Nursing Essay on Meaningful Use for Nurses: Implications and Recommendations

Meaningful Use for Nurses: Implications and Recommendations

Introduction

The beliefs for better health care services in USA and the country’s major states are pegged on the understanding of fundamental changes brought forth by the American Recovery and Reinvestment Act. According to the US’s office for National Health Care Coordination, the federal government through its focus on meaningful use does not only focus on better healthcare outcomes through technology adoption, but also on the exchange and application of healthcare information for improved clinical decision-making at every level of patient’s care (Davis, 2009). This means that every service provider in the healthcare sector must be familiar with the exchange matrix of meaningful use and major healthcare policies, and how the impact on patients, healthcare units, primary care practices as well as the effect on public healthcare provisions can be managed.

This paper focuses on meaningful use, programs, and criteria and their implications on patients and healthcare institutions. At the final stage of development, this paper offers certain recommendations that can be followed by service providers to improve the quality of healthcare services, reduce healthcare disparities among the population and also engage other stakeholders in ensuring improve medical care. For easy comprehension and understanding of the concepts of meaningful use, the paper is structured into an overview of meaningful use program; analysis of the implications of meaningful use core criteria; evidence-based recommendations for the collection of additional criteria; and a summary statement on the analysis and recommendations of the additional criteria.

Overview of meaningful use

The concepts of meaningful use retail around the application of certified electronic records otherwise known by the short form EHR technology for a number of healthcare functions like improving the quality of medical services, safety of patients and nurses, efficiencies and health disparities; engaging patients, families and other stakeholders in healthcare programs; improving care coordination to the general public and; maintaining privacy and security of heath information (Davis, 2009). The federal government together with state governments and other policy makers across USA believe that compliance with meaningful use will allow better health outcomes among the people; increase transparency and efficiency across health dimension and; empower citizens to take part in health promotion through more scientific research data and information on available health programs and systems.

Meaningful use programs include the Medicare and Medicaid EHR incentives, which uses the certified EHR technological platform to enhance patients’ care and population health conditions (Fetter, 2009). The financial incentives provided under the Medicare and Medicaid programs have also subsidized the cost of medical services and this has reduced health disparities that existed before the healthcare reforms. The federals government focuses on the needs for service providers to show interest and value by objectively meeting the healthcare standards before receiving EHR incentive payments (Fetter, 2009). The incentive programs as described by the American Medical Association is staged into three major phases with several increasing demands. As per the desires of federal states, the healthcare providers need to demonstrate high level of acceptance of the various programs falling within the category of meaningful use. The healthcare providers must in addition be able to demonstrate meaningful use every year in order to obtain financial incentives and also to avoid medical payment adjustment.

As already stated, meaningful use programs are staged into three phases with the first phase (stage 1) demanding a full demonstration of successful implementation of the 2014 CEHRT policies and other scheduled programs. For example, the release of a final rule by the CMS in mid-2014 that granted service flexibility among healthcare service providers within the EHR 2014 reporting period (Fetter, 2009). This rule was meant to improve the quality of medical services and also maintain high levels of service flexibility at relatively lower costs of administration.

  At stage 2, the final rule released by CNS allowed service availability and flexibility for the implementation of the 2014 CEHRT edition following the observed delays during the 2014 reporting periods. Within stage 2, service providers have the alternative of demonstrating meaningful use for those who have not fully considered the 2014 CEHRT edition (Fetter, 2009). This can be done by demonstrating the 2013 stage 1 objectives or by combining the 2011 and 2014 CEHRT Editions; demonstrating the 2014 stage 1 objectives and finally; demonstrating stage 2 objectives or combining the 2011 and 2014 CEHRT editions.

Stage 3 of meaningful use is however focus on quality, safety, and efficiency improvement policies. The stage is based on supportive clinical decisions following the needs to prioritize on the general health of the public and improve public access to self-health management tools. The chart below can be used to represent the progressive toll-out of the three stages as already discussed with specific attachment on the time of implementation (Fetter, 2009), alignment with HIE (Health Information Exchange), and stage requirement objectives.

Analysis of the implication of core criteria

Core criteria for meaningful use are also categorized following the three stages mentioned above. In the first stage, the criterion focuses on electronic capture of patient’s health and medical information in a coded format. The coding facilitates information accessibility to aid in tracking health conditions and also to assist with care coordination. At this stage, the electronic capture also facilitates clinical decision-making in a way that improves disease and medication management (Scherb, Maas, Head, Johnson, Kozel, Reed & Moorhead, 2013). Stage 2 criteria on the other hand emphasizes on the disease management, supportive clinical decisions, care management, patients’ access to personal health records, healthcare transition and improved communications between physicians and health agencies. The criteria defined under stage 2 only aims at improving service effectiveness through better communication linkages, data and information processing as well as ensuring self-managed care support. As already mentioned, the criteria for stage 3 of the meaning use focus on improved service quality, safety and efficiency following system improvements in the first and second stages.  The implications for meaningful use include:

  • Improved service quality and a reduction in service disparities

Under improved service quality and reduced service disparity, the programs prioritize on the comprehensive access to patient’s health information, data storage and information referencing. In this case, the clinicians are required to be more diligent on how they capture key information about the health status of patients in order to meet the service objectives like providing safe, efficient and effective care (Scherb, Maas, Head, Johnson, Kozel, Reed & Moorhead, 2013). This means that if nursing teams are unable to capture data elements required for patient’s health improvements, information will not be available for the most current advance directives. In other words, health problems and poor medication will be some of the vital signs showing failures in specific plans to meet the care objectives. As far as the care plan is concerned, the expectation of meaningful use is that by the end of 2015, healthcare organizations will be in a position to use evidence-based sets of order, perform closed-loop medication procedures, and provide sportive clinical decisions within the real time of service delivery (Scherb, Maas, Head, Johnson, Kozel, Reed & Moorhead, 2013). The implication in this case is to improve the quality, safety and efficiency of clinical services alongside reducing health disparities that exists among citizens.

  • Improved engagement on the side of patient, family members and other stakeholders

Patients and family engagement aims at providing patients and respective families prompt and accurate access to data about patient’s health, medication knowledge and the different tools that can be used to make informed decisions for improved self-care. The implication for meaning use is that personal health records and data are made available to clients meaning that clinicians can retrieve and use information for the purposes of diagnosing and ensuring medical reconciliation (Scherb, Maas, Head, Johnson, Kozel, Reed & Moorhead, 2013). This is because chronic diseases require care management and to ensure positive health outcomes, focusing on IT capabilities, especially in areas of education resources, tracking individual preferences for the treatment services and applying self-management techniques become relevant.

  • Enhanced care coordination at public and private health institutions

Another implication for the program is the ability to provide an improved platform for the exchange of key clinical information with the objective of providing safer and more effective care at specific encounters. The enhancement of service coordination underlies three key areas: summary of the patients’ clinical information, electronic processing for the subscriptions, and electronic reconciliation of the medication procedures (Scherb, Maas, Head, Johnson, Kozel, Reed & Moorhead, 2013). The meaningful use in this case covers those processes that will lead to proper collection, storage and sharing of patient’s data across healthcare organizations, communities and regions, but with the approval of the patient.

Meaningful use recommendations

From the analysis, it its evident that the criteria are limited to three implications, which may be considered insufficient when it comes to understanding the needs of the population. In this case the sets of criteria for identifying the target public health and controlling cybercrime may be necessary since the transmission of patient’s data occur through a range of interconnected networks. On the side of public health targeting, proper documentation and effective communication of vital data on patient’s health like immunization and lab results in fundamental as one ways towards meeting a patient-centred care. Other than prioritizing on the needs of patients, IT-based communication is highly valued because improves individual’s abilities to adapt to and deliver care services in a way that meets the needs of particular communities.

On the same note, information safety can only be possible in cases where the system allows for access by authorized users. Even though trust is highly associated by the roles of nurses, there is still need to apply strict policies and monitoring to limit breach of confidentiality, which is key to a nursing profession. In order to provide a more secure environment, the healthcare organizations must accept to provide timely accounting and disclosures for treatment and any payment based on the applicable laws.  

Conclusion

The changes in healthcare policies across the USA aims at improving the quality of life, maintaining a closer operational relationship between nurses, patients and the respective families alongside ensuring a reduction in the cost of providing medical services. The factor to consider in all the attempts is the role of technology towards disease diagnosis, collection of patient’s data, compilation storage and transmission to other departments for improved analysis and final processing (Davis, 2009). With the use of IT and its related components, it becomes possible to improve the quality of services, provide safety care environment and link patients’ needs with the country’s healthcare concerns.

References

Davis, R. L. (2009). Exploring possibilities: virtual reality in nursing research. Research and theory for nursing practice, 23(2), 133-147.

Fetter, M. S. (2009). Using case studies to define nursing informatics interoperability. Issues in mental health nursing, 30(8), 524-525.

Scherb, C. A., Maas, M. L., Head, B. J., Johnson, M. R., Kozel, M., Reed, D., … & Moorhead, S. (2013). Implications of electronic health record meaningful use legislation for nursing clinical information system development and refinement. International journal of nursing knowledge, 24(2), 93-100.