Meaningful Use of Health Information Technology in a Primary Care Practice
Kristin Rinn
University of Colorado Denver School of Nursing
Leaders in health care have two fundamental goals. The first is to provide high quality, evidence based patient care. The second is to be active engagers in the transformation of the health care delivery system. The ability to measure the quality of patient care efficiency and accurately to make the right decisions for the patient is the inherent goal of the use of the electronic health record (EHR). The EHR is currently underutilized in the United States, although the use has been progressively increasing over the last decade. Between 2009 and 2010, the percentage of office based physicians
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This includes assessment of organizational motivation, awareness, and support, a needs assessment (how EHR technology can meet clinic needs by improving efficiency and improving patient care), and an assessment of existing barriers to change and technology adoption. The organizational environment is crucial to adoption and implementation of meaningful use. We must understand and help support staff understand how implementation of meaningful use fits with clinic goals and patient care goals. (Ford, 2010). This includes selecting an EHR that is usable and meets the needs of the clinic. Usability is one of the major factors hindering widespread adoption of EMRs. Usability has a strong, often direct relationship with clinical productivity, error rate, user fatigue, and user satisfaction–critical factors for EMR adoption. Clinicians lose productivity during the training days and for months afterward as they adapt to new tools and workflow. Adoption rates by physicians and hospitals have been slower than expected in the US, in part, due to poor efficiency and usability. A “usable” EMR, complemented with effective training and implementation methods, will have a positive impact on user adoption rates (Kibbe, 2010). Our first step as providers is to evaluate a variety of vendors carrying certified EHRs for usability and select one that is most suitable for our practice. The concepts that we can use for evaluation of EHRs are 1) How much reading is
In regards to technology and how its influences healthcare today we see the use of EHRs, which allows for a high capacity healthcare environment by condensing patient information into an easily accessible form for all healthcare professionals. “EHRs allow us to collect meaningful data to determine the efficacy in which our units are functioning” (Biddle & Milstead 2016, p.12). This technology can help manage the high capacity hospital environment while not compromising quality. This
The adoption of EHR has been slower than expected (Gans 1323). With numerous systems available, it is particularly difficult for a smaller practice to identify which system best meets its needs. Other notable challenges for some practices include assumption of the capital investment as well as managerial responsibilities associated with the IT infrastructure. A common implementation challenge encountered is the lack of a universal vision and definition of EHR. Since there are multiple interpretations of the definition of EHR and attendant requirements, identifying current and future needs is a complex process for potential users. Short term limited ability systems will eventually become obsolete as there is a move toward more global EHR systems. On June 18,
Electronic health records (EHR) are health records that are generated by health care professionals when a patient is seen at a medical facility such as a hospital, mental health clinic, or pharmacy. The EHR contains the same information as paper based medical records like demographics, medical complaints and prescriptions. There are so many more benefits to the EHR than paper based medical records. Accuracy of diagnosis, quality and convenience of patient care, and patient participation are a few examples of the
Hence, EHR 's are inherently complex amalgamations of diverse subsystems targeted toward varied users. The stakeholders are the users and must have a role in implementing any IT or EHR system into its work flow. An EHR can be customized to accommodate any environment depending on the level of expertise of the vendor and how long they have been in the business of creating an optimum system that 's customized to fit the organizations needs. For the most part, EHR 's must be designed for efficient, error free use. Ideally, an EHR is a system that encompass all the subsystems that make a hospital meet "meaningful use" criteria to acquire incentives for adopting EHR into practice. In the next five years, EHR adoption will no longer be a luxury, it will be a "MUST". EHR 's and other health information technology will be a necessity to practice medicine (econsultant.com, 2010). Rather than purchase several standalone systems, it would behoove one , in my opinion , to purchase an EHR that would satisfy all the needs of the stakeholders, the physician , nurses and other hospital staff and all parties involved in the tertiary practice too. Although LWMS 's budget is not large enough to accommodate the full cost of implementing an EHR,
In the recent years, EHR implementation has been one of the biggest change that occurred in the health care delivery system. The adoption of EHR system which aims to improve the quality of healthcare, however, has met a lot of issues and barriers that are detrimental to its success. Thus, for any healthcare organization to achieve a favorable outcome after the EHR implementation, numerous factors have to be examined. Merrill (2010) has listed down the top ten factors for a successful EHR adoption. It includes right leadership, shared vision, right culture, governance, physicians, nurses and key stakeholders are engaged early and accountable to lead the clinical transformation, resources, clinical content standardization, realistic timelines and expectations, effective training and communication plan, and right vendor partnership relationship.
EHRs can positively influence workplace efficiency and communication and improve productivity with better access to and organization of patient data (McGinn, et al., 2011). EHRs can improve operational efficiency by providing the capability of sharing of information within the practice. Additionally, health information can be shared with external health care organizations provided the proper interoperability infrastructure is in place. Physicians can access patient information anytime and anywhere the system is enabled, enhancing patient safety as well as quality and continuity of care, particularly for physicians on call or working at multiple sites. They also can have access to drug recalls or other alerts provided through the EHR.
In efforts to reform the United States healthcare system and create a nationally unified data exchange system the federal government has established an incentive program to eligible professionals and hospitals. The federal government has turned to certified electronic health record (EHR) technology to help facilitate the process of broadening health IT infrastructures. The federal government views EHR system used in meaningful ways as the key to reforming the healthcare systems. Meaningful use of the EHR systems can also improve the overall quality of healthcare, insure patient safety, as well as reduce the cost of healthcare to individuals (Bigalke & Morris, 2010, p. 116).
Over the previous eight years, there has been a significant investment of private and public funds to upsurge the adoption of Electronic health records (EHRs) across the nation. The extensive adoption and “meaningful use” of electronic health records is a national priority. EHRs come in various forms and can be utilized in distinct organizations, as interoperating systems in allied health care units, on a regional level, or nationwide. The benefit of utilizing an EHR depends heavily on provider’s uptake on technology. Benefits related to electronic health records are numerous and may have clinical, organizational and societal outcomes. However, challenges in implementing electronic health records has attained some attention, the implementation
I spoke with the Director of Informatics, Dorothy Vanderweil, to learn how our hospital addressed the implementation of an EHR. Dorothy was able to tell me how they assessed readiness, planned their approach, selected a certified EHR, and conducted training and implementation of the EHR. HMC assessed the specific flow of each department. At the start, they discovered there were individual needs for each department. They then assessed which departments could consolidate to share work flow. They evaluated the need for training of individuals and found many staff could barely use a mouse. HMC determined which devices would best suited when documenting in the EHR, along with how many devices were needed. The planning then began and the decision was made to use the C5 tablet for documenting. Of course, they needed to know the cost involved with the procurement of these devices. Decisions were made as to how and what they wanted to be able to view and chart. Since they were moving from paper charting there was no data integration to be concerned about. They formulated a plan for training including the adoption of super users for extra support during the first few months of going live. They selected Cerner as the EHR system to implement. Once all staff were trained and physicians as well, a decision was made to go live. By January 2010 HMC was ready and implemented the EHR certified system Cerner. Go live was very well planned with extra staff
Use of EHR (electronic health records) in United States has increased in past years and have gained widespread use in the country. The use of EHR-Electronic Health Records or EMR-Electronic Medical Records and the systems that support them have gained standardized collection of health information and data for patient and healthcare providers. Because of these technologies, healthcare providers now have information about their patients at their fingertips, which has led to better and more accurate care. There are debates on using EHR. According to Mushtaq (2015), one of the most common debate is the use of EHR compliance and the value of these technologies that surround them (Mushtaq, 2015). Providers wonder if EHR use is useful and what is to be gained for the HCP-Healthcare provider. In regards to such debates and ongoing conversations, it is important to understand the definition of meaningful use and whether these technologies have resulted in meaningful use. According to Burchell (2016), The government developed the HITECH (Health Information Technology for Economic and Clinical Health) Act of 2009, which incorporates the meaningful use program (Burchell, 2016). The program has goals that tell us how to use the meaningful use with EMR or EHR. It helps HCP and organizations alike attain, use and keep goals like patient and clinical outcomes, individual patient autonomy, and increased transparency for providers. When these goals are attained and kept it will greatly
The cons of an EHR are part of the driving force behind the model restricted from the need to integrate EHRs throughout the health system and share information with network of referring hospitals. However, this sharing of information is often not possible (EHR,2013). Finding a hospital partner that is willing to open the lines of communication is critical to the success. The cost associated with EHRs is often a deterrent. Not only must the provider pay for the physical hardware and/or software, the organization must also put forth a considerable dollar amount for setup, maintenance, training, IT support and system updates (EHR,2013). With EHRs, much more documentation is required of physicians before, during and after a patient visit. This has its pros and cons. For example, a benefit of more strong documentation is that it provides additional information for the coders that may justify a higher level of service being billed(EHR,2013).
In 2004 president George Busch announced the goal to mandate electronic health records for every American by 2014. This would require every paper chart to be converted to electronic chart so that health care providers and the patient themselves can access their information through the internet (Simborg, 2011). The purpose of developing the EHR is to provide appropriate patient information from any location. Also to improve health care quality and the coordination of care among hospital staff. To reduce medical error, cost and advance medical care. Last to ensure patient health information is secure (DeSalvo, 2014) The Department of Health and Human Services appointed the Office of the National Coordinator for Health
Therefore, several authors share some of the same ideas as to what some of the barriers faced during the transition to Electronic Health Records (EHRs) and if these barriers still exist once the transition to a full EHR system is complete. Herrick, et al., 2010, states that currently, there is no hard-core evidence to support the argument that Electronic Health Record (EHRs) and Health Information Technology is the best route for health organizations to prevent errors. In fact, the use of such technology could potentially lead to errors if information incorrectly entered in the system and Haupt, 2011, statement that smart software could help to prevent life-threatening errors better when administering medicines. Whereas, Boonstra & Broekhuis, 2010, states from a physician point a view need the understanding of the possible barriers that faced during implementation of EHRs because there a tremendous amount of literature on the obstacles but no suggestion on how to resolve these barriers have not been viewed. Barriers such as, financial on great startup and ongoing cost, technical and time to train staff and how much knowledge do they have with computer skills and psychological when support needed from vendors, etc. It suggests that once those barriers have been ironed out and a plan has set in place, then the transition from paper documentation to Electronic Health Records (EHRs) may go a lot easier for the healthcare arena physician, nurses and administrative
The EHR article explains the progress and the adaption of rates of EHR systems over the years. The article states there has been a slow participation in the EHR incentive program, but there has been a shown continue increase in implementation in provider settings of EHR in 2014. As for Physician and Hospital, there has not been a fast implementation. Many of these facilities are at only stage one of the meaningful use in 2014 about one out of five hospitals and only 38% of hospitals is at the second stage of meaningful use. There have been gains in the implementation of new EHR systems in 2014 there was a 75% adoption rate in 2014 compared to 61% in 2013 for hospitals and for physicians 62% plan to participate in the EHR
Electronic health records (EHR’s) have many advantages, but there are plenty of disadvantages. EHR’s were created to manage the many aspects of healthcare information. Medical professionals use them daily and most would feel lost without it. Healthcare organizations were encouraged to adopt EHR’s in 2009 due to the fact that a bill passed known as The Health Information Technology for Economic and Clinical Health Act (HITECH Act). “The HITECH Act outlines criteria to achieve “meaningful use” of certified electronic records. These criteria must be met in order for providers to receive financial incentives to promote adoption of EHRs as an integral part of their daily practice”, (Conrad, Hanson, Hasenau & Stocker-Schneider, 2012).