NURS 8210 Assignment Meaningful Use Paper
Why are many health care organizations hesitant to adopt electronic health records (EHR) when they have the potential to improve quality, increase access, and reduce costs? Some organizations are concerned with the ethical and legal issues that may arise in daily operations. In 2010, legislators noticed health care’s reluctant transition into full EHR integration, and began to provide financial incentives to those organizations that not only adopt EHRs, but also use them meaningfully to improve quality of patient care. As an advanced practice nurse, it is important to be aware of the challenges, policies, and incentives associated with integrating EHR systems. It is also critical that you understand the concept of “meaningful use” and how it plays out in today’s health care organizations.
The rationale for introduction of health information technology (HIT) in the health care system is to enhance health care process by promoting safe, affordable, efficient, and quality care delivery. Consequently, the need for meaningful use (MU) of electronic health records (EHRs) has been established to help in fostering improvements in the efficiency of health care provision. Therefore, it is necessary for clinicians and hospitals to adopt MU of certified EHRs to achieve the desired outcomes. In particular, the meaningful use of EHRs tends to enhance quality, efficiency, and safety. Besides, EHRs reduces health disparities, involve patients and their family in their health care provision, ensure privacy and confidentiality of patient health information, and promotion of care coordination (Slight et al., 2015).
Meaningful use is defined as the utilization of certified EHR technology in a manner that fosters electronic exchange of health information to enhance the health care quality and effectiveness. Overall, the objective of meaningful use is to promote cooperation between clinical and public healthcare, enhance patient-centered care, and sustain consistent development of vigorous consistent data exchanges. Essentially, MU mostly entails a process of recording the actions of a physician and what is essential in ensuring that the patient receives a holistic treatment rather than merely treating the presenting health concerns (Kruse, Bolton, & Freriks, 2015). Nonetheless, despite the vital role played by the EHRs in the healthcare system, the meaningful use of EHRs are significantly impacted by various factors such as legal, financial, and ethical issues leading to uncertainty in the effective utilization of EHRs systems in reforming the health care system. Therefore, this paper seeks to summarize different issue related to the meaningful use of legislation and determine how they may be impediment to the implementation of the meaningful use legislation.
Indeed, there are many legal issues involved in the meaningful use of EHRs. The first issue constitutes paying little attention to regulate the changeover from the utilization of manual paper-based records to the utilization of the EHRs. Notably, there is a pressure to establish health information exchanges at the national, state, and local levels. As a result, the physicians are expected to have a substantial access to computers, including accessing more than one organizational paper-based chart. However, despite the positive intentions of such initiatives in tackling the challenges of clinical information that is either defective or deficient, it is unfortunate that no law exists to guide the health care providers in understanding their scope and degree of liability in examining information on EHRs targeted to the whole community and containing information from various sources (Ben-Assuli, 2015). Worse yet, the utilization of computer systems which is widespread in EHRs foster the storage of massive amount of data, which often results in generation of colossal information. However, the availability of immense information can be disastrous to physicians because it may lead to the potential risk of failing to notice vital findings containing crucial information from the pool of documentation captured in the computer system. In case of occurrence of such incidence, health care providers often face dire consequences including institution of legal actions against them for negligence. Besides, the health care settings where such incidences occur also face liability under the legal notion of “respondent superior” (Ben-Assuli, 2015). This liability often arises in circumstances where the name of health care providers does not appear in the lawsuit or being directly impacted by the utilization of EHRs. Moreover, the process of EMR implementation is undoubtedly challenging and physicians involved in the implementation process are exposed to the risk of medical malpractice claims. Notably, the chances of committing error are higher during transitioning period or implementation period when the health care organization moves from the use of the manual paper-based system that health providers are used fond of to a new system.
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The other legal issue involved in the meaningful use legislation is possibility of increase in the legal accountability and responsibility of health care providers. Essentially, the EHR audit system can be effective in helping the management of health care organization to effortlessly recognize health care providers who have failed to examine a particular information or fundamental information (Slight et al., 2015). Besides, the meaningful use facilitates easy trailing of health care providers who fail to account for strange incidences that they have assessed. Mostly, EMRs fosters such responsibility and accountability through their ability to enhance the accessibility of documentation or information that can assist in establishing or support a malpractice claim. On the other hand, the eradication of CDS alerts also constitutes another legal concern that may be emanating from the meaningful use of EHRs. Presently, the legal connotations regarding the ouster of CDS alerts are interpreted as being vague in the same manner as the repercussions for failure of health care providers to comply with those CDS alerts. Fundamentally, intricate legal consequences always emanate from the meaningful use legislation, particularly in regard to concerns about EHRs usability, quality, and reliability.
Financial Matters that may Arise
The adoption and execution of the EHR or HIEs requires an overall authority that will oversee the matter. As such, this raises the question of who will be held responsible in case of anything since the finances generated from such project are generally supplied to the payers and not the financiers or funders of the same (Ben-Assuli, 2015). The determination of an extended maintenance of the electronic health record is similarly difficult since the process is expensive and complex.
Ethical Issues that May Arise
The use of electronic health records in a meaningful way leads to the emergence of several ethical points concerning the ownership of the information alongside the protection of the same as conducted by the health care provider. The presence of the possibility of a breach of privacy has led to apprehension amongst the patient population as concerns the security of their PHI or unauthorized access to EHR. Improper use of HER has the capacity to dent the ethical standards of a health care facility when it comes to such things as selling patient database copies linked to medical device marker by vendors, the researchers or even the pharmaceutical firms (Mittelstadt, & Floridi, 2016). Ethical issues exist in this scenario since DE-identified data could be manipulates using data sources that are eternal to the system in a public manner. Moreover, the ease with breach of information through the computer occurs raises the possibility of ethical issue as relates to meaningful use of laws. Ab quintessential example is unauthorized login in to a system when a use has forgotten to log out.
The contention as to whether the beneficence principle should receive universal recognition raises another ethical issue as relates to authorization. Moreover, the principles of autonomy is similarly in jeopardy particularly when patient information or data is shared with third parties. These two scenarios raise ethical questions as regards to receiving the requisite authorization from the patients as regards to how their data may be utilized.
Barriers to Successful Implementation within a Facility
Several ways exist regarding the manner in which some of the issues discussed above may hamper successful implementation of the EHR system in a health care facility. The training and installation of the EHR system is capital intensive and this may affect its acquisition by a health care facility (Richardson, 2016). Further, the risk of exposure of patient data may prevent both a health care facility as well as patients from fully embracing the usage of the EHR. Consequently, the adoption of the paper system may become favorable to these people in spite of their limitations.
Making the Most of EHR
Making the system flexible in terms of adding new functionalities to it is a fundamental way of ensuring that EHR systems have the capacity to facilitate certain workflow necessities. Further, the adoption of real-time features as regards medication dictation will prevent health care facilities from making medication errors. The above feature has to have direct note incorporation or voice recognition functionality to have the above effect. In addition, increasing the security features by encrypting the system using functional firewalls may prevent cybersecurity attacks or internal breaches (Ng-Mak & Ruetsch, 2019). Further, the management also has to play an integral role in this process through the formulation of the requirements for the system and also limiting the initial choices, which prevents a facility from misusing money. The above is preceded by proper comprehension of the workflow associated with a department or an office by the management.
Implementation of Meaningful Use Legislation in Our Organization
The adoption of technology as far as patient identification happens in our organization forms the basis of the implementation of the meaningful use legislation in our organization. To that effect, electronic identification bands for the patients have been adopted by our health care facility, which prevents mistakes related to wrongful identification hence treatment. Moreover, our health care organization has facilitated the sharing and capturing of the data at fundamental levels and also ensuring that data exchange occurs in a seamless and accurate manner between the correct agencies.
Electronic health records offer health care organizations financial incentives and also increase patient satisfaction through improved quality. However, certain limitations particular related to cybersecurity breaches, increased financial burden and privacy issues amongst the patient population affect the system. In general, policymakers and experts believe that the potential to enhance the quality of patient care via embracing the EHR systems exists as long as they are used in a meaningful way.
Ben-Assuli, O. (2015). Electronic health records, adoption, quality of care, legal and privacy issues and their implementation in emergency departments. Health policy, 119(3), 287-297.
Kruse, C. S., Bolton, K., & Freriks, G. (2015). The effect of patient portals on quality outcomes and its implications to meaningful use: a systematic review. Journal of medical Internet research, 17(2), e44.
Mittelstadt, B. D., & Floridi, L. (2016). The ethics of big data: current and foreseeable issues in biomedical contexts. Science and engineering ethics, 22(2), 303-341.
Ng-Mak, D., & Ruetsch, C. (2019). Association between meaningful use of electronic health records and patient health outcomes in schizophrenia: a retrospective database analysis. The American journal of managed care, 25(9 Suppl), S159-S165.
Richardson, T. A. (2016). Meeting Meaningful-Use Requirements With Electronic Medical Records in a Community Health Clinic.
Slight, S. P., Berner, E. S., Galanter, W., Huff, S., Lambert, B. L., Lannon, C., … & Payne, T. H. (2015). Meaningful use of electronic health records: experiences from the field and future opportunities. JMIR medical informatics, 3(3), e30.