIPS is a quality measure program that has been in place since 2008. These core measures are a set of data metrics that must be electronically uploaded to The Centers of Medicare and Medicaid Services (CMS) on a quarterly basis in order to obtain CMS and/or The Joint Commission accreditation. Without an inpatient psychiatric hospital providing this data they are unable to receive any federal funding or obtain CMS certification. A few of these core measure include diagnostic assessment related to psychosocial elements, substance use and previous hospitalization. Another focus for these measures relates to antipsychotic medication as well as discharge planning and coordination of care.
I am in support of this regulation and requirement in order to obtain CMS and The Joint Commission accreditation. These measure are extremely important and establish quality of care and services for inpatient psychiatric hospitals. This data is then made public and published comparing each hospital and establishing national benchmarks which is very important for the consumer.
National Association for Behavioral Healthcare. Hospital-Based Inpatient Psychiatric Services Core Measure Set. 2019. https://www.nabh.org/policy-issues/quality/hbips-core-measures/
Thank you for sharing the information about Core Measurement Standards for inpatient psychiatric services. Subjectively, The Center for Medicare and Medicaid (CMS) core measures have a negative connotation for healthcare providers, due to added paperwork or documentation and extra work required to maintain CMS reimbursement. This reimbursement is then replicated by other insurance companies, so it carries clout and is important to the financial well-being of a healthcare institution. However, CMS standards are in place to ensure providers are providing the quality care that patients deserve, especially high-risk patient populations that can be found in behavioral health units as you stated. Through these quality initiatives, outcomes, processes, and systems are driven to higher standards (Centers for Medicare and Medicaid Services, 2022). With this guiding principle in mind, I also support these regulations. Patients seeking healthcare deserve to have high expectations that care is safe and effective. As a healthcare professional, there is accountability when data can be publicly searched. Clients are able to make informed choices.
Reference
CMS. (2022, April 14th). Quality Measures. https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/QualityMeasures
The law signed in 2009, American Recovery and Reinvestment Act provided funding to strengthen health care information technology. Nurses have an opportunity to participate in the design, testing, and teaching use of electronic health records through parts of multiple data input and extraction nurses perform. (Alexander, et al, 2019)
I support the change to electronic health records (EHRs) to improve patient safety, improve the ability to provide quality care, reduction in paperwork, improved care coordination, legibility of notes. Improved quality through clinical alerts that reduce and prevent medication errors and duplicate orders. (Centers for Medicare and Medicaid Services, 2015). Electronic health records can facilitate improved communication between providers and patients if patients have the ability to access charts through a patient portal. Example Mychart Providence.
Healthcare technology, such as electronic health records (EHRs) is critical for quality improvement. EHRs store data re: medication, diagnosis, clinical guidelines, demographics, objective and subjective data. The ability to retrieve data and have benchmarks makes it easier to implement safety protocols and other quality initiatives. (AHRQ, 2022)
When using health care technology, such as EHRS, we should continue to use our values. The information in EHRs is a patient’s history- viewing the information should take on empathy, compassion, integrity, and authenticity as if you’re face to face with the patient.
Agency for Healthcare Research and Quality (AHRQ) Using health information technology for primary care quality improvement (QI). 2022. https://www.ahrq.gov/evidencenow/tools/health-it-tools.html
Alexander, S., Frith, K. H., & Hoy, H. (Eds.). (2019). Applied clinical informatics for nurses (2nd ed.). Jones & Bartlett Learning. ISBN-13: 9781284129175
Centers for Medicare and Medicaid Services (2015) Electronic health records provider. https://www.cms.gov/Medicare-Medicaid-Coordination/Fraud-Prevention/Medicaid-Integrity-Education/Downloads/docmatters-ehr-providerfactsheet.pdf
The 618th section of the Food and Drug Administration Safety and Innovation Act (FDASIA) of 2012 created recommendations and strategies on how there should be a risk-based framework for health IT. This allows for innovation while maintaining patient safety and security from regulatory replication. This allowed the FDA to charge fees for generic or brand medications or medical equipment. The provided engagement into the process of the Food and Drug Administration (FDA) and encourage innovation in the pharmaceutical world to provide the quicker access to safe products (Mullin, 2018).
I am not a huge proponent of adding fees to fix problems, as that can result in driving up the cost to pharmaceuticals and medical production to the front line consumer. I appreciate the encouragement that it provides for innovation. I do have concerns that these fee can result in some consumers not having access due to financial constraints. I do believe in this specific case the risk does outweigh the benefit. This partnership with the FDA for safety and encouragement for innovation is what has my overall support of the legislation.
From the lens of the Christian world view it is important to be able to provide everyone with the same access to care. That has been and will continue to be a struggle for us in the upcoming years. There is also a motivation to have access to the best possible care which I also see to the very important from this viewpoint. I do see this viewpoint as being supportive of FDASIA as well.
References
Mullin, G. (2018). Health technology sb, 1st (1st ed.). Aggregate Intelligence, Inc. dba Omnigraphics.
Over time, patient care has grown to be a largely technology-driven practice. Health care professionals record patient data technologically and use similar means to coordinate care. Critical patient information is shared every day as healthcare providers implement informatics in healthcare delivery. However, the process is riskier than ever before and exposes patients to more harm and abuse of private health information. Regulations and laws have been integral in protecting and securing private patient data.
One of the widely used regulations is the Health Insurance Portability and Accountability Act (HIPAA). It contains crucial provisions for health insurance coverage and reducing Medicare fraud but protecting the privacy and security information applies to informatics (Alexander et al., 2019). The privacy rules focus primarily on the rights of the patient. It emphasizes the need for patient consent when sharing private information (Centers for Disease Control and Prevention (CDC), 2018). Under HIPAA, standards were established to protect health information transmitted verbally, electronically, visually, or in paper formats (Alexander et al., 2019). The HIPAA also obliges health care professionals to secure confidential information, particularly in electronic health records (EHRs). Keshta and Odeh (2021) noted that EHRs are common sources of privacy breaches since patient data can be accessed by unauthorized individuals who can use it for non-medical reasons. As a result, any identifiable patient information requires technical, administrative, and physical safeguards.
I support the use of HIPAA in protecting and securing protected health information. As health care professionals guided by the Christian worldview, ensuring that patient care is ethical is not optional. As health care providers collect, store, and share confidential patient data, privacy and security should be key considerations. HIPAA provides measures to secure information shared electronically. It ensures that appropriate standards are followed, and violation is punished accordingly. Through HIPAA, patients are less vulnerable to security breaches typical when using computer and technology systems in health care delivery.
References
Alexander, S., Frith, K. H., & Hoy, H. (Eds.). (2019). Applied clinical informatics for nurses (2nd ed.). Jones & Bartlett Learning.
CDC. (2018). Health Insurance Portability and Accountability Act of 1996 (HIPAA). https://www.cdc.gov/phlp/publications/topic/hipaa.html
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
Electronic health records are very advantageous when working at an Oregon Health plan that provides coverage for Medicare and Medicaid Services. Per Oregon Health Authority (OHA), “strong, integrated Health Information Technology and Health Information Exchange to support meaningful use of Electronic Health Records within the provider community, thereby improving quality in health care outcomes towards reducing overall health care costs”. (Oregon Health Authority, nd)
Health IT, especially EHRs is used in Oregon’s Coordinated Care Model. Health IT supports coordinated care organizations (CCOs) through improving care coordination, population management, and integration of physical, behavioral, and oral health. It provides benchmarks for quality improvement and improves collaboration with patients.
The benefit of having incentives for health care organizations to implement EHRs, it makes providers accountable. It provides a way to check data. For example Quality assurance and improvement HEDIS, etc.
I too support HIPPA-it’s a layer of protection to respect the privacy of a patient, “Protecting the privacy and security information applies to informatics “. (Alexander et al., 2019).
Alexander, S., Frith, K. H., & Hoy, H. (Eds.). (2019). Applied clinical informatics for nurses (2nd ed.). Jones & Bartlett Learning. ISBN-13: 9781284129175
Oregon Health Authority (nd). Information technology. Medicaid HER incentive.
The Health Information Technology for Economic and Clinical Health (HITECH) Act was enacted as a part of the American Recovery and Reinvestment ACT of 2009 to help stimulate the nation’s economy. The goal of the enactment was to reduce cost, decrease health disparities, and, most importantly, improve the quality of care (Alexander et al., 2019). With this, increasing the availability of medical records was related to the purpose of the law. Electronic health records (EHR) increased the capability to provide care as it was easily accessible and provided a detailed health history (Enriquez, 2020). Because Healthcare providers can easily access EHRs, it helps avoid duplication of tests and treatments and promotes care coordination among different providers and practices (Alexander et al., 2019). With this, enabling access to medical records requires additional national security to provide the privacy of individuals. Organizations must abide by the Health Insurance Portability and Accountability Act (HIPPA) which regulates and protects sensitive patient information from being released without the patient’s consent (Enriquez, 2020).
The EHR has been groundbreaking in the medical field because it has created an openness among healthcare providers regarding patient history, previous treatments, and other pertinent medical records. The issue with delicate information being easily accessible is that protecting the information from those who may abuse it is needed (Patel, 2019). In addition to the EHR, nursing informatics plays an imperative role in protecting and encrypting information. According to Patel (2019), encryption of protected health information (PHI) uses many algorithms to change regular text into encoded text. Doing so protects unauthorized users from accessing sensitive information. From a Christian perspective, as a healthcare professional, doing good unto others extends to protecting the patient and their information from others. We are trusted with the patient’s life and personal information. Healthcare providers see their health records and personal records such as insurance information, social security, and other sensitive information on a face sheet.
References:
Alexander, S., Frith, K., & Hoy, H. (2019). Applied clinical informatics for nurses (2nd ed.). Jones & Bartlett Learning.
Enriquez, L. (2020). Data-rich and knowledge-poor: How privacy law privatized medical data and what to do about It. Columbia
Law Review, 120(8), 2319–2357.
Patel, N. (2019). Your personal health information may have been compromised: Using encryption to prevent data breaches on end-user devices. Hofstra Law Review, 48(2), 563–595.
For healthcare institutions to succeed, you need functional, dependable technology to meet patients’ needs for care and keep processes running smoothly. Healthcare IT, from the rapidly expanding world of virtual care and clinical mobility to patient data security to streamlined healthcare, is essential to providing the best care possible.
Telemedicine took a great leap forward during the Covid-19 pandemic. In January 2020, an estimated 24 percent of healthcare organizations had an existing telehealth program. Many healthcare organizations will be focusing on how best to integrate telehealth services with existing physical ones. Virtual visits will continue to be used to increase access to primary care and urgent care, as well as to improve collaboration with clinics, long-term care facilities, dialysis centers, and mental health services. (Austrian Federal Ministry of Health Telemedicine, 2019)
Advances in video conferencing technology, combined with the expansion of mobile internet and the proliferation of wearable devices, have made telehealth one of the most important trends in medical technology in 2019. Utilizing a mobile device and a two-way camera, care providers can have one-on-one encounters with patients from a distance. These patients are usually either in rural areas or unable to secure transportation to a physical facility. Health monitors such as wearable devices can check for heart rate, blood pressure, and blood oxygenation. Web-enabled and app-enabled supplements can filter patient requests accordingly and save both providers and patients critical time and energy. Even the most routine telehealth visit can save lives. They reduce barriers to care such as transportation, language, and geography (Siwicki B, 2020).
For older people living alone, regular checkups can help avoid strokes, heart attacks, and other adverse events, and, logistically, there is less risk of exposure to other diseases. As the technology improves and incorporates augmented and virtual reality, usage could graduate from simple virtual check-ups to a whole fleet of medical procedures performed remotely, even including, with the aid of robotics, full-fledged surgical operations. Since its early operation, electronic reporting systems have played an unparalleled role in discovering and containing the spread of diseases in a timely fashion while protecting lives and improving the health of entire populations by reducing the financial and human impact of diseases on the society.
References
Austrian Federal Ministry of Health Telemedicine, https://www.bmgf.gv.at/home/Gesundheit/E-Health_Elga/Telemedizin/Telemedizin
Siwicki B. Healthcare IT News, 2020. Telemedicine during COVID-19: Benefits, limitations, burdens, adaptation: https://www.healthcareitnews.com/news/telemedicineduring-covid-19-benefits-limitations-burdens-adaptation.
President Barrack Obama signed the HITECH (Health Information Technology for Economic and Clinical Health) Act into law the year 2009 to promote the adoption of EHRs by physicians across the US. This policy has not only sealed loopholes in the 1996 HIPAA (Health Information Portability and Accountability) Act but also tightened its language (Adler-Milstein & Jha, 2017). With the use of financial incentives for EHRs adoption and increased penalties for the HIPAA violations of security and privacy rules, today, most healthcare organizations have improved security and privacy protections for all health-related data. The HITECH Act comprises of parts A to D that describe health information technology promotion, how to test health information technologies, funding through loans and grants, and security and privacy of electronic health data respectively (Adler-Milstein & Jha, 2017).
According to Gold & McLaughlin (2016), the HITECH Act has resulted in an improvement in care coordination, efficiency, decreased healthcare-related costs, improved public, and population health, increased the engagement of caregivers and patients in routine care, and improved security and privacy of health related data. These outcomes are the five priority areas that the act purposed to address and revolutionize in the American healthcare system. Besides, the act triggered an increase in the number of healthcare clinics, particularly ambulatory care clinics, in pursuit if increasing access to care for Americans hence influencing healthcare delivery from both administrative and clinical perspectives (Alammari et al., 2021). Technology is today speeding up healthcare delivery by providing clinicians with more oversight of health data and control of in-organization events. For instance, by using technologies such as telemedicine, mHealth (mobile health), and tools for remote monitoring, healthcare providers can effortlessly track patients’ progress while observing the HIPAA regulations. A perfect example is during the COVID-19 pandemic, providers can obtain patient data on COVID-19 immunizations and put it into meaningful use to promote public and population health.
Before the implementation of most recent policies that transformed the landscape of the American healthcare system, healthcare was fragmented and non-interoperable. Patients’ encountered many difficulties navigating the system. Furthermore, the initial use of paper records to store patient data partly contributed to increased morbidity and mortality of adverse healthcare events. For these reasons, I support the HITECH Act. This policy has not only helped to put in place a well-trained and meaningful health workforce, but also helped to coordinate and align care among states and connect patients to the community in the event of an emergency (Gold & McLaughlin, 2016). These outcomes align with the ethics of the Christian worldview of helping and caring for the sick.
References
Adler-Milstein, J., & Jha, A. K. (2017). HITECH Act drove large gains in hospital electronic health record adoption. Health affairs, 36(8), 1416-1422. doi: 10.1377/hlthaff.2016.1651
Gold, M., & McLaughlin, C. (2016). Assessing HITECH implementation and lessons: 5 years later. The Milbank Quarterly, 94(3), 654-687. https://dx.doi.org/10.1111%2F1468-0009.12214
Alammari, D., Banta, J. E., Shah, H., Reibling, E., & Ramadan, M. (2021). Meaningful use of electronic health records and ambulatory healthcare quality measures. Cureus, 13(1). https://dx.doi.org/10.7759%2Fcureus.13036