Week 6 Assignment: Meaningful Use Paper

Write a 4- to 5-page essay in which you:

• Summarize the legal, financial, and ethical issues that may arise as a result of meaningful use legislation.
• Explain how these issues might present barriers to successful implementation within an organization.
• Discuss ways that health care organizations can make the most of their electronic health record investments in light of meaningful use.
• Explain how EHR-related meaningful use legislation is being implemented in your organization.

Assignment: Meaningful Use Paper

The use of healthcare technologies has significantly transformed healthcare in the modern world. Healthcare technologies such as electronic records have proven effective in enhancing the safety, quality and efficiency of patient care. Since the implementation of the Meaningful use, healthcare organizations constantly explore the ways in which they can utilize healthcare technologies to achieve their desired competitive edge in their markets. The implementation of meaningful use is however associated with a number of issues that have impeded its success. Therefore, the purpose of this paper is to explore the legal, financial, and ethical issues in the implementation of the meaningful use and ways in which they act as barriers in the implementation process. It also explores ways in which health organizations can make the most of their health records investments and implementation process of the meaningful use legislation in my organization.

Legal, Financial and Ethical Issues

The implementation of the meaningful use legislation may be associated with a number of legal, ethical and financial issues. One of the legal issues that may be experienced with the implementation of the meaningful use is the lack of legal framework to guide the implementation process. Accordingly, states have not created a sound legal framework to guide the implementation and adoption of new technologies in healthcare. Healthcare institutions lack a legal system to guide them in navigating the system and process transition from the paper-based systems to the use of electronic health records. States have also failed to provide the legal frameworks to address issues related to the provider responsibility in reviewing healthcare data in the integrated electronic health records (Mello et al., 2018). There is also the legal concern that the implementation of the meaningful use legislation is likely to increase provider accountability and responsibility. The increased use of electronic records is projected to increase legal cases due to ineffective use of technologies in patient care, hence, placing more pressure on the healthcare providers when compared to the previous use of paper-based systems (Entzeridou et al., 2018).

The implementation of the meaningful use legislation may also lead to a number of ethical issues in healthcare. Firstly, it may raise concerns on the ownership of the protected healthcare information as well as the responsibility of the healthcare providers in preventing and informing patients on issues such as privacy breaches (Ntoutsi et al., 2020). The implementation also raises concerns about the confidentiality and privacy of the patients’ data. In this case, patients are increasingly worried that electronic health records vendors may engage in unlawful practices such as selling the copies of their databases to marketing and research companies. The increased use of electronic health records predisposes health organizations to adverse events such as security breaches and unauthorized access to data (Hand, 2018). As a result, health organizations are legally predisposed to adverse outcomes should breaches in security of data occur, worsening the complexities associated with the adoption of the meaningful use.

The implementation of the meaningful use legislation may also lead to a number of financial issues. One of them is the entity that will be responsible for paying the costs incurred in the implementation of health integrated systems as well as electronic health records. The existing evidence shows that healthcare payers benefit the most from the implementation of the meaningful use when compared to healthcare institutions and financiers of meaningful use (Keshta & Odeh, 2021). The implementation of the legislations may also decline the productivity of the healthcare institutions. For instance, statistics estimates show that full implementation may lead to up to 10% decline in organizational productivity (Mello et al., 2018). Therefore, the financial implications of implementing the meaningful use may hinder the whole process in healthcare institutions.

How Issues may Present Barriers to Successful Implementation

The ethical, financial and legal issues associated with the implementation of the meaningful use may act as barriers for the successful implementation process. Accordingly, the lack of sound legal frameworks to guide the implementation of the meaningful use may impede the implementation of systems such as integrated health records for coordinating care. The lack of a formal legal framework implies that health organizations and providers are likely to be held liable for any adverse outcomes associated with the implementation of the meaningful use. Health organizations exist to ensure the protection of rights of the populations they serve (Hand, 2018). As a result, they may not be willing to implement the critical components of the meaningful use due to the potential harm to their populations, hence, the need for formal legal frameworks to guide the process.

The earlier analysis showed that the implementation of the meaningful use legislations also places more authority and responsibility to the healthcare providers. Healthcare providers take the responsibility of collecting, organizing and using electronic data from different sources to ensure effective patient care. The consequence of the increased authority and responsibility is that healthcare providers will be highly prone to errors due to the intensive nature of care process (Mello et al., 2018). It will predispose them to lawsuits due to violation of ethics in practice, hence, acting as a potential barrier for the successful implementation of the meaningful use.

The successful implementation of the entire meaningful legislations is also associated with significant financial costs to healthcare organizations. As noted above, the implementation of the meaningful legislations will result in the reduction in the productivity of healthcare organizations. Healthcare organizations will also incur costs in purchasing, maintaining and improving their systems to ensure their efficiency in patient care. Healthcare providers also have to be trained on the use of the systems in patient care. The cost burden of the meaningful use may act as a potential barrier. In this case, the implementation contradicts with the aim of healthcare institutions, which is to be profitable in service provision for their sustainability (Mello et al., 2018). Therefore, the cost implications of the meaningful use should be considered for the successful implementation of its legislations.

Making the Most of the Health Records Investments

Health care organizations can make most of their electronic health records in light of the meaningful use in a number of ways. Firstly, they can invest in equipping their staffs with the needed competencies in optimizing the benefits of electronic health records. Developing the competencies of the staffs will ensure that they have the knowledge and skills to explore the additional ways in which healthcare technologies can be used to improve the care outcomes of their populations (Lin et al., 2019). The other way is through the incorporation of new technologies into the electronic health records to improve the safety, quality and efficiency of care. An example of a way in which they can achieve the objective is through the incorporation of telehealth into the existing technologies to ensure the provision of patient-centered care to the diverse populations (Radanović & Likić, 2018). They can also incorporate systems such as barcode medication administration into the electronic health records to improve the safety of patient care.

Implementation of the Meaningful Legislation in my Organization

My organization has adopted interventions that support the implementation of the meaningful use. One of them is the use of electronic health records. The organization uses electronic health records for data collection, storage, analysis, and retrieval for use in making decisions on patient care. The organization also provides patients access to their health-related data. Patients can access their health related data to ensure that they are informed about their care needs and lifestyle and behavioral interventions they need to promote their health. The organization also captures vital data such as smoking status of adults aged 18 years and above and transmits it to the state database to inform public health initiatives.

Conclusion

In sum, the meaningful use has considerable benefits to healthcare. However, the implementation of its legislations is associated with a number of dilemmas that should be considered in healthcare. The dilemmas may act as potential barriers to the implementation of the meaningful use in health care. Therefore, healthcare institutions should explore ways of making the most of the meaningful use despite the challenges associated with it.

References

Entzeridou, E., Markopoulou, E., & Mollaki, V. (2018). Public and physician’s expectations and ethical concerns about electronic health record: Benefits outweigh risks except for information security. International Journal of Medical Informatics, 110, 98–107. https://doi.org/10.1016/j.ijmedinf.2017.12.004

Hand, D. J. (2018). Aspects of Data Ethics in a Changing World: Where Are We Now? Big Data, 6(3), 176–190. https://doi.org/10.1089/big.2018.0083

Keshta, I., & Odeh, A. (2021). Security and privacy of electronic health records: Concerns and challenges. Egyptian Informatics Journal, 22(2), 177–183. https://doi.org/10.1016/j.eij.2020.07.003

Lin, Y.-K., Lin, M., & Chen, H. (2019). Do Electronic Health Records Affect Quality of Care? Evidence from the HITECH Act. Information Systems Research, 30(1), 306–318. https://doi.org/10.1287/isre.2018.0813

Mello, M. M., Adler-Milstein, J., Ding, K. L., & Savage, L. (2018). Legal Barriers to the Growth of Health Information Exchange—Boulders or Pebbles? The Milbank Quarterly, 96(1), 110–143. https://doi.org/10.1111/1468-0009.12313

Ntoutsi, E., Fafalios, P., Gadiraju, U., Iosifidis, V., Nejdl, W., Vidal, M.-E., Ruggieri, S., Turini, F., Papadopoulos, S., Krasanakis, E., Kompatsiaris, I., Kinder-Kurlanda, K., Wagner, C., Karimi, F., Fernandez, M., Alani, H., Berendt, B., Kruegel, T., Heinze, C., … Staab, S. (2020). Bias in data-driven artificial intelligence systems—An introductory survey. WIREs Data Mining and Knowledge Discovery, 10(3), e1356. https://doi.org/10.1002/widm.1356

Radanović, I., & Likić, R. (2018). Opportunities for Use of Blockchain Technology in Medicine. Applied Health Economics and Health Policy, 16(5), 583–590. https://doi.org/10.1007/s40258-018-0412-8

 

Meaningful use refers to an electronic health records (EHR) incentive program, which offers incentive payments for specific healthcare providers to adopt EHR technology in ways that improve patient care. The program encourages eligible providers to use the EHR’s capabilities to arrive at benchmarks that promote improved patient care (CMS, 2017). The meaningful use program has particular requirements that the eligible providers must meet to get the incentive payments. This paper seeks to discuss the legal, financial, and ethical issues that may arise due to meaningful use legislation and how they may hinder the successful implementation of meaningful use in an organization.

Legal, Financial, and Ethical Issues That May Arise As A Result Of Meaningful Use Legislation

Legal issues that can occur during meaningful use legislation include increased legal responsibility and accountability for healthcare providers. Complex electronic-based auditing procedures can point out providers who review or fail to review vital patient information in the EHR (Balestra, 2017). As a result, providers can be sued on the grounds of medical negligence for failing to address priority patient issues. Challenges related to the quality, usability, and reliability of the available EHRs may bring complex legal implications. Most EHR contracts have a ‘hold harmless’ clause which restricts health providers from reporting EHR-related challenges (Balestra, 2017). Furthermore, documentation-related EHR issues may result in legal liabilities. Documentation must be accurate and clear to offer a foundation for every provider to improve patient outcomes (Balestra, 2017). However, electronic documentation that does not meet these principles may result in undesirable outcomes for the provider, patients, families, or the healthcare organization, resulting in legal proceedings.

Financial issues that may occur from meaningful use include unresolved issues on the party that should pay for the implementation and use of the EHR. In most of the current provider reimbursement models, the highest percentage of the EHR monetary benefits go to health care payers instead of those currently financing the EHR implementation (Lite et al., 2020). Health care providers may raise financial concerns about the cost and resources needed to implement and maintain the EHR.  The transition costs from paper-based records to EHR documentation are barriers to successful, meaningful use legislation (Lite et al., 2020). The transition is associated with costs to reduce patient load during the transition process, staff training, various technical support charges, and costs to load medical records from paper into the EHR system.

Evidence reveals that EHRs result in unintentional consequences with patient safety implications. EHR usability challenges may result in ethical issues that may need ethical decision-making models to guide health providers on the appropriate actions to promote safe, effective patient care (McBride et al., 2018). The EHR has enhanced portability and accessibility, which raises ethical questions on the ownership of protected health information. Ethical issues may also arise on the health providers’ responsibility to prevent and notify patients of the potential for privacy breaches when using the EHR (McBride et al., 2018). Computer-based breaches on personal health information may result in complex ethical and legal issues on the suitability of the approaches used to address them.

How These Issues Might Present Barriers to Successful Implementation within an Organization

Potential legal, financial, and ethical issues significantly hinder the implementation of meaningful use within a healthcare organization. Legal issues hinder successful, meaningful use implementation since healthcare leaders become concerned about the legal liabilities that EHR implementation may bring to the organization (McBride et al., 2018). The legal fees needed to develop EHR contracts also hinder the successful implementation of meaningful use, especially in small practices (Lite et al., 2020). Financial issues such as limited resources limit organizations from purchasing the EHR, which is a major barrier to implementing meaningful use. Ethical issues related to patient privacy and data integrity bar organizations from implementing meaningful use due to concerns of failing to uphold the HIPAA rule on maintaining patients’ privacy when using the EHR.

Ways That Health Care Organizations Can Make the Most of Their Electronic Health Record Investments In Light Of Meaningful Use

The Meaningful Use program promotes a safer, more efficient way to deliver healthcare services. Health care organizations can make the most of their EHR in view of meaningful use by using it to foster smooth, accurate data-sharing among the healthcare providers and improved quality of care for all patients (Wani & Malhotra, 2018). Organizations can use the EHR to ensure that the providers have access to complete and accurate information, facilitate the diagnosis of health conditions, and provide the best possible patient care. Besides, they can use the EHR to improve care coordination in the organizations (Wani & Malhotra, 2018). With the EHR, information can be shared instantaneously across care organizations, including hospitals, physician offices, and health systems, resulting in better care coordination.

Organizations can use the EHR to increase their patient engagement. The EHR strengthens the capacity of organizations to receive their medical records electronically and share them securely over the Internet. Health organizations can use it to their benefit to encourage patients to take a more active role in managing their health and their families (Wani & Malhotra, 2018). Organizations can also use the EHR to improve patient safety. For instance, they can use the EHR to promote fast electronic access to patient information about allergies, conditions, medications, and treatment history, thus significantly reducing the risk of medical errors (Wani & Malhotra, 2018). Lastly, organizations can use the EHR to promote healthier patient populations and communities by capturing vital data about diseases and outcomes and sharing it with other health professionals locally, regionally, and countrywide.

How EHR-Related Meaningful Use Legislation Is Being Implemented In My Organization

Meaningful legislation is being implemented in my organization through interventions consistent with the 13 Core Objectives and 9 Menu Objectives of stage one (CMS, 2017).  Clinicians use computerized provider order entry (CPOE) and clinical decision support (CDS) in making clinical decisions and carry out drug-drug and drug-allergy checks. The organization maintains an updated problem list of current and active diagnoses, an active drug list, and an active medication allergy list for patients. In addition, we have adopted E-Prescribing for the largest percentage of our patients (CMS, 2017). We also implement meaningful use by documenting patients’ demographics, changes in vital signs, and smoking status for patients 13 years and above. Furthermore, the organization offers patients the capacity to view, download, and transmit their health data online.

The organization further implements meaningful use by conducting a security risk analysis to protect electronic health data. Clinicians also provide patients with clinical summaries for their outpatient visits within three business days. It also submits electronic data to immunization registries and electronic syndromic surveillance data to public health agencies (CMS, 2017). Besides, we conduct drug formulary checks and create lists of patients by their specific conditions. We also send reminders to patients for their preventive and follow-up care and provide them with patient-specific education resources. Health providers in the organization implement meaningful use by integrating clinical lab-test results, carrying out medication reconciliation, and recording the summary of care for transitions of care.

Conclusion

            Legal issues related to meaningful use can be attributed to complex EHR systems, problems with quality, usability, and reliability of the EHR, and electronic documentation. Financial issues include inadequate resources to purchase and maintain the EHR  as well as the transition from paper-based records to EHR. Ethical issues may be related to patient safety and breach of patient privacy. These issues may hinder the successful implementation since organizations become concerned about the legal and ethical liabilities and lack adequate resources to maintain the EHR.

References

Balestra, M. L. (2017). Electronic health records: patient care and ethical and legal implications for nurse practitioners. The Journal for Nurse Practitioners, 13(2), 105-111. https://doi.org/10.1016/j.nurpra.2016.09.010

Centers for Medicare & Medicaid Services. (2017). Electronic health records (EHR) incentive programs. Eligible Hospital and Critical Access Hospital Meaningful Use Core Measures: Measure, 6.

Lite, S., Gordon, W. J., & Stern, A. D. (2020). Association of the meaningful use electronic health record incentive program with health information technology venture capital funding. JAMA network open, 3(3), e201402-e201402. https://doi.org/10.1001/jamanetworkopen.2020.1402

McBride, S., Tietze, M., Robichaux, C., Stokes, L., & Weber, E. (2018). Identifying and addressing ethical issues with the use of electronic health records. Online J Issues Nurs, 23(1). https://doi.org/10.3912/OJIN.Vol23No01Man05

Wani, D., & Malhotra, M. (2018). Does the meaningful use of electronic health records improve patient outcomes?. Journal of Operations Management, 60, 1-18. https://doi.org/10.1016/j.jom.2018.06.003