Meaningful Use is part of the EHR requirements targeted for completion in 2014. Meaningful Use was created in order to capture the right data to improve patient outcomes.
With this in mind, how can you as a nurse ensure that Meaningful Use is being implemented into the EHR? If you were the nurse manager, how would you implement this documentation and ensure buy-in by your staff?
Meaningful Use
What is meaningful use (MU)? Is this a term with which you are familiar? Ask your nurse leader or anyone responsible for reimbursement at your place of employment and a lively discussion is likely to result.
In 2004, President Bush established an initiative to mandate the establishment of electronic health records (EHR) for all U.S. citizens over the next 10 years (Hebda & Czar, 2013). As healthcare providers and agencies scrambled to meet the mandate to avoid penalties from the Centers for Medicare and Medicaid (CMS), incentive funding became available. However, attached to that funding was a stipulation of MU.
The HITECH Act is part of the 2009 American Recovery and Reinvestment Act enacted during President Obama’s administration. This legislation created programs under the Centers for Medicare and Medicaid Systems (CMS) for incentives to those agencies demonstrating meaningful use of technology (http://www.cdc.gov/ehrmeaningfuluse/introduction.html). Will meaningful use of technology and EHRs for every American improve healthcare quality, reduce healthcare costs, and improve patient and nurse safety? Time will tell.
Reflection
With the federal initiative for implementation of EHRs, can you think of a time when your documentation in a written record was lacking detail? How could the lack of information in the written record be improved with an EHR?
The MU requirement is being implemented in stages. For additional information, review Chapter 14, Box 14-1, Stage 1 Meaningful Use Core Requirements for Hospitals in Hebda and Czar (2013).
Box 14-1 Stage I Meaningful Use Core Requirements for Hospitals
1.Record demographic information (preferred language, gender, race ethnic background, date of birth, date/cause of death (inpatient setting only)).
2.Computerized provider order entry.
3. Clinical decision support and the ability to track compliance with rule(s).
4. Automatic, real-time drug-drug and drug-allergy interaction checks based on the medication list, allergy list.
5. Maintain an active medication list.
6. Maintain an active medication allergy list.
7. Record and retrieve vital signs (height, weight, blood pressure, BMI, growth charts for ages 2–20 years).
8. Record smoking status for patients 13 years old and older.
9. Mechanisms to protect information created or maintained by the certified EHR technology that include access control.
10.Electronically exchange key clinical information among providers and patient-authorized entities.
11.Supply patients with an electronic copy of their health information upon request.
12. Supply patients with an electronic copy of their discharge instructions upon request.
13. Report required clinical quality measures to CMS.
14. Maintain up-to-date problem lists of current and active patient diagnoses.
Source: U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services Medicare and Medicaid Programs. (July 28, 2010). Electronic Health Record Incentive Program Final Rule. Federal Register, 75(144), 44313–44588. Retrieved from http://edocket.access.gpo.gov/2010/pdf/2010-17207.pdf
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