Meaningful Use Concept in Healthcare - Essay Example

? Meaningful Use concept Healthcare reform is no doubt becoming a reality very soon considering that it is the biggest priority of not only the current government but also diverse players in the healthcare sector. The introduction of automated patient record is one of the major components and priority agenda of the foresighted healthcare reforms considering its varied benefits to healthcare delivery and players in the industry (Flanders, 2010). However, the benefits of the Electronic Health Record (EHR) cannot be realized without proper utilization thus the introduction of the “Meaningful Use” to standardize use of certified EHR. The concept of “Meaningful use” is one of the requisite requirements for adopted EHR as per the desire of Centers for Medicare and Medicaid Services (CMS). Meaningful use refers to the application of certified EHR technology in attaining specific healthcare objectives. Meaningful use is centered along the roles of healthcares professions and hospitals with respect to the adoption and implementation of EHR technology in their respective practice (CDC, 2013). This claim can be justified by the guidelines of the EHR incentive program, which requires medical professionals and hospitals to demonstrate that their chosen certified EHR has met specific health outcomes priorities. The concept of meaningful use is based on a number of vital health outcome priorities which include but not limited to improved population and public health; enhanced privacy and security of patient medical information; superior quality, efficiency, safety and minimized health disparities; enhanced care coordination; and increased engagement of patients and their families in the care (“Policymaking, Regulation”, 2012). This means that eligible medical professions and hospitals must ensure that their certified EHR meets the above results before they get CMS inventive payment. The healthcare outcomes will be used as the criteria for establishing effective use of the deployed health IT tools by healthcare providers. According to the CMS incentive program eligible medical professionals, hospitals and critical access hospitals (CAHs) will receive up to $44,000 over 5 years and up to $63,750 over 6 years through the Medicare and Medicaid EHR incentive program respectively (CDC, 2013). It is noteworthy that CMS inventive program is voluntary, but negative consequences especially financial ones have been put in place for medical providers who fail to join the program by 2015. The concept of Meaningful Use was first introduced during the Obama administration though enactment and final signing of the American Recovery and Reinvestment Act (ARRA) of 2009 into law (Flanders, 2010). The ARRA through a number of measures particularly the "Health Information Technology for Economic and Clinical Health (HITECH) Act" has witnessed improved national healthcare IT infrastructure. The HITECH proposed the concept of meaningful use of the EHR through the country’s healthcare delivery system as a vital national goals and it remains to be the critical focus for legislative, financial and ethical concern for hospitals and professional in the healthcare sector (“Policymaking, Regulation”, 2012). The initiative for automating medical records is facilitated by the Office of the National Coordinator for Health IT (ONC) in conjunction with Centers for Medicare & Medicaid Services (CMS) after the current administration realized that IT infrastructure is impetus for addressing longstanding healthcare challenges which range from escalating healthcare costs, low quality and safety, as well as high wastage (CDC, 2013). Meaningful Use has been divided into phases in order to encourage gradual widespread EHR adoption and implementation universally besides relieving excessive burden on medical care providers. The first phase which covers 2011 involves aspects of data capture and sharing; the second face, which involves advanced clinical processes elements covers up to 2013 while the final phase involves issues related to improved outcomes and it goes up to 2015. Nurse practitioners are classified as eligible professionals under the Medicare EHR incentive Program. This is a clear justification that the ethical, legal and financial issues related to the Meaningful Use of EHR bind nurse practitioners. As it stands, demonstrating meaningful use with respect to adoption, implementation or upgrade of certified EHR technology would be a mandatory requirement in the next two years by all professionals and hospital under both Medicare and Medicaid incentive program (Flanders, 2010). This is as per the requirements of Health Information Technology for Economic and Clinical Health Act, Center for Medicare and Medicare Services and the Office of the National Coordinator for Health Information Technology, which stipulate penalties for those healthcare providers that shall have failed to adopt and demonstrate meaningful use of EHR by 2015. This means that there is a legal requirement for compliance with HITECH Act of 2009, thus raising the first major legal issues surrounding Meaningful use. Nurses having been covered by the Act mean that they must meet the specified objectives and regulations set under the CMS incentive program in order to avoid penalties. Meaningful use dictates that by a certain time (2015) all eligible medical professions should be using EHR to capture, store, share and retrieve patients records. This mandatory demonstration of meaningful use of EHR raises many ethical concerns beginning with breach of privacy and confidentiality, autonomy and injustice (Layman, 2008). Privacy and security issue is one of the biggest concerns associated with meaningful use of EHR that bothers healthcare leaders, policy makers and personnel. Breach of privacy is not only a concern in EHR but also the paper-based records considering that it is often orchestrated in a calculated manner. Privacy breach can take place in a number of ways, which may range authorized users accessing unauthorized patient data to unauthorized users in particular hackers gaining access to the hospital system. This means that healthcare providers are faced with a double threat to the privacy of patient’s medical records that threat from within and outside the organization. Breach of confidentiality when it comes to patient records is another major ethical issue is likely to arise because of meaningful use (Patterson, 2006). One of the core requirements of policy makers especially the Centers for Medicare & Medicaid Services and the National Coordinator for Health IT (ONC) as per the definition of meaningful EHR use for eligible professional is to ensure increased information exchange of medical data between providers and organizations. In other words, medical policymakers want to increasing sharing of patient clinical data between medical practitioners and there is no doubt that in the event of sharing such information during care will breach the patient confidentiality. A lot of information about patients’ medical history and present condition is captured in the EHR and this confidential information may lose criteria set for confidentiality when it exchanged between organization and professionals. It is noteworthy that professionals stand a high chance of breaching the principle of autonomy, which is one of the fundamental ethical requirements when dealing with a client. According to Layman (2008), most medical professionals and organizations are likely to overlook patients’ autonomy by sharing medical records without soliciting for clients’ consent thus breaching patients’ autonomy. There is also likelihood of breaching the principle of justice through meaningful EHR use. Most patients come from diverse educational background whereby certain class of patients may not understand matters concerning digital healthcare systems thus denying them equal access to healthcare with those who understand the system better. Notable financial issues that may arise with meaningful EHR use legislation relates to the adoption and maintenance of the digital healthcare platform. The cost of building an effective electronic health record is considered by many healthcare leaders to be the main reason behind slow adoption of the EHR systems in the country. Most of healthcare providers and professionals do not have adequate cash to meet the cost of setting up certified EHR that would meet the meaningful use objectives set by the CMS. Setting up an EHR is largely a capital venture whose financial returns cannot be gained within a short period. Another major financial issue relating to meaningful EHR use involves maintenance cost (Patterson, 2006). Taking into consideration the rate of technological advancement especially in respect to software development maintenance of the EHR becomes an imperative component of the systems life. The hospitals and medical professionals will be forced to upgrade their EHR systems to meet new technological development and address mushrooming digital challenges in order to maintain meaningful EHR use. References Centers for Disease Control and Prevention (CDC). (2013). Introduction. Retrieved May 10, 2013 from: http://www.cdc.gov/ehrmeaningfuluse/introduction.html Flanders, A. (2010). The Real “Meaning” behind Meaningful Use. Retrieved May 10, 2013 from: http://radiographics.rsna.org/content/30/5/1329.full Layman, J. (2008). Ethical issues and the electronic health record. US National Library of Health, 27(2): pp 165-76. Patterson, D. (2006). Towards an interoperable healthcare information infrastructure -- working from the bottom up. BT Technology Journal, 24(3), 17-17. Policymaking, Regulation, & Strategy: Meaningful Use. Retrieved May 10, 2013 from: http://www.healthit.gov/policy-researchers-implementers/meaningful-use Read More