\Meaningful Use for Nurses: Implications and Recommendations
Abstract
The formation of the HITECH Act 2009 by the U.S federal government led to the implementation of the Meaningful Use program in the country. The major goal of this program is to enhance the EHR (Electronic Health Records) adoption rate in the country and thereby modernize the country’s health care sector. It is identified that the Meaningful Use program has a range of positive implications for the nation’s health care sector although it adds to nurses’ work stress to some extents.
Introduction
The United States has spent billions of dollars on health care reforms and policy initiatives over the last decades in order to enhance the quality of care in the country. The introduction of the ‘Meaningful Use’ program was a milestone in the health care history of the United States as it facilitated the preservation of patient health records in an easier and more secure manner. As this policy change improved patients’ access to their health information records, this newly implemented program allowed patients to obtain better engagement in the treatment and improved collaboration with health providers. This paper will critically evaluate the Meaningful Use program paying particular attention to its implications for nurses and the nursing profession.
The Meaningful Use program is a revolutionary healthcare program introduced by the US federal government as part of the 2009 Health Information Technology for Economic and Clinical Health (HITECH) Act. The Meaningful Use program intends to motivate health care providers to demonstrate their commitment to the ‘meaningful use’ of Electronic Health Records (EHRs). The health care providers, who comply with the HITECH Act and thus become eligible, receive incentive payments for their compliance. The main objective of the program is to encourage wider use of electronic health record systems, which in turn may form an infrastructure that ensures ‘the quality, safety and efficiency of patient care’ in the country (What is Meaningful Use?). According to the managing director of National Coordinator for Health Information Technology, Farzad Mostashari (as cited in What is Meaningful Use?), this program would enhance the healthcare of the country as a whole and cut down the overall healthcare costs. In order to qualify for the incentive payments, health care providers have to adopt an EHR and strictly adhere to a number of standards (What is Meaningful Use?). The Centers for Medicare and Medicaid Services (CMS) gives particular emphasis to the Meaningful Use program in an effort to enhance the efficiency of health care IT in the United States. In the Medicare Meaningful Use program, individual physicians and other eligible health care providers may receive up to $44,000 whereas it can be up to $63,750 in case of the Medicaid Meaningful Use program (“What is Meaningful Use?”). The actual amount they receive may vary according to when they begin to meet the program requirements. The HITECH Act also includes provisions for imposing financial penalty on eligible providers who do not comply with the meaningful use of certified EHR technology. The fine amount may be less than 100% of eligible providers’ Medicare fee for professional services (What is Meaningful Use?).
Analysis of the Implications
The Meaningful Use program has mixed implications on nurses and nursing as a whole. One of the major benefits of this program for nurses is that it can assist them to earn up to $63,750 if they properly comply with the requirements of the program (Blumenthal & Tavenner, 2010). However, nurses are the major group that is required to take great efforts to meet the requirements of this program. Many hospitals had already adopted the EHRs before the federal government planned to issue incentives to implement this system. Nurses in those facilities may find it easy to comply with the standards of the Meaningful Use program. This newly implemented health care program adds to the worksite burden of nursing practitioners. To illustrate, this program requires the electronic recording of vital signs, which is fundamentally a nursing responsibility. In addition, many of the quality reporting requirements specified in the Meaningful Use program would add to the worksite stress of nurses. It is a known fact that physicians simply pass any burden associated with documentation to nurses. Therefore, the burden of the whole electronic documentation process relating to the Meaningful Use program is most likely to be imposed on nurses. As a result, nurse practitioners may find it difficult to focus properly on their core duties and responsibilities. Ultimately, nurses have a crucial role to play in making sure that this program is carried out as planned. The proponents of this program claim that it can eliminate manual labor to a great extent and thereby give the nursing staff more time to be with patients.
The Meaningful Use program assisted the US federal government to establish a national health policy regarding the maintenance of electronic health records in the whole country. With the help of this program, health regulators are able to develop a uniform measure of quality by which the performance of health professional can be evaluated. In addition, this national health policy facilitates the comparison of EHRs throughout the United States. As a result, it is easy for the country’s health regulators to assess the performance efficiency of health organizations, units, and departments in terms of the quality of Meaningful Use program.
Similarly, it seems that the Meaningful Use program can have a range of positive effects on patient outcomes in the country. Through this policy change, patients are able to obtain greater access to their health information and to achieve enhanced involvement in their treatment. In addition, patients can enjoy better collaboration with their health providers (Snyder & Oliver, 2014). This program allows patients to receive an electronic reminder about their next visit so that it can effectively promote medication compliance. In addition, patients are delivered an electronic copy of their health information following an appointment. To sum up, on the strength of this health information technology, patients can experience positive changes in the way they interact with the health care system. Undoubtedly, all these changes would contribute significantly to better patient outcomes. Since the formation of the HITECH Act in 2009, the US health care system has been experiencing the positive implications of the Meaningful Use program. Reports indicate that this national health program can enhance the quality of emergency care because of the nationwide availability of a patient’s health records in electronic format (Chin & Sakuda, 2012).
Recommendations
I strongly believe that no additional criteria are necessary for Meaningful Use Stage 1 or 2. The major reason is that the Meaningful Use program is currently working outstandingly in the United States. To illustrate, the percent of U.S doctors using an EHR increased from just 17% in 2008 to over 60% in 2013 (Jha, 2015). Similarly, when only 9 percent U.S hospital used an EHR in 2008, it was improved to over 60 percent in 2013; and health industry analysts indicate that it is a stunning improvement in the rate of EHR adoption because no other country in the world has enhanced its EHR adoption rate this fast (Jha, 2015). In this context, addition of new criteria in Stage 1 or 2 is likely to affect the progress of the program in the United States. In addition, when new criteria are added, it would impose additional burden on eligible health providers including nurses as they are required to comply with those additional criteria too in order to be qualified for the payment benefits under the Meaningful Use program. It is likely that this additional work stress may persuade nursing professionals not to adhere to EHR adoption as they would think the costs of adopting this health information technology outweigh its benefits. This scenario would adversely affect the EHR adoption rate in the United States. Likewise, addition of new EHR may involve a number of policy changes and this in turn would lead to administrative and supervisory complications in the country’s health care sector. Sometimes, introduction of new criteria may increase the health costs of the federal government in terms of nurse training, additional staff hiring, and change management. At this juncture, it is better for the U.S federal government to continue the existing criteria for the Stages 1 and 2 of the Meaningful Use program.
Personal Reflections
The Meaningful Use program implemented by the U.S federal government is a sensible strategy to improve the country’s health care infrastructure. It is identified that this innovative health program is capable of enhancing the quality, safety, and efficiency of patient care and reducing health disparities in the country. Another potential feature of this program is that it promotes the engagement of patients and families in their health. When patient information is stored in electronic format, it can greatly assist health providers and hospitals to improve care coordination significantly. Many health care professionals rate the Meaningful Use program outstanding on the ground that it enhances the security and confidentiality of patients’ personal health information (Abdelhak, Grostick & Hanken, 2014, p.216).When patient information is stored in a document format, it is likely to be accessed and misused by unauthorized people. Therefore, the Meaningful Use program is an effective way to protect patient rights in the country.
It is expected that this health information program would result in better clinical outcomes as well as population health outcomes. Health regulators indicate that it can enhance the transparency and efficiency of health services in addition to meeting patient empowerment. A notable feature of the Meaningful Use program is that it can provide relevant research data on health systems so that it may back the country’s research efforts to develop improved health policies and technologies. The objectives of this national health policy that are distributed over 3 Stages namely ‘data capture and sharing advance clinical processes, and improved outcomes’ have the potential to enhance the quality of services delivered by the country’s eligible professionals and hospitals (“Meaningful Use Definition & Objectives”).Although this program is likely to impose some additional burden on health professional including nurses, it can certainly improve the overall health outcomes of the United States.
Conclusion
References
Abdelhak, M., Grostick, S & Hanken, M. A. (2014). Health Information: Management of a Strategic Resource. US: Elsevier Health Sciences.
Blumenthal, D & Tavenner, M. (2010). The “Meaningful Use” Regulation for Electronic Health Records. The New England Journal of Medicine, 363:501-504.
Chin, B. J., & Sakuda, C. M. (2012). Transforming and Improving Health Care through Meaningful Use of Health Information Technology. Hawai’i Journal of Medicine & Public Health, 71(4 Suppl 1), 50–55.
Jha, A. (March 25, 2015). The Final Stage Of Meaningful Use Rules: Will EHRs Finally Pay Off? Health affairs Blog. Retrieved from http://healthaffairs.org/blog/2015/03/25/the-final-stage-of-meaningful-use-rules-will-ehrs-finally-pay-off/
Meaningful Use Definition & Objectives. (n.d.). HealthIT.gov. Retrieved from https://www.healthit.gov/providers-professionals/meaningful-use-definition-objectives
Snyder, E. F & Oliver, J. S. (2014). Evidence-Based Strategies for Attesting to Meaningful Use of Electronic Health Records: An Integrative Review. The Online Journal of Nursing Informatics (OJNI), 18 (3). Retrieved from www.himss.org/ResourceLibrary/GenResourceDetail.aspx?ItemNumber=33523
What is Meaningful Use? (n. d.). Athena health. Retrieved from http://www.athenahealth.com/knowledge-hub/meaningful-use/what-is-meaningful-use
