HCA 3302, Critical Issues in Health Care 1

Course Learning Outcomes for Unit V Upon completion of this unit, students should be able to:

5. Explain the impact of technology on the health care industry. 5.1 Identify a specific health technology, the financial implications, and the ethical concerns of its

meaningful use.

Course/Unit Learning Outcomes

Learning Activity

5.1

Unit Lesson Chapter 7 Chapter 8 Unit V PowerPoint Presentation

Required Unit Resources Chapter 7: Ethics in the Management of Health Information Systems Chapter 8: Technological Advances in Health Care: Blessing or Ethics Nightmare? Unit Lesson In this unit, we will learn about health care technology. Specifically, we will discuss the ethics and laws surrounding the management and use of health information systems and the adoption of emerging technologies. Health information technology is intended to enhance patient care and increase the equity, effectiveness, and efficiency of health care delivery (Morrison & Furlong, 2014). Health care organizations are struggling to understand if the adoption of such health care technology is beneficial. Will health care technologies improve quality, or will they result in harm?

Health Information Technology and Management Health information technology and health information management are a large part of effective and efficient management of health information systems, and they are essential to the accurate treatment of patients (Morrison & Furlong, 2019). The ethical principles of fairness and justice are the main ethical concerns regarding health information technology (Morrison & Furlong, 2014). There are serious ethical concerns that make health care organization leadership skeptical about the benefits of health information technology because it is a prominent tool in health care that supports multi-professional and multi-organizational programs. Health care organizations face many challenges that include interoperability of health information technology and communication between health care providers in addition to ethical issues that occur. Complying with regulations, providing confidentiality while also supporting data sharing for coding and research are a couple of examples of ethical challenges. Advances in health information technology are on the rise, and in parallel, there are also social and ethical concerns:

• patient privacy abuses, • inappropriate use of patient data, • unauthorized patient consent, and • computer peripherals assistance during procedures (Morrison & Furlong, 2014).

UNIT V STUDY GUIDE Health Care Technology

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Health care reform has increased the need for health information technology; however, health information technology comes at a large monetary cost. In order for health care organizations to meet quality standards and to provide effective quality of care, the adoption of health information technology is imperative. Due to the high expense of health information technology, health care organizations need to truly understand the benefits of adopting these new technologies. Some health information technology benefits include increased productivity, lowed administrative costs, and improved health outcomes. The American Recovery and Reinvestment Act and the Health Information Technology for Economic

and Clinical Health Act The American Recovery and Reinvestment Act (ARRA) was signed into law in February 2009 (Office of Inspector General, n.d.). The primary objective of ARRA was to save and create jobs, but it also aimed to provide relief and invest in infrastructure, renewable energy, health, and education (Federal Communications Commission, 2011). The Health Information Technology for Economic and Clinical Health Act (HITECH), which is a piece of ARRA, supported the use of electronic health records (EHR) and meaningful use, focused on increasing the use of a certified EHR by hospitals and providers, as well as addressed privacy and security concerns regarding electronic health data (Office for Civil Rights [OCR], 2009a). The HITECH Act also provided funding for the EHR incentive program, known as meaningful use. The Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology manage meaningful use, which is a set of standards that guides the use of EHRs and allows eligible health care providers and hospitals to earn incentives if certain measures are met (Reider & Tagalicod, 2013). Meaningful Use Meaningful use is built on the five pillars of health outcomes policy priorities:

• increase quality, safety, efficiency, and reduce health disparities; • engage patients and families in their health care; • improve care coordination; • improve population and public health; and • safeguard privacy and security protection for personal health information (Reider & Tagalicod, 2013).

Participation in meaningful use is completely voluntary, but CMS gives an incentive payment to any eligible provider or hospital that can demonstrate that they have engaged in adopting, implementing, or upgrading a certified EHR. To encourage adoption of an EHR, promote innovation, and avoid the excess burden on health care organizations, meaningful use was rolled out in three stages. Stage 1 of meaningful use was announced in 2010 and promotes basic EHR adoption and the gathering and sharing of health data (OCR, 2009b). Health care organizations focused on storing health information electronically in a standardized format that is easily accessible and authorized by providers and patients. In 2014, Stage 2 of meaningful use began, and it focused on care coordination and the exchange of patient data. Stage 3 of meaningful use began in 2015 and focused on the advance use of EHRs, health information exchanges, and improvement to health outcomes (Agency for Healthcare Research and Quality, 2013). As meaningful use unfolded, Stages 2 and 3 were modified. If an eligible provider or hospital met the meaningful use criteria, it received incentive payments ranging from $44,000 over 5 years for the Medicare providers to $63,750 over 6 years for Medicaid providers (Agency for Health Care Research and Quality, 2013). Meaningful use has served a valuable purpose by ensuring that money allocated from ARRA was used meaningfully and for creating a nationwide EHR infrastructure. In 2016, more than 95% of eligible hospitals accomplished meaningful use (Office of the National Coordinator for Health Information Technology, 2016). Prior to the passing of the HITECH Act and the start of meaningful use, adoption rates for certified EHRs were low and slow to rise. This is believed to be because of the cost of implementation and the lack of knowledge concerning the return on investment. According to the Journal of Health Affairs, after the HITECH Act was passed, the EHR adoption rate increased from 3.2% to 14.2% (Alder-Milstein & Jha, 2017). However, despite

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federal government mandates, some health care organizations have opted out of the Medicare electronic health record incentive program and have chosen reimbursement reductions instead. The U.S. government aims to mandate health care organizations to adopt health information technologies, like EHRs. This is in hopes to improve health care quality, doctor-patient communication, access to health data, and the availability of provider performance data that will reduce health disparities and increase care coordination.

Health Insurance Portability and Accountability Act As referenced earlier, a very important act is the Health Insurance Portability and Accountability Act, also known as HIPAA; it supports medical history and personal medical information by protecting it from any entity not allowed to access the information. Passed by the U.S. Congress in 1996 and enforced by the Office for Civil Rights, HIPAA aimed to ensure that workers in the United States who had previous health insurance coverage from an employer would not have to requalify their preexisting chronic conditions when changing employment or between jobs (OCR, 2008). This means that there is no waiting period for insurance coverage to begin for chronic conditions. For example, when an employee with cancer changed to a new job, he or she would not have to wait to receive care or medication, but rather, the insurance coverage would be immediately available. HIPAA has two main rules: the Security Rule and the Privacy Rule. First, the HIPAA Security Rule states the minimum requirements to protect electronic personal health information. It established national standards to protect patients’ electronic health information that was created, received, used, or maintained by a covered entity (OCR, 2009b). The Security Rule aims to secure and protect personal health information from destruction or unlawful disclosure or intent and also outlines the technical, physical, and administrative safeguards that a covered entity under HIPAA must implement. The physical safeguards protect a health care organization’s structures from natural or environmental hazards (OCR, 2009b). Safeguards protect software, hardware, and backup data that contain electronic personal health information. Technical safeguards include protecting access to sensitive and personal health information by having unique user identification, auto log-off, encryption, security, etc. The administrative safeguards manage the security of electronic personal health information and the conduct of the health care organization’s staff. The administrative safeguards require a risk analysis and an overseer of a security program (OCR, 2009b). The second HIPAA rule is the Standards for Privacy of Individually Identifiable Health Information, also known as the Privacy Rule. It established a set of national standards aiming to protect personal health information (OCR, 2008). The HIPAA Privacy Rule aims to ensure privacy of patient information in both paper and electronic formats. It further discusses that personal health information can only be released when allowed by the law or an authorized individual.

Conclusion The federal government plays a large role in the use, adoption, and regulation of health information technologies. Specifically, the government plays an active role in the security and privacy of patient medical information through acts like HIPAA and HITECH. The security of a health care organization’s data and information technology systems is necessary to protect the privacy of patients. Security of a health care organization’s data and health information technology systems is necessary to protect patient privacy and their most sensitive data. Health information technology is working prove it is beneficial to patient care and improves quality and efficiency of services delivered to patients.

References Adler-Milstein, J., & Jha, A. K. (2017). HITECH Act drove large gains in hospital electronic health record

adoption. Health Affairs, 36(8). https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2016.1651 Agency for Healthcare Research and Quality. (2013). Practice facilitation handbook: Module 17. Electronic

health records and meaningful use. https://www.ahrq.gov/professionals/prevention-chronic- care/improve/system/pfhandbook/mod17.html

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Federal Communications Commission. (2011). American Recovery and Reinvestment Act of 2009. https://www.fcc.gov/general/american-recovery-and-reinvestment-act-2009

Morrison, E. E., & Furlong, B. (Eds.). (2014). Health care ethics: Critical issues for the 21st century (3rd ed.).

Jones & Bartlett Learning. Morrison, E. E., & Furlong, B. (Eds.). (2019). Health care ethics: Critical issues for the 21st century (4th ed.).

Jones & Bartlett Learning. Office for Civil Rights. (2008). Summary of the HIPAA privacy rule. U.S. Department of Health & Human

Services. https://www.hhs.gov/hipaa/for-professionals/privacy/laws-regulations/index.html Office for Civil Rights. (2009a). HITECH act enforcement interim final rule. U.S. Department of Health &

Human Services. https://www.hhs.gov/hipaa/for-professionals/special-topics/hitech-act-enforcement- interim-final-

Office for Civil Rights. (2009b). The security rule. U.S. Department of Health & Human Services.

https://www.hhs.gov/hipaa/for-professionals/security/index.htmlrule/index.html Office of Inspector General. (n.d.). The American Recovery and Reinvestment Act of 2009.

https://www.hudoig.gov/arra Office of the National Coordinator for Health Information Technology. (2016). Hospital progress to meaningful

use. https://dashboard.healthit.gov/quickstats/pages/FIG-Hospital-Progress-to-Meaningful-Use-by- size-practice-setting-area-type.php

Reider, J., & Tagalicod, R. (2013). Progress on adoption of electronic health records. https://www.healthit.gov/buzz-blog/electronic-health-and-medical-records/progress-adoption- electronic-health-records

Course Learning Outcomes for Unit V
Required Unit Resources
Unit Lesson
Health Information Technology and Management
The American Recovery and Reinvestment Act and the Health Information Technology for Economic and Clinical Health Act
Health Insurance Portability and Accountability Act
Conclusion
References