The federal Health Information Technology for Economic and Clinical Health Act (HITECH) was enacted in 2009 as part of the American Recovery and Reinvestment Act (ARRA) (Gialanella 2012). The purpose of the ARRA was to stimulate the economy and improve health care (Gialanella 2012). As a result health information technology policies and standards privacy and security and meaningful use were developed to meet the requirements to protect patient health information and receive financial incentives tied to reimbursement initiatives (Gialanella 2012).
HITECH Impact on my Organization
My facility recently implemented computerized physician order entry (CPOE) as a result of the new legislation. The for-profit facility is part of the Hospital Corporation of America (HCA) the largest provider of health services in America. The implementation of a large computer system or any business or clinically associated improvement is enacted throughout all organizations and most hospitals are not given a choice regarding which technology to implement. As a result all facilities utilize the same computer systems. Although this is considered a wise business strategy due to cost benefits and improved patient care coordination most organizations would rather have input regarding decisions that affect clinicians and workflow processes.
The implementation of CPOE had a positive impact on the organization because it helped to meet compliance regulations associated with reimbursement but it was not met with enthusiasm by clinicians. I am not sure that my facility would have chosen to implement the technology if it were not related to long-term financial incentives and reimbursement. The act essentially forced one of the largest providers of health care to implement the computer system and comply with meaningful use criteria. As a for-profit organization HCA values the profit margins it generates and although it strives to ensure high-quality care meeting financial goals across hospital divisions is equally as important to stakeholders. My facility is an excellent example of how the legislation forced facilities to start to comply with the requirements and mandated the necessary infrastructure to support the proper use to obtain meaningful data.
Address how its related incentives influence the adoption of health information technology in health care and impact the quality of patient care
How Incentives Influence Adoption of Health Information Technology
The HITECH provision was created to provide financial incentives for hospitals to implement necessary tools to provide meaningful information and care coordination across providers (Murphy 2010). Five initiatives meet meaningful use criteria:
1. Improve quality safety and efficiency and reduce health disparities.
2. Engage patients and families.
3. Improve care coordination.
4. Improve population and public health.
5. Ensure adequate privacy and security protections for personal health information (Murphy 2010).
The federal government allocated $19 billion to incentivize providers to implement electronic health records (EHR) (Murphy 2012). According to Brown (2010) the final ruling surrounding meaningful use has three stages and criteria associated core requirements. There are 14 eligibility core requirements for hospitals to meet and 15 core requirements for healthcare providers (Brown 2010). Ten additional objectives are required and both hospitals and providers must chose five. As long as hospitals/providers meet and submit the measures within the specified year then they will receive the incentive payments (Murphy 2010).
Technology and reporting requirements will have a large impact on patient care are projected to be extensive. Clinical research is perhaps one of the biggest benefits of HIT implementation (Gialanella 2012). Specified quality measures are reported to Medicare and Medicaid and will impact the delivery of care affecting cost and improve quality through tracking data that lead to evidence-based care. The measures will also enhance coordination of patient care among providers to reduce repeat testing and decrease medical errors (Gialanella 2012). Health care reform is focusing on promoting prevention early detection and improved management of chronic diseases through health information technology. Promoting wellness will be enhanced through the use of HIT for early detection of disease states rapid responses to pandemics and identify at risk-patient populations (Gialanella 2012).
Provide a summary of the article you identified and explain how it demonstrates the ability of health information technology to meet the requirements of meaningful use.
Summary of Article and Demonstration of Technology to Meet Meaningful Use
Authors Jones Heaton Friedberg and Schneider (2011) investigated meaningful use as it relates to decreasing hospital mortality in three areas heart attack heart failure and pneumonia by using electronic medication order entry systems. There is uncertainty whether meaningful use standards will improve care reduce errors and improve patient safety. Evaluating the benefit of electronic order entry is sought to provide data to support the assertion (Jones et al. 2011). Stage one meaningful use requires facilities to use computer order entry systems for approximately 30% of patients to be eligible for reimbursement. The percentage of use requirements would increase with subsequent stages eventually requiring 80% use of computer order entry for eligible patients by stage three (Jones et al. 2011). The authors obtained data from the Association Annual Survey database. The database provided data on 4156 acute care facilities included in the Hospital Compare Database of which 2543 had responded to the 2007 American Hospital Association Information Technology Supplement. 2543 represented the cohort size (Jones et al. 2011).
The authors reported 61% of the hospitals studied did not use electronic medication order entry 13% of the hospitals reported ordering from one to 25% four percent of hospitals reported ordering 26 to 50% and six percent of hospitals reported using electronic ordering from 51 to 90% of patients (Jones et al. 2011). Despite the small number of facilities utilizing computer order entry in any capacity the benefit of its use was appreciated with improved mortality rates in heart attack and heart failure categories (Jones et al. 2011). Significantly improved mortality was seen with higher use of computer order entry systems and a much better statistics.
Overall the authors reported that hospitals meeting stage one requirements could appreciate 1.2% reduction in mortality rates but this is not statistically significantly because estimated thresholds were not met (Jones et al. 2011). With stage 2 requirements reduced mortality could be as high as 2.1% (Jones et al. 2011). The study was beneficial in proving that greater use of computer order entry has the potential in reducing mortality rates.
References
Brown B. (2010). The final rules for meaningful use of EHRs. Journal of Health Care Compliance12(5) 4950. Retrieved from http://sfxhosted.exlibrisgroup.com/waldenu?url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&ctx_enc=info:ofi/enc:UTF-8&ctx_ver=Z39.88-2004&rfr_id=info:sid/sfxit.com:azlist&sfx.ignore_date_threshold=1&rft.object_id=111030132863024&rft.object_portfolio_id=&svc.fulltext=yes
Gianlanella K. M. (2012). Legislative aspects of nursing informatics: HITECH and HIPPA. In McGonigle D. & Mastrian K. G. (Eds.). Nursing informatics and the foundation of knowledge. (pp. 161-184). (Laureate Education Inc. custom ed.). Burlington MA: Jones & Bartlett Learning
Jones S. S. Heaton P. Friedberg M. W. & Schneider E. C. (2011). Todays Meaningful Use Standard For Medication Orders By Hospitals May Save Few Lives; Later Stages May Do More. Health Affairs 30(10) 2005-2012. doi:10.1377/hlthaff.2011.0245