Articles
Introduction
Following the continued development in technology, hospitals have also embarked on improving their technology and have fully appreciated the developments and have embraced them fully from keeping of documents to performing major operations. This paper exclusively covers the technology of record keeping that involves the use of Meaningful Use program. It has remarkably facilitated the normal running of events in a hospital set up and has in a great way reduced paperwork. It has also made the services to the sick to be rendered in a very efficient way since information concerning the patients can be transferred from a point to the other very fast. Patients should no longer line up in the labs waiting for lab reports. Every detail concerning them is transferred via this program. It has also made it easier to keep data concerning all the patients safely. This has also contributed to patients receiving the rightful medication. This paper, therefore, gives an overview of what this program (Meaningful Use) is all about. It also focuses on the various implications this program has had on the nurses, nursing, national health policy, patient outcomes and population health. It also recommends additional co criteria that have not been presently identified in Meaningful Use collection of stages one or two
An overview of meaningful use program
Meaningful Use is a technology that is tailored to reduce paperwork in hospitals. Eligible Professionals (EPs) and hospitals in the world need to demonstrate meaningful use of electronic health records for them to qualify for incentive payments under the Medicare EHR incentive program administered by the Center for Medicare and Medicaid services (CMS). The meaningful use involves the certified use of Electronic Health Records (EHRs) technology to perform a variety of functions in a hospital set-up (Sparber, 2003).Key amongst these is:
- To ensure safety, efficiency, to improve quality and reduce health disparities.
- It is also done to involve patients and families in their health care.
- To improve population and public health
- To improve care and coordination
While all along
- To ensure safety, efficiency, to improve quality and reduce health disparities.
- It is also done to involve patients and families in their health care.
- To improve population and public health
- To improve care and coordination
- maintaining privacy and security of data
This is a program that is mandated by the government to receive incentives from the Medicare EHR incentive program to facilitate all hospital have this program to move on with their normal operations effectively
This program usually consists mainly of main tree components as discussed below
- Use of EHR in a meaningful manner for example doing an e-prescribing.
- Use of EHR technology to perform duties such as submitting Clinical Quality Measures(CQM) and another measure of such a kind selected by the secretaries
Use of certified EHR technology for electronic exchange of health information to improve heath care
The program consists of three stages based on its development and enhancements to meet the general need of most hospitals and Eligible Professions (EPs):
- Use of EHR in a meaningful manner for example doing an e-prescribing.
- Use of EHR technology to perform duties such as submitting Clinical Quality Measures(CQM) and another measure of such a kind selected by the secretaries
Stage 1- This period was generally between 2011 and 2012. It was meant for data capture and sharing. This meaningful use criteria mainly focuses on the following:
- Use of EHR in a meaningful manner for example doing an e-prescribing.
- Use of EHR technology to perform duties such as submitting Clinical Quality Measures(CQM) and another measure of such a kind selected by the secretaries
- Electronically capturing health information in a standardized way.
- Using that information to track key clinical records
- Communicating that information for care coordination in the processes
- Initiating the reporting of clinical quality measures and public health information
- Using the information to involve patients and family members in their care
Stage2- The period was generally in the year 2014. This meaningful use criteria focuses on advancing clinical processes in the following ways:
- More rigorous health information exchange (HIE)
- Increased requirement for e-prescribing and incorporating lab results
- Electronic transmission of patient care summaries across multiple setting
- More patient-controlled data.
Stage 3- It is the latest and is mainly focused for 2016.This meaningful use criteria mainly focused on improving outcomes through:
- Improving the quality, safety, and efficiency leading to improved health outcomes.
- Decision support for the national high- priority condition.
- Patient access to self-management tools
- Access to patient information through patient-centered Health Information Exchange(HIE)
An analysis of the implications of Meaningful Use on core Criteria
T
his technology has many positive effects on patients will no longer have to fill endless forms any time they go for medication since information relating to them will be readily available in the hospital system and can easily be sent from ne hospital to the other irrespective of the distance (In Goudreau & In Smolenski, 2014). The histories of children who have no parents to tell about their birth will no longer have problems with information relating to them will be available. Also, patients will no longer have to take endless lab tests since the information required is not readily available. The main problem is how this will take place. The main thing that all nurses have got to do is to just keep them with up to date information on how their firm is embracing this new EHR technology so that they can ensure that their voice is heard in the progress and be involved in making a decision.
The nurse should be actively involved in the development of EHRs and also dealing with the implications for such a practice. For example, health details will rely on the observation made by the nurse. It will be done through electronic recording vital signs. Most of this information will be true and of great quality being a reporting requirement from the beginning of 2012. This will rely on nursing documentation.
Most of the activities that require physicians to do them especially things to do with documentation flow to the nurses. For example he/she may be required to order for some medicine using a fully enabled Computer Provider Order Entry (CPOE) system. It is capable of checking the allergy interactions, with the drug and maintains problem medication and maintains program medication and allergy list among others. Nurses will have to speak up to ensure that care is being safe and efficient. Nurses should volunteer to serve the implementation team. They need to raise their voices so that they can be heard, so they are the ones who will ensure that it works for the patients and them. In an attempt to encourage and promote the widespread use of HER, most governments have decided to give incentives to hospitals that have already decided to adopt HER. For example in America, the Congress passed The Healthcare technology for the for economic and clinical health.(HITECH) Act as part of the American Recovery and Reinvestment Act of 2009.The legislation included the financial incentives inform of payment of bonus aimed at achieving extensive adoption by HER
For hospital and providers to qualify for they must meet the EHRs objective
They must maintain at least 80% of the patients’ record in a certified EHR system. Providers therefore have to meet at least 20% Meaningful objective which is also inclusive of all the abilities to prescribe the medication electronically and ability to extract copies of their record (Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine., Robert Wood Johnson Foundation., & Institute of Medicine, 2011). That hospital must then meet the meaningful objectives that include system capabilities such as computerized order entry for a physician.
The health information technology for economic and clinical health (HITECH) act of 2009 established a Medicare and Medicaid incentive program that would encourage the adoption of EHRs by hospitals and eligible professionals. Important to note that key action for the meaningful use of certified HER including the drug-drug allergy, drug allergy, medication, and allergy are some of the requirement for proper use of stage one (Shi, Upadhyaya & Erdem, 2012). After fulfilling the fifteen core objectives and having chosen five from additional specified objective the menu bar of ten then the user has meaningfully used the stage however advancements are being made to ensure that there is improvement in care, processing, and patient outcomes.
Patient outcomes are usually the best the HER are used in the very best way. However, there are some factors that can lead to poor patient outcomes, for example, workflow challenges, lack of knowledge, and lack of interoperability cost. All other successful stages of Meaningful Use become more difficult as you climb the ladder. It is not clear about how many eligible professions will move to the later stages. The real effects of the use of meaningful use are the quality, efficiency, and safety. The adoption rate for HER increases functionality. For clinical decision making, support systems and research are needed to ensure effectiveness and efficiency of this program.
Meaningful Use has actually impacted on the population/public health key amongst them is through providing electronic syndromic surveillance data to the public health agencies hospitals can now be able to access all the data they need concerning anything with ease as compared to days earlier. It has also provided an electronic submission of reportable lab results to the public health agencies which have helped to save so many lives and time as well since patient movement in the hospital is in away reduced. Finally, Meaningful use has helped to submit data to the immunization registry or systems. It has helped to reduce significantly paperwork
Conclusion
Having looked at the various aspects of the Meaningful Use core criteria and the important role that this aspect is playing in the hospital set up, it is important for me to recommend the various core criteria that have been left out in the stages 1 and 2 of the program and these include:
- Improving the quality, safety, and efficiency leading to improved health outcomes.
- Decision support for the national high- priority condition.
- Patient access to self-management tools
- Access to patient information through patient cantered Health Information Exchange(HIE)
These are the functions that the Meaningful use technology is going to be playing with completion shortly. It is important that we all appreciate the importance of EHRs
References
Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine., Robert Wood Johnson Foundation., & Institute of Medicine (U.S.). (2011).
The future of nursing: Leading change, advancing health. Washington, D.C: National Academies Press. In Goudreau, K. A., & In Smolenski, M. C. (2014).
Health Policy and Advanced Practice Nursing: Impact and Implications. Shi, J., Upadhyaya, S., & Erdem, E. (January 01, 2012).
Health Information Exchange for Improving the Efficiency and Quality of Healthcare Delivery. Sparber, A. (January 01, 2003).
Complementary therapy in critical care settings: a review of surveys and implications for nurses. Critical Care Nursing Clinics of North America, 15, 3, 305-12.
