Introduction
The implementation of electronic health records (EHR) allowed medical establishments to keep a better track of their patients, diagnosis, billing statements, and other components of health care services that affect its delivery. However, the information stored in these systems should be confidential because it includes specific details about individuals, their diagnosis, and other components. Due to this reason, the US government created the Meaningful Use Guidelines that serve as a regulation that describes the specifics of the EHR application in practice. This presentation will describe the Meaningful Use Guidelines, their purpose, compliance with this policy within the Independence Medical Center, and will provide recommendations for improvement.
The primary aim of the Meaningful Use Guidelines is to ensure that patient data that is used by medical centers is adequately stored and transferred to other organizations, for instance, insurers. Therefore, clinics such as the Independence Medical Center should dedicate attention towards information technology application.
For Vila Health Meaningful Use Guidelines mean that the EHS applied by the organization has to function in compliance with this regulation, which will facilitate data safety and proper functioning of the hospital. The challenges that this hospital may encounter when ensuring adherence to these rules are connected to the existing system – Opus that has been used for over 2008 and may require an update.
State of Compliance
While the application of these guidelines is voluntary for healthcare establishments, it should be noted that those failing to comply may be subjected to penalties or lack of financial incentives (Slight et al., 2015). The current state of compliance in the Independence Medical Center is sufficient since the organization implemented electronic systems that help track information about patients outlined in the guidelines.
However, the communication with employees that utilize the system revealed several issues. Firstly, no standardized approach to input currently exists because some health insurers have specified requirements for data input. Secondly, the selected program does not work in cooperation with other applications that the Independence Medical Center uses and thus, the transition of information is compromised. Finally, the quality of care may be impaired due to the fact that Opus has many fields and requirements that need to be filled out by medical professionals that are unnecessary for the admission and treatment, however, they extend the timeframe of processes.
Thus, it can be concluded that organizations willing to comply with the Meaningful Use Guidelines may be unable to do so because systems available on the market are outdated and do not provide necessary support to medical professionals. Areas of unclear and incomplete information that can help improve the EHR in Independence Medical Center include the budget and timeframe required to implement changes into the existing system or for replacing it with a different option.
Current HIS
The previous section outlines the specifics of Meaningful Use Guidelines and EHR, while this part will focus on the findings of the EHR functioning within the Independence Medical Center. The data process that the Independence Medical Center uses involves inputting patient information in the Opus system, which is done upon admission or before it, in case of a pre-planned visit.
Additionally, laboratory tests are managed by the organization’s HIS, which allows to schedule tests and store results. Medicine is also part of this system because physicians have to be aware of the type of medication currently available in order to be able to prescribe it to patients. Therefore, the existing EHR system helps the Independence Medical Center to regulate the process of admission and patient care by providing a source of information to medical professionals. All departments that are engaged in work within the Independence Medical Center use the EHR system. Additionally, the program was updated to adhere to the Affordable Care Act requirements, which should have improved its functioning.
The evaluation of the EHR used by the Independence Medical Center reveals several areas of improvement that need to be facilitated. It is because in most cases, medical professionals state that the current system obstructs them from working efficiently and do not correspond to the daily workflow of this hospital. Pratt (2016) states that “software doesn’t always work perfectly” (para. 5). It should be noted that most respondents argue that it is helpful in scheduling shifts or reviving patient-specific data such as treatment plan or next visit. All in all, it can be concluded the current system does not comply with the guidelines discussed in this presentation and thus should be changed for a different one (Slight et al., 2015) argue that most medical establishments encounter issues with HIS outlined above, which complicates the ability to evaluate the quality improvement that such systems should facilitate. It can be done through the development of the current meaningful use Guidelines and by adjusting the Opus system to be more flexible.
While many reasons explain the need for adaptation of EHR systems, including a rapidly changing external environment of the healthcare industry and a need to change the patient-physician relationship, it should be acknowledged that these programs help simplify a lot of procedures. Additionally, the efficiency of work is enhanced because physicians do not have to work on manually filling out forms and imputing information about the diagnosis.
Therefore, the medical personnel benefits from EHR because they can review information about the patient efficiently. Patients benefit because the quality of care improves as physicians can dedicate more time to talking to them and identifying specific complaints. Additionally, the ability to cross-share information between departments results in better care as well, since different medical professionals can view data and interpret it. Therefore, it is easier for a team of professionals, including nurses and doctors, to work on a specific case.
Patient outcomes can be improved by improving the system, including its functioning, and ability to update patient information, that will help physicians share insights with colleagues. Simplification of the existing processes can be facilitated through the ability to input and view data using an electronic device, for instance, physicians can get immediate access to patient history or test results. In addition, due to communication with other departments or hospital employees, a patient can receive better treatment. According to Slight et al. (2015), more research is required on this topic because current data does not confirm at EHR’s significantly impact the quality. Conflicting evidence exists regarding the beneficial impact of EHR programs.
Firstly, the admission department uses the EHR to input data about the patient, which can be done either before his or her visit and upon the patient’s arrival. This explains the process of capturing data that is the primary element of EHR’s functioning. Next, different departments, track this information to notify patients about the preparation for procedures or to manage the supply of medication. This helps the efficiency because the system allows identifying the number of tests, surgeries, or consultations that will occur in the Independence Medical Center on a particular day.
Next, information is analyzed and shared by the personnel of this hospital. For instance, nurses use the EHR system to identify medication they have to provide to individuals or to check for blood draw procedures they need to perform. Additionally, they can leave notes to nurses who will be working in the next shift to notify them of what has been done already. Nurses in ICU, Cancer Center, Emergency Department, and Ambulatory Services use the data to plan their work and facilitate appropriate procedures and medication.
The areas that comply with the Meaningful Use Guidelines are the ability to present patient data in an electronic form. Additionally, the Opus system has standardized forms for medical personnel that help create a unified approach to information sharing. However, this model is not functioning in compliance with the requirements of all insurers that the Independence Medical Center works with, therefore, this area does not adhere to the Meaningful Use Guideline.
Issues exist with the departments of ICU, Emergency, and Ambulatory and thus this indicates the areas of noncompliance with the guidelines. It was stated by the employees that when accessing the Opus system through a wireless connection patient data was not updated, which affects the ability to share information. Additionally, the system often slows the work of nurses, which impacts the patient outcomes adversely.
Upgrades and Improvements
The task of integrating new technology into the existing processes of a health care organization is difficult due to the complexity of these establishments. Therefore, the issues that the Independence Medical Center experiences are prevalent in the industry as currently, the requirements of the Meaningful Use Guidelines do not correspond with the capabilities of medical establishments. However, several aspects of the current functionality of this system can be enhanced to ensure a better efficiency of work and improved patient care in the Independence Medical Center.
In order to maintain the requirements of the Meaningful Use Guidelines, this medical center has to review its existing approach to information technology application because the current system is inefficient. Slight et al. (2015) state that the implementation of this policy involved three stages, and thus it is necessary to examine the Independence Medical Center’s implementation of EHR and identify whether all aspects of this process were correctly implemented. The primary consideration that should be considered is the safety of patient information. Additionally, it is crucial to select a system that will suit the needs of this establishment and educate staff on using the program.
Best practices that Independence Medical Center can use for long-term compliance to current incentive programs include continuous monitoring of the EHR functioning, additional attention to the safety of data, and cooperation between staff members. Boonstra et al. (2014) argue that a comprehensive strategy that incorporates these elements can help hospitals facilitate a successful implementation of the EHR.
Additional recommendations for the EHR system involve the process of selecting a better program and setting it up within the environment of the Independence Health Center.
User functions refer to the cooperation of the medical personnel and EHR systems. According to Boonstra et al. (2014), it is vital to implement a program that will be user-friendly. This is also important because the evaluation of the existing EHR revealed that some staff members are not satisfied with the work of it. Therefore, it is recommended to choose a different EHR that will be more tailored towards the needs of the personnel.
Training is essential for the adequate implementation of EHR because the personnel of the clinic can be unequipped or can lack skills and knowledge necessary to work with EHR systems, which will mitigate the benefits of it and will disable compliance with the guidelines.
Pratt (2016) recommends relying on medical professionals within the Independence Medical Center who already have sufficient understanding of information technology because these individuals will be able to provide on-site assistance to their colleagues. Additionally, the author offers a week-long training session facilitated by the vendor of the EHR as an illustration of an appropriate strategy. Pratt (2016) also recommends scheduling training sessions in the hospital to ensure that physicians can address their questions and concerns. It is best to divide individuals into small groups and focus on competencies instead of hours of training, which should ensure a proper understanding of the EHR principles.
Ongoing compliance with the department heads is necessary because according to Boostra et al. (2014) support of the hospital’s management determines the outcomes of EHR’s implementation. Therefore, supportive leadership and involvement are required by the CEO of Independence Medical Center. Therefore, evidence-based recommendations are based on the literature review of the best practices conducted by Boonstra et al. (2014), and they involve cooperation, education, proper selection of EHR, and management involvement. The criteria for evaluating the approach will help determine whether the chosen strategy is successful.
The emerging models in the identified departments, such as medical records, business services, laboratory, pharmacy, and nursing should adopt the practice described by Garg, Lee, Evans, Chen, and Shieh (2015). The authors argue that specifically developed checklists can help physicians get used to the new system and improve their ability to use EHR. Additionally, the confidence of the establishment’s personnel in regards to using information technology is cited by Garg et al. (2015) as crucial for the outcomes of EHR. Therefore, specific attention should be dedicated to this element.
According to Cartwright-Smith, Gray, and Thorpe (2017), “there are numerous legal and policy considerations surrounding the question of who owns health information, including whether and how to confer specific ownership rights to health information” (p. 207). Thus, it is crucial for the executives of the Independence Medical Center to understand that the existing system requires an upgrade and personnel should be educated on the issue to provide patients with excellent services and ensure the safety of their data.
It is essential to consider the prospective risks that can affect the process of improving EHR at Independence Medical Center. Boonstra et al. (2014) argue that “resistance of clinical staff, in particular of physicians, is a major barrier to EHR implementation, but can be reduced by addressing their concerns” (p. 370). Therefore, it is crucial to examine the attitudes of the personnel and communicate with them to address concerns.
Overall, it can be concluded that the Meaningful Use Guidelines compliance is essential for any healthcare organization because they enable a better functioning of the processes, which results in better care. The review of the Independence Health Center’s EHR revealed that the organization has to review its current strategy to ensure compliance with the policy in question. This includes selecting a new system, training staff members, and providing support from managers.
References
Boonstra, A., Versluis, A., & Vos, J. F. J. (2014). Implementing electronic health records in hospitals: a systematic literature review. BMC Health Services Research, 14(1), 370. Web.
Cartwright-Smith, L., Gray, E., & Thorpe, J. H. (2017). Health information ownership: Legal theories and policy implications. Vanderbilt Journal of Entertainment and Technology Law, 19(2), 207.
Garg, T., Lee, J., Evans, K., Chen, J., & Shieh, L. (2015). Development and evaluation of an electronic health record–based best-practice discharge checklist for hospital patients. The Joint Commission Journal on Quality and Patient Safety, 41(3), 126-131. Web.
Pratt, M. K. (2016). 6 tips to help practices adapt to a new EHR. Web.
Slight, S., Berner, E., Galanter, W., Huff, S., Lambert, B., Lannon, C., … Bates, D. (2015). Meaningful use of electronic health records: Experiences from the field and future opportunities. JMIR Medical Informatics, 3(3), e30. Web.