Introduction
The purpose of this research is to evaluate the Meaningful Use program and analyze its implications for nurses, nursing, national health policy, patient outcomes, and population health associated with the collection and use of Meaningful Use core criteria. It covers an overview of the Meaningful Use program, the implications of Meaningful Use core criteria, and recommendations for improvements. The Health Information Technology for Economic and Clinical Health (HITECH) Act 2009 requires healthcare providers to adopt and ensure Meaningful Use of electronic health records (EHRs) to qualify for reimbursement under the defined core criteria for eligibility. Meaningful Use implies that healthcare providers must use EHRs to achieve considerable advancements in care provision. The Act relates achievement of improvements, processes, patient outcomes, and reimbursement (Blumenthal & Tavenner, 2010).
Overview of the Meaningful Use Program
The Meaningful Use program has five purposes (Emmons, 2010). First, the Meaningful Use Program aims to enhance “quality, effectiveness, safety and lessen healthcare disparities” (Emmons, 2010). The second goal strives to enhance communication with “patients and their families electronically” (Emmons, 2010). The third purpose is to enhance “healthcare provision coordination” (Emmons, 2010). Fourth, the Meaningful Use program also aims to promote sufficient “privacy and security for patient personal data” (Emmons, 2010). Finally, the goal is to enhance public and population health by collecting and analyzing data for a given period.
For all these purposes, nurses and hospitals have vital roles with EHRs to ensure that they become meaningful and relevant for all stakeholders for the periods under review. In this regard, nurses and healthcare facilities must meet specific objectives under the core criteria of the program. The core objectives would ensure that EHRs promote improved healthcare outcomes (Blumenthal & Tavenner, 2010). The fundamental elements in these core objectives include creating effective medical records to capture “primary data; patients’ vital signs and demographics, active medications and allergies, up-to-date problem lists of current and active diagnoses, and smoking status” (Blumenthal & Tavenner, 2010).
Other core objectives focus on the use of relevant software applications to achieve optimal benefits of “EHRs for enhancing safety, effectiveness, and quality of care” (Blumenthal & Tavenner, 2010). Thus, nurses should rely on such applications to make informed decisions and prevent common errors (Blumenthal & Tavenner, 2010). The Act requires clinicians to adopt EHRs to capture data and use them for effective decision-making in order to qualify for incentive reimbursement. In the process, they must demonstrate such benefits to patients who should get their health information through electronic platforms.
The Meaningful Use program also provided alternative tasks often for providers to choose any five for their implementation to facilitate the realization of the goals between the years 2011 and 2012. In these tasks, providers could focus on drug checks, including laboratory results, alert patients who need care, promote patient-specific care education and use EHRs to support transition (Blumenthal & Tavenner, 2010). In addition, providers must use a specific EHR for a given rate to be considered meaningfully used. It is believed that the rates would facilitate the adoption, use of EHRs and ensure that they achieve average practices.
Moreover, the Act states that Meaningful Use should be reflected “in electronic quality data reporting” (Blumenthal & Tavenner, 2010). In this regard, providers will learn about the outcomes of their practices, and eventually, the public will receive impacts on EHRs’ implementation. Nurses are expected to provide data on weight, tobacco smoking, and blood pressure as part of the three core quality measures (Blumenthal & Tavenner, 2010). In addition, they must also report on other three alternative measures to include in the EHRs.
Analysis of the implications of Meaningful Use core criteria
The adoption of EHRs has been widespread among healthcare providers in the US (Blumenthal & Tavenner, 2010). The aim of the Meaningful Use program is to improve healthcare outcomes, and patients and the public should experience such outcomes and benefits. It is however imperative to recognize that EHRs will not undergo an easy transition because stakeholders are yet to determine its benefits, establish consensus and adoption is relatively low (Blumenthal & Tavenner, 2010).
On the contrary, a recent study by Wright et al. (2013) suggested that healthcare providers had achieved significant growth in the implementation of EHRs and Meaningful Use as they strived to avoid possible penalties by the year 2015. In addition, a systematic review of literature established that an increased number of healthcare facilities provided features of a patient portal to enhance Meaningful Use when patients could easily view their information electronically (Kruse, Bolton, & Freriks, 2015).
Initially, healthcare providers had argued that core criteria objectives were “broad, slow in pace and too demanding and inflexible because of the all-or-nothing test, which too few providers could pass” (Blumenthal & Tavenner, 2010).
Currently, the core criteria appear adequate to cover various aspects of EHRs. Adoption and Meaningful Use, however, have faced certain implementation challenges such as high costs of technologies, workflow hurdles, knowledge gaps, and poor interoperability (Wright et al., 2013). While all federally funded extensions that facilitate EHR adoption have passed their enrollment targets, a smaller percentage of enrolled clinicians have demonstrated Meaningful Use while continued financial support for the extension centers remains unclear.
Although there is an ongoing review of core criteria, Wright et al. (2015) have acknowledged that later stages of Meaningful Use could lead to greater difficulty while it remains uncertain whether clinicians will successfully demonstrate Meaningful Use in later stages of adoption. In addition, the authors observed that later stage advantages of Meaningful Use on “quality, safety and efficiency are not yet known while further increases in EHR adoption, functionality for clinical decision support systems and studies are needed to ensure the effectiveness of the meaningful use program” (Wright et al., 2013).
Meaningful Use Recommendations
The earliest results from studies have indicated increased use of EHRs to promote Meaningful Use and realize quality, safety, and efficiency in healthcare provision. However, studies have established limited achievements based on Meaningful Use expectations, and barriers have been identified. In this regard, core criteria objectives may not be fully realized. Therefore, the Meaningful Use program requires adequate funds, user education, workflow improvement, and enhanced interoperability. In addition, continued review of core criteria and consultation with the Department of Health and Human Services (DHHS) is necessary to ensure comprehensive and transparent processes during core criteria improvement and implementation (Wright et al., 2013).
Conclusion
The Act strives to ensure that the healthcare system in the US is modern for improved quality and effectiveness in healthcare provision. Hence, Meaningful Use focuses on the use of EHRs to achieve these goals and guarantee reimbursement for healthcare providers who realize significant improvements. Earlier studies have demonstrated widespread adoption of EHRs, but few healthcare providers have demonstrated positive achievements of Meaningful Use. In this regard, a constant review of core criteria and barriers that inhibit effective implementation should be evaluated to realize the purpose of the Meaningful Use program.
References
Blumenthal, D., & Tavenner, M. (2010). The “Meaningful Use” Regulation for Electronic Health Records. New England Journal of Medicine, 363, 501-504.
Emmons, N. (2010). Higher Purpose: What Meaningful Use Means to Nurses. Web.
Kruse, C. S., Bolton, K., & Freriks, G. (2015). The Effect of Patient Portals on Quality Outcomes and Its Implications to Meaningful Use: A Systematic Review. Journal of Medical Internet Research, 17(2), e44.
Wright, A., Henkin, S., Feblowitz, J., McCoy, A. B., Bates, D. W., & Sittig, D. F. (2013). Early Results of the Meaningful Use Program for Electronic Health Records. New England Journal of Medicine, 368, 779-780.