Ehrs in Health Care

EHRs in wellness C atomic number 18 x x x Abstract In 2009, the Health Information Technology for economic and clinical Health dress (HITECH) was passed into law mandating interoperable Electronic Health Record (EHR) adoption throughout the joined States health address brass instrument for all permitrs who serve Medic are or Medicaid forbearings. The HITECH Act sets meaning(prenominal) commit requirements, intents, and objectives, and gives peculiar(prenominal) timelines for which to achieve them.As an incentive to expedite the process, the Centers for Medicare and Medicaid Services (CMS) has offered m unrivalledtary rewards for those facilities and physicians who are pickings steps to tool an EHR system by 2015. Beginning in 2015, CMS go forth penalize facilities and physicians who require not implemented an EHR system. One of the stipulations of receiving the incentive bullion is demonstrating meaningful part, or utilizing EHR technology in a meaningful way that improves tolerant care.Meaningful use has 3 stages, each focusing on unalike areas of unhurried care. There are several advantages and disadvantages of implementing an EHR system, but the benefits greatly outweigh the risks. The HITECH Act is champion of the most important pieces of health care legislation to date and has been called the foundation for health care reform (Blavin & Ormond, 2011). In 2004, the Bush administration introduced a plan to ensure that the checkup trading completely converts to electronic health write downs (EHR).This plan was passed into law by the Obama administration in 2009 under the Health Information Technology for Economic and Clinical Health Act (HITECH), which is a provision of the Ameri prat Recovery and Reinvestment Act (ARRA) (Kwami, n. d. ). This Act is essentially a $27 billion stimulus parcel of land meant to accelerate health care information technology in the United States. It surrenders the Centers for Medicare and Medicaid Servi ces (CMS) to offer financial incentives (up to $44,000 from Medicare and $63,750 from Medicaid per physician or up to $2 million per hospital) for implementing anElectronic Health Record (EHR) system in their facility by 2015 (Murphy, 2012). Not only do they cast off to implement it, they moldiness(prenominal) too meet the meaningful use requirements set forth by CMS for roaring utilization of the EHR system. To receive the maximum incentive payment, physicians/facilities mustiness begin connection by April 1, 2013. Starting in 2015, physicians and facilities who have not met those requirements let be penalized. What is Meaningful Use? Meaningful use is an umbrella term for the rules and regulations that hospitals and physicians must meet to qualify for the national incentive funding under ARRA.There are three stages of meaningful use each has contrary goals and objectives. For example, stage one focuses on data capture and sharing, and is grouped into five patient-driven areas related to patient health outcomes 1. ) Improve quality, safety, and efficiency, 2. ) Engage patients and families, 3. ) Improve care coordination, 4. ) Improve populace and population health, and 5. ) Ensure privacy and security for personal health information (Meaningful Use 101, n. d. ). Step two focuses on the advanced clinical processes involved in patient care and stage three will focus on improving actual patient outcomes.Requirements for meaningful use include the ability to e-prescribe, electronically ex careen patient health information, and notify on clinical data. The eventual goal is a national health information network. Facilities and physicians must achieve stage three of meaningful use by 2015. Traditionally, physicians have been reimbursed ground on how m either services they provide (fee for service). Meaningful use shifts this paradigm to a much patient bear on process and concentrates on performance-based initiatives like pay for performance (P4P) re imbursement.CMS recently introduced three P4P programs mandated by ARRA designed to reward higher-performing hospitals and penalize poorer-performing hospitals through these reimbursement practices. Hospitals performing at or below the 50th percentile nationally on hospital quality and patient experience measures can expect to take heed a significant reduction in payment from CMS as early as 2012 (Pay for Performance Payment, n. d. ). The shift from volume-based to value-based reimbursement methodology puts more emphasis on patient care and achieving positive outcomes. near other part of meaningful use requires that EHRs are interoperable with other facilities and physicians even if they are not the within the alike(p) organization. This manner that every organizations EHR system must to be able to talk to other organizations systems. If a patient travels to another tell or another country and subscribe tos to go to the doctor for any reason, the physician there will be able t o bring up the patients EHR and treat them based on the up-to-date medical information contained in their EHR. This is especially important in emergency situations where the patient whitethorn not be in the position to supply undeniable information.Locally, interoperability is important because it helps physicians communicate with other facilities such as a referral. A patients family physician may refer them to a specialty doctor and with an EHR, both doctors can view and document findings in one record rather than having separate typographys that contend to be brought in by the patient and filed in their paper record. EHRs are also an summation within the same facility. When a patient hires a lab or x-rays done, the physician can immediately bring up the results rather than having to ask for the lab/x-ray technician to physically bring the results to them.Interoperability makes coordination of care easier and more efficient. Advantages of Implementing an EHR In addition to the benefits of interoperability, there are several other advantages of implementing an EHR. The main goal of an EHR is to improve the quality and safety of patient care. EHRs can help provide better health care by improving all aspects of patient care like safety, performanceiveness, patient-centeredness, communication, education, timeliness, and efficiency (What Are the Advantages, n. . ). Having a single record that includes all of a patients health information and is up to date, complete, and accurate allow for better coordination of care, accessibility of information, convenience, simpler disease management, enhanced collaboration between providers by improved information sharing, a significant reduction in medical errors, up-to-date medication and allergy lists, and cost savings in the grand run (Benefits of EHRs, n. d. ). EHRs also reduce waste and liminate duplicate screenings and tests, as thoroughly as help physicians make better, more comprehensive clinical decisions by integrating patient information from multiple sources into one EHR (What Are the Advantages, n. d. ). Another advantage of having your health record in electronic format is increase security and privacy. With a paper record, anyone can pull it off the shelf and browse through it, but with an electronic record there are differing levels of authorization allowing only certain people access to your chart. Also, your chart cannot get lost.Instead of someone having to sign it out every time they need to use it and having to manually track it, an EHR allows multiple users to access it at different times, on different computers, and leaves an audit trail automatically. Disadvantages of Implementing an EHR There are also disadvantages of EHRs including overall cost, ongoing maintenance costs, changes in work flow, and temporary loss of productivity just to name a few (Menachemi Collum, 2011). One of the biggest concerns of implementing an EHR system is the initial cost.Acquiring and i mplementing an EHR system can be quite expensive depending on the coat of the facility. The projected total cost for a medium sized con facility with a seven family EHR installation is approximately $19 million. In the outpatient setting, cost is approximately $14,000 per physician in the initial year of implementation for a six-physician practice, and $19,000 per physician with three or fewer physicians (Menachemi Collum, 2011). small practices may find it hard to cope with the added expense of an EHR system the viability of those practices may suffer as a result.Another disadvantage of implementing an EHR system is the cost of transitioning from paper to electronic records. Additional staff will be required to translate in all of the paper documents into electronic format. This process can fool away months depending on how big the facility is so it could really have an disturb on a facilities bottom line. There will also be a period of time where the staff is less producti ve than they would ordinarily be as they learn how to use the electronic system. This period is called the erudition curve.To help remedy this, temporary staff will need to be hired to fill in the gap and keep the workflow up to date which also has a significant financial effect on an organization. The maintenance of an EHR system can be costly and technology is not always reliable. Hardware must be replaced and software must be upgraded on a regular basis. In addition, providers must have ongoing training for staff as well as IT aliveness available, such as a 24/7 help line. Also, as with all things electronic, there is always the possibility of the system going down.Hospitals and physicians must have a plan in place outlining what the proper summons is for the down time until the system is up and running again. This generally means they will have to revert back to paper documentation spell the system is down, so they also need to have a recovery plan in place detailing how t hey will go most getting the paper documentation from the down time transferred into the EHRs. Conclusion Although some might argue that an EHR system is too costly and too more work, it is a federal mandate that all physicians/facilities (who service Medicare or Medicaid patients) implement an EHR system.And while the transition from paper to electronic is a costly and airy process, the benefits of an EHR are numerous and greatly outweigh the cost of implementation. As chairman Obama said, You shouldnt have to tell every new doctor you see about your medical history or what prescriptions youre taking. You shouldnt have to repeat costly tests. All that information should be stored securely in a private medical record so that your information can be tracked from one doctor to another even if you change jobs, even if you move, even if you have to see a number of different specialists.Thats just common sense. (Making the Switch Replacing, 2010). References Benefits of EHRs. (n. d . ). Retrieved February 13, 2013, from http//www. healthit. gov/providers-professionals/improved-care-coordination Blavin, F. , Ormond, B. (2011, May). HITECH, meaningful use, and public health Funding opportunities for state immunization registries White paper. Retrieved from http//www. medicaidhitechta. org/Portals/0/Users/011/11/11/ImmunRegWhitePaper. pdf Kwami, K. K. (n. d. ). The EMR federal requirements of physicians. Retrieved February 13, 2013, from http//www. how. com/list_6961848_emr-federal-requirements-physicians. html Making the switch Replacing your EHR for more money and more control White paper. (2010, September). Retrieved from http//www. healthcareitnews. com/sites/default/files/ resource-media/pdf/making_the_switch_replacing_your_ehr. pdf Meaningful use 101. (n. d. ). Retrieved February 13, 2013, from http//www. medicity. com/meaningful-use-101. html Menachemi, N. , Collum, T. H. (2011, May 11). Benefits and drawbacks of electronic health record systems. Retriev ed from http//www. ncbi. nlm. nih. ov/pmc/articles/PMC3270933/ Murphy, K. (2012, May 9). American Recovery and Reinvestment Act (ARRA). Retrieved from http//ehrintelligence. com/ rubric/american-recovery-and-reinvestment-act-arra/ Pay for performance payment systems that reward or penalize hospitals based on performance. (n. d. ). Retrieved February 13, 2013, from http//www. getwellnetwork. com/services/health-reform/pay-performance What are the advantages of electronic health records? (n. d. ). Retrieved February 13, 2013, from http//www. healthit. gov/providers-professionals/faqs/what-are-advantages-electronic-health-records