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 reporting having systems that met the criteria of a basic or a fully functional system increased by14.2% and 46.4%, respectively. However, the United States is still far behind other developed countries (Hsiao, 2010).
“Meaningful use” is a term that was defined in American Recovery and Reinvestment Act of 2009. It consists of three main components. 1) The use of a certified electronic health record (EHR) in a meaningful manner, for example, e-prescribing 2) The use of certified EHR technology for electronic exchange of health information to improve quality of care, and 3) The use of certified EHR technology to submit clinical quality and other measures (Centers for Medicare & Medicaid Services, n.d.). Meaningful use requires using the EHR for structured data collection, e-prescribing, health information exchange, clinical decision support, patient engagement, security assurance, and quality reporting. The goal of the Act is to get all health care providers on board with the meaningful use of electronic health records for two main reasons: 1) To ensure patient safety by reduction of errors through improved access of health information, e-prescribing, and clinical decision support and 2) to compile patient charts and information together to facilitate the access of current, complete, and accurate health information across provider networks thereby improving coordination of care and health outcomes and increasing efficiency. Meaningful use also hopes to reduce health disparities, improve access to care, and engage patients and families in their medical care. Eventually it is hoped that it will lead to improvements in public health and the overall health of populations (Rachman, 2010).
The federal government is encouraging the utilization of EHRs by the creation of Medicare and Medicaid EHR incentive programs that are providing financial incentives for eligible providers who implement the “meaningful use” of EHR technology to achieve health and efficiency goals. To earn the financial incentives, we need to be able to show that we are adopting and implementing certified EHR technology in ways that can be measured. These clinical quality measures must be reported to receive incentives. The data elements that must be collected in coded format include demographics, vital signs, problems and diagnoses, immunizations, lab results, and medications (Centers for Medicare & Medicaid Services, n.d.). Centers for Medicare and Medicaid services (CMS) specifies a core set of 15 objectives and measures that must be met to qualify for meaningful use (see Appendix A). There are ten additional menu objectives of which five must be chosen. Overall, 20 out of 25 objectives must be met to meet criteria for adoption of meaningful use and to receive incentive payments in 2011 and 2012 (stage 1) (See appendix A). These concepts are clinical criteria that are directly associated with providing constant high quality care. They can all be transferred into structured data that can be directly measured. This data is how providers can use...
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