NURS 8210 Meaningful Use Paper

Sample Answer for NURS 8210 Meaningful Use Paper Included After Question

By Day 7 of Week 6

Write a 4- to 5-page essay in which you:

  • Summarize the legal, financial, and ethical issues that may arise as a result of meaningful use legislation.
  • Explain how these issues might present barriers to successful implementation within an organization.
  • Discuss ways that health care organizations can make the most of their electronic health record investments in light of meaningful use.
  • Explain how EHR-related meaningful use legislation is being implemented in your organization.

A Sample Answer For the Assignment: NURS 8210 Meaningful Use Paper

Title: NURS 8210 Meaningful Use Paper

Meaningful use refers to an electronic health records (EHR) incentive program, which offers incentive payments for specific healthcare providers to adopt EHR technology in ways that improve patient care. The program encourages eligible providers to use the EHR’s capabilities to arrive at benchmarks that promote improved patient care (CMS, 2017). The meaningful use program has particular requirements that the eligible providers must meet to get the incentive payments. This paper seeks to discuss the legal, financial, and ethical issues that may arise due to meaningful use legislation and how they may hinder the successful implementation of meaningful use in an organization.

Legal, Financial, and Ethical Issues That May Arise As A Result Of Meaningful Use Legislation

Legal issues that can occur during meaningful use legislation include increased legal responsibility and accountability for healthcare providers. Complex electronic-based auditing procedures can point out providers who review or fail to review vital patient information in the EHR (Balestra, 2017). As a result, providers can be sued on the grounds of medical negligence for failing to address priority patient issues. Challenges related to the quality, usability, and reliability of the available EHRs may bring complex legal implications. Most EHR contracts have a ‘hold harmless’ clause which restricts health providers from reporting EHR-related challenges (Balestra, 2017).

Furthermore, documentation-related EHR issues may result in legal liabilities. Documentation must be accurate and clear to offer a foundation for every provider to improve patient outcomes (Balestra, 2017). However, electronic documentation that does not meet these principles may result in undesirable outcomes for the provider, patients, families, or the healthcare organization, resulting in legal proceedings.

Financial issues that may occur from meaningful use include unresolved issues on the party that should pay for the implementation and use of the EHR. In most of the current provider reimbursement models, the highest percentage of the EHR monetary benefits go to health care payers instead of those currently financing the EHR implementation (Lite et al., 2020). Health care providers may raise financial concerns about the cost and resources needed to implement and maintain the EHR.  

The transition costs from paper-based records to EHR documentation are barriers to successful, meaningful use legislation (Lite et al., 2020). The transition is associated with costs to reduce patient load during the transition process, staff training, various technical support charges, and costs to load medical records from paper into the EHR system.

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Evidence reveals that EHRs result in unintentional consequences with patient safety implications. EHR usability challenges may result in ethical issues that may need ethical decision-making models to guide health providers on the appropriate actions to promote safe, effective patient care (McBride et al., 2018). The EHR has enhanced portability and accessibility, which raises ethical questions on the ownership of protected health information. Ethical issues may also arise on the health providers’ responsibility to prevent and notify patients of the potential for privacy breaches when using the EHR (McBride et al., 2018). Computer-based breaches on personal health information may result in complex ethical and legal issues on the suitability of the approaches used to address them.

NURS 8210 Meaningful Use Paper
NURS 8210 Meaningful Use Paper

How These Issues Might Present Barriers to Successful Implementation within an Organization

Potential legal, financial, and ethical issues significantly hinder the implementation of meaningful use within a healthcare organization. Legal issues hinder successful, meaningful use implementation since healthcare leaders become concerned about the legal liabilities that EHR implementation may bring to the organization (McBride et al., 2018). The legal fees needed to develop EHR contracts also hinder the successful implementation of meaningful use, especially in small practices (Lite et al., 2020).

Financial issues such as limited resources limit organizations from purchasing the EHR, which is a major barrier to implementing meaningful use. Ethical issues related to patient privacy and data integrity bar organizations from implementing meaningful use due to concerns of failing to uphold the HIPAA rule on maintaining patients’ privacy when using the EHR.

Ways That Health Care Organizations Can Make the Most of Their Electronic Health Record Investments In Light Of Meaningful Use

The Meaningful Use program promotes a safer, more efficient way to deliver healthcare services. Health care organizations can make the most of their EHR in view of meaningful use by using it to foster smooth, accurate data-sharing among the healthcare providers and improved quality of care for all patients (Wani & Malhotra, 2018). Organizations can use the EHR to ensure that the providers have access to complete and accurate information, facilitate the diagnosis of health conditions, and provide the best possible patient care. Besides, they can use the EHR to improve care coordination in the organizations (Wani & Malhotra, 2018). With the EHR, information can be shared instantaneously across care organizations, including hospitals, physician offices, and health systems, resulting in better care coordination.

Organizations can use the EHR to increase their patient engagement. The EHR strengthens the capacity of organizations to receive their medical records electronically and share them securely over the Internet. Health organizations can use it to their benefit to encourage patients to take a more active role in managing their health and their families (Wani & Malhotra, 2018). Organizations can also use the EHR to improve patient safety.

For instance, they can use the EHR to promote fast electronic access to patient information about allergies, conditions, medications, and treatment history, thus significantly reducing the risk of medical errors (Wani & Malhotra, 2018). Lastly, organizations can use the EHR to promote healthier patient populations and communities by capturing vital data about diseases and outcomes and sharing it with other health professionals locally, regionally, and countrywide.

How EHR-Related Meaningful Use Legislation Is Being Implemented In My Organization

Meaningful legislation is being implemented in my organization through interventions consistent with the 13 Core Objectives and 9 Menu Objectives of stage one (CMS, 2017).  Clinicians use computerized provider order entry (CPOE) and clinical decision support (CDS) in making clinical decisions and carry out drug-drug and drug-allergy checks. The organization maintains an updated problem list of current and active diagnoses, an active drug list, and an active medication allergy list for patients.

In addition, we have adopted E-Prescribing for the largest percentage of our patients (CMS, 2017). We also implement meaningful use by documenting patients’ demographics, changes in vital signs, and smoking status for patients 13 years and above. Furthermore, the organization offers patients the capacity to view, download, and transmit their health data online.

The organization further implements meaningful use by conducting a security risk analysis to protect electronic health data. Clinicians also provide patients with clinical summaries for their outpatient visits within three business days. It also submits electronic data to immunization registries and electronic syndromic surveillance data to public health agencies (CMS, 2017).

Besides, we conduct drug formulary checks and create lists of patients by their specific conditions. We also send reminders to patients for their preventive and follow-up care and provide them with patient-specific education resources. Health providers in the organization implement meaningful use by integrating clinical lab-test results, carrying out medication reconciliation, and recording the summary of care for transitions of care.

Conclusion

Legal issues related to meaningful use can be attributed to complex EHR systems, problems with quality, usability, and reliability of the EHR, and electronic documentation. Financial issues include inadequate resources to purchase and maintain the EHR  as well as the transition from paper-based records to EHR. Ethical issues may be related to patient safety and breach of patient privacy. These issues may hinder the successful implementation since organizations become concerned about the legal and ethical liabilities and lack adequate resources to maintain the EHR.

References

Balestra, M. L. (2017). Electronic health records: patient care and ethical and legal implications for nurse practitioners. The Journal for Nurse Practitioners13(2), 105-111. https://doi.org/10.1016/j.nurpra.2016.09.010

Centers for Medicare & Medicaid Services. (2017). Electronic health records (EHR) incentive programs. Eligible Hospital and Critical Access Hospital Meaningful Use Core Measures: Measure6.

Lite, S., Gordon, W. J., & Stern, A. D. (2020). Association of the meaningful use electronic health record incentive program with health information technology venture capital funding. JAMA network open3(3), e201402-e201402. https://doi.org/10.1001/jamanetworkopen.2020.1402

McBride, S., Tietze, M., Robichaux, C., Stokes, L., & Weber, E. (2018). Identifying and addressing ethical issues with the use of electronic health records. Online J Issues Nurs23(1). https://doi.org/10.3912/OJIN.Vol23No01Man05

Wani, D., & Malhotra, M. (2018). Does the meaningful use of electronic health records improve patient outcomes?. Journal of Operations Management60, 1-18. https://doi.org/10.1016/j.jom.2018.06.003

A Sample Answer 2 For the Assignment: NURS 8210 Meaningful Use Paper

Title: NURS 8210 Meaningful Use Paper

Health information and technology use in the provision of healthcare has gained significant popularity and demand in the modern world. Countries such as the US, UK, and Australia are at the forefront in embracing healthcare technologies that have the potentials of improving the efficacy in the provision of care and reducing the costs incurred by the institutions of healthcare. The increased demand for the use of technology in healthcare has seen the adoption of the meaningful use program that aimed at strengthening the use of electronic health records ( Herasevich & Pickering, 2018). The program improves the efficiency and outcomes of the delivery of healthcare services by utilizing technology to make an effective use of provider, consumer, and healthcare institution information.

The origin of the meaningful program can be traced to 2009 when the Health Information Technology for Economics and Clinical Health Act was adopted into the law. The law mandated governments to allocate a significant proportion of their resources to expanding the use of electronic health records. The act was adopted with the hope that it could promote improvement in healthcare efficiency for all the American citizens. The US government recognized that the adoption would face some resistance from the adopters. As a result, it rolled out an incentive program for the healthcare providers and institutions that use certified electronic health records in a meaningful way (Davis & LaCour, 2016). The meaningful use of the system entails ensuring that it promotes safety, quality, and efficiency, eliminates disparities, and enhanced coordination of healthcare services.

            The health information and technology systems that were introduced by the program are varied. They include EMR, EHR, and ePHR. Electronic medical records (EMR) provides a system where repository for clinical data, support for clinical decisions, order entry, applications for clinical documents, and controlled medical vocabulary are stored. Electronic Health Records (EHR) provides a secure system for every person’s encounters with the healthcare institution. Lastly, Personal Health Records provides a system for managing the clients’ health information (Balgrosky, 2019). These systems work together to ensure that health information is stored, organized, interpreted, and is available when needed by its users.

The adoption of the meaningful use program has significant implications to the practice of nursing. It translates into the improvement in the safety and quality of care given to those in need. The improvement is attributed to the reduction of medical errors that predispose the patients to undesired outcomes such as increased hospital stays and worsening in their conditions. The program also implies that nurses have to play an active role in safeguarding the privacy and confidentiality of the information of their clients. Health information systems are vulnerable to cyber-attacks. The vulnerability makes nurses the advocates for the adoption of interventions that prevent data breach in the institution. Lastly, the meaningful use program implies that clinical decision-making among the nurses and other healthcare providers will be improved (Teitelbaum & Wilensky, 2017). The improvement arises from the timely availability of data and easy collaboration among the healthcare providers.

Discussion and Analysis of the Meaningful Use Program

The goals and objectives of the meaningful use program are varied. One of them is to enhance the collaboration between the public as well as clinical healthcare. The collaboration is projected to result in the improvement in quality of care offered to the public due to active stakeholder engagement (Daim, 2019). The other goal of the program is to improve the provision of patient-centered care that prevents health problems and promote health. The use of health information technologies eliminates any possible adverse outcomes due to medical errors. It also increases the effectiveness of clinical follow-up of cases (Slight et al., 2015). Consequently, it is believed that continued use of the health information systems will enhance the provision of patient-centric care to those in need.

The other aim of the meaningful use program is to ensure the protection of the patient information. Institutions of healthcare are required to utilize certified health information systems that safeguard the private and confidential data of their clients. They are needed to adopt sophisticate physical, technical, and administrative safeguards that offer strict access to patients’ data. Healthcare institutions achieve this outcome by encrypting electronic information of their patients. They can also ensure that strict check systems are utilized before healthcare providers access the information they need (Piliouras et al., 2016). Therefore, protection of patient information is important in increasing the use of health information technologies in healthcare.

The other goal of the meaningful program is to enhance the coordination of care in healthcare institutions. Health information technologies such as electronic health records increase the rate at which clinical decisions are made. It enhances the collaborative efforts between the various stakeholders of the healthcare system. The fact that information is readily available implies that clinical decisions can be made with ease based on the health status of the client. The availability of data also increases the efficiency in which the operations of healthcare organizations are done (Piliouras et al., 2016). Consequently, additional benefits such as improvement in patient engagement, quality of care, and consumer satisfaction are achieved.

The success of the meaningful use program is two-fold. For a majority, the program has been successful due to the increase in healthcare coverage in the state. The incidences of adverse medical events have also reduced. The utilization of healthcare services in the state has also risen due to the efficiency associated with delivery of healthcare services. Some of the scholars also argue that the program has failed. The failure is attributed to the program’s failure to address vital human resource issues affecting the US healthcare system. An example is the acute shortage of healthcare workforce to provide the care needed in the state. The failure is also seen in the significant resistance from the healthcare providers in adopting the program (Adler-Milstein et al., 2015). Despite the above challenges, the program has been effective in reducing the costs incurred by healthcare organizations and the patients. The reduction can be seen in the efficient coordination of care and decision-making in healthcare institutions. Quality of care has also improved due to enhanced safety in the nature of care and accessibility as well as the reduction in medical errors (Holman et al., 2016). Therefore, while there are few challenges with the program, it has been effective in improving the quality of care offered to those in need in the state.

The adoption of the meaningful use program has both strengths as well as weaknesses. One of the strengths is that it focuses on promoting patient-centered case. The program ensures that the healthcare needs of the patients are prioritized. This is irrespective of the affordability of care since healthcare institutions are expected to provide quality care with low costs. The program also places more emphasis on the safety of care through collaboration and reduction of adverse events in healthcare. The other strength of the program is that it improves the operations of healthcare systems. Health information technologies allow institutions of healthcare to utilize the big data analytics. The outcome of this access is an improvement in the efficiency in which activities are run in health organizations (Holman et al., 2016).

The information exchange also provides healthcare institutions with insights on the ways in which quality healthcare could be improved further. The last strength of the meaningful use program is its focus on clinical and societal outcomes. The program has been shown to drive clinical outcomes that include averted and increased revenues for institutions of healthcare. Other institutional benefits include improved compliance with legal requirements, increased satisfaction among healthcare providers, and utilization of evidence-based data in clinical practice (Gidwani et al., 2017). The societal focus includes the promotion of the health of the public.

One of the weaknesses of the meaningful use program is its cost of adoption. Healthcare institutions have to invest their resources in acquisition of healthcare technologies that support the program. They also have to train their workforce on the use of the systems in providing healthcare. These activities are costly to healthcare organizations, hence, affecting its use in them. The other weakness of the program is that it increases the risk of loss of productivity in an institution of healthcare. The decline could be attributed to staff dissatisfaction with the changes and resistance to the adoption of the system from them (Gidwani et al., 2017). Despite these weaknesses, meaningful use program has been effective in transforming the healthcare system in the US.

Core Requirements

Three progressive stages were developed as guidelines of the incentive payments for meaningful use of electronic health records. All eligible professionals are required to meet at least 15 core objectives as well as 5 additional objectives from the menu set in the first stage. The objectives include e-prescription, use of computerized physician order entry, and implementation of clinical decision support rule among others.  Of the core objectives, the most important ones for this research are using drug-to-drug and checks on drug allergy interaction and recording vital signs. Healthcare providers including nurses, doctors, and pharmacists can use the electronic health records to check the prescribed drugs for drug interactions and contraindications. They also use it to confirm the drug dosage and signs of possible adverse reactions to them.

Through it, patient safety is protected through the elimination of adverse outcomes. The healthcare providers also make informed decisions that influence the patients’ recovery processes. There is also active collaboration among the healthcare providers on determining the appropriate management of the patients. The data on adverse events and immunizations can also be kept in the registry. Consequently, it promotes the health of the public. Healthcare providers can also use the electronic health system to monitor vital signs (Dewan, Luo & Lorenzi, 2015). The use of the systems allow for the detection of the abnormal findings that demand immediate response from the healthcare teams.

The second stage of meaningful use program was implemented in 2014. The mandate requires institutions of healthcare and healthcare professionals to build on their existing functionalities and achieve additional advanced capabilities such as securing online access for patients. The objectives in this stage include implementing formulary checks, using clinical lab test in structured data, and send reminders used for follow up and preventive care. The most important objectives in this stage are implementing formulary checks and recording patient notes electronically. The healthcare providers should be able to perform regular checks on the systems to ensure that they align with their practice. They should be able to record patient’s data in electronic formats to enhance efficiency in their operations. Through it, the quality of care will improve due to efficiency in decision-making. There will also be a reduction in the duplication of duties in the institution (Dewan et al., 2015). The third phase of the implementation of the meaningful use program was in 2016. The aim was to improve on safety, quality, population health metrics, and cost efficiency of health operations.

Challenges and Recommendations

The adoption of meaningful use program is faced with significant challenges. One of them is resistance to its adoption among healthcare providers. Some of the healthcare providers are not ready to embrace technological changes in healthcare. The resistance could be due to reasons such as fear of the unknown or lack of knowledge on the expected benefits of the change. Therefore, it is important that interventions that aim at improving their level of awareness are embraced (Holman et al., 2016). This includes training them on the use of healthcare technologies, as a way of minimizing resistance among them.

The other challenge in the adoption of meaningful use program is the high costs associated with the process. The adoption of healthcare technologies is an expensive venture for healthcare institutions. They have to spend their resources in acquiring and maintaining the systems alongside training their staffs on the use of the technologies (Holman et al., 2016). The high cost hinders the adoption of the program in most institutions. This challenge can be addressed by subsidizing the costs associated with the adoption process. User-friendly systems that do not require intensive training of the staffs could be developed. The systems should also not have regular maintenance, which might be expensive for health organizations.

The last challenge associated with meaningful use program is the rise in data privacy and confidentiality issues. The use of electronic health records to store patient data exposes them to breach by unauthorized parties. As a result, it raises concerns on how safe the individual data is protected by healthcare institutions. However, the challenge can be addressed by procuring highly effective and efficient systems that protect the data of the clients. The access should be restricted to only authorized persons and most of the commands encrypted.

Conclusion

In summary, meaningful use program has shaped the nature of healthcare offered to the US citizens significantly. It has contributed to the improvement in safety, efficiency, and coordination of care. It has also led to a reduction in costs of healthcare alongside an improvement in the health of the public. Some of the strengths of the program include its focus on patients, promotion of data privacy, and its focus on clinical and societal benefits. However, its adoption faces challenges such as the high costs of setup, resistance from the staffs, and increased vulnerability of the clients’ data. Therefore, a focus should be placed on exploring opportunities associated with the program while minimizing the factors contributing to the identified weaknesses.

References

Adler-Milstein, J., DesRoches, C. M., Kralovec, P., Foster, G., Worzala, C., Charles, D., … & Jha, A. K. (2015). Electronic health record adoption in US hospitals: progress continues, but challenges persist. Health affairs34(12), 2174-2180.

BALGROSKY, J. (2019). Understanding health information systems for the health professions. Place of publication not identified: JONES & BARTLETT LEARNING

Daim, T. U. (2019). R&D management in the knowledge era: Challenges of emerging technologies. Cham: Springer.

Davis, N. A., & LaCour, M. (2016). Foundations of Health Information Management – E-Book. Philadelphia, PA:Saunders.

Dewan, N. A., Luo, J. S., & Lorenzi, N. M. (2015). Mental health practice in a digital world: A clinicians guide. Cham: Springer.

Gidwani, R., Nguyen, C., Kofoed, A., Carragee, C., Rydel, T., Nelligan, I., … & Lin, S. (2017). Impact of scribes on physician satisfaction, patient satisfaction, and charting efficiency: a randomized controlled trial. The Annals of Family Medicine15(5), 427-433.

Herasevich, V., & Pickering, B. W. (2018). Health information technology evaluation handbook. Boca Raton, FL:  CRC Press/Taylor & Francis Group.

Holman, G. T., Waldren, S. E., Rivera, A. J., & Dardick, L. D. (2016, June). Using challenges associated meaningful-use criteria to prioritize needed changes in electronic health records. In Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care (Vol. 5, No. 1, pp. 55-60). Sage India: New Delhi, India: SAGE Publications.

Piliouras, T., Yu, P. L., Salloum, L., Chavez, J., Suss, R. J., Cheung, Y. T., & Su, W. (2016, April). Impacts of meaningful use and what’s next: The Next Generation Accountable Care Organization model. In 2016 IEEE Long Island Systems, Applications and Technology Conference (LISAT) (pp. 1-6). IEEE.

Slight, S. P., Berner, E. S., Galanter, W., Huff, S., Lambert, B. L., Lannon, C., … & Payne, T. H. (2015). Meaningful use of electronic health records: experiences from the field and future opportunities. JMIR medical informatics3(3), e30.

Teitelbaum, J. B., & Wilensky, S. E. (2017). Essentials of health policy and law: Includes the 2018 annual health reform update. Burlington, MA: Jones & Bartlett Learning.