Implementation Of Electronic Health Record (EHR) Was Mandate

Implementation Of Electronic Health Record Ehr Was Mandated By The G

Implementation of Electronic Health Record (EHR) was mandated by the government under the Health Information Technology for the Economic and Clinical Health (HITECH) Act (2009) that provided financial incentives for EHR implementation as well as imposed penalties for non-compliance. Evaluate the compliance with HITECH by solo Physician Practices in 2020. Make sure to note why the different practice sizes and types have different compliance levels in the adoption of the EHR. Discuss further governmental policies and incentive programs and the penalties for non-compliance intended to assure complete compliance with HITECH in terms of effectiveness and efficacy. The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as a part of the American Recovery and Reinvestment Act (ARRA) of 2009, was signed into law on February 17, 2009 (Health Information Technology for Economic and Clinical Health (HITECH) Act: Impact on HIPAA Privacy and Security Provisions (asha.org)) to promote the adoption of Health Information Technology (HIT). The HITECH Act mandated the use of HIT by computerizing the medical record through Electronic Health Record (EHR) implementation and connecting it with Regional Health Information Organizations (RHIOs) and then the RHIOs to the Nationwide Health Information Network (NwHIN/NHIN) for the national level health information exchange. Although the EHR implementation has progressed to a satisfactory level (Hospitals Use of Electronic Health Records Data, | HealthIT.gov), the RHIOs and NHIN have not. Evaluate three factors, one each in the financial, technical (interoperability), and administrative (data ownership/legal) areas that have impacted the adoption of health information exchange technologies at the RHIO and NwHIN/NHIN levels. Assess the government and private plans to overcome these barriers. Frame at least three recommendations for overcoming these barriers. How would the stakeholders be affected by these plans, if implemented? Watch this video on SDLC (Software Development Life Cycle) steps - . Analyze the SDLC process explained in the video. How it would differ/be the same when applied to the development of Healthcare Management Information Systems (HMIS) and/or Healthcare Information Systems (HIS)? Explain which of the step(s) can you omit if your organization does not maintain internal IT staff (Hint: Feasibility Study slide), and how would you complete this step of the SDLC process without affecting the integrity of the HMIS/HIS? Justify the cyclic nature of the SDLC process. Develop the managerial process steps with 2-3 main action item points intended to define the specific requirements for the necessary HMIS or HIS acquisition ( ). Make sure it follows a basic process decision-making model ( ) to make a choice between turn-on or in-house built system considering the economic, workforce, scope of practice and application as well as managerial compliance of the final decision.

Paper For Above instruction

The implementation of Electronic Health Records (EHRs) was a pivotal policy initiative driven by the U.S. government through the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009. This legislation was enacted to accelerate the adoption of health information technology across healthcare systems, particularly emphasizing the digitization of patient records, improving healthcare quality, safety, and efficiency (Blumenthal & Tavenner, 2010). By providing financial incentives and penalties for non-compliance, the law aimed to motivate healthcare providers to adopt certified EHR systems, ultimately fostering a nationwide health information infrastructure.

Compliance of Solo Physician Practices with HITECH in 2020

By 2020, compliance rates among solo physician practices remained varied. According to reports from the Office of the National Coordinator for Health Information Technology (ONC), solo practices exhibited lower adoption rates compared to larger group practices or hospital-based entities (ONC, 2020). The primary reasons for this discrepancy include limited financial resources, reduced technical capacity, and administrative challenges that impede full EHR integration. Solo practitioners often lack the economies of scale that larger practices benefit from, making investment in EHR systems and subsequent interoperability challenging. Additionally, smaller practices face difficulties in training staff, maintaining ongoing support, and ensuring regulatory compliance, all of which influence their compliance levels.

Impact of Practice Size and Type on EHR Adoption

Practice size directly correlates with EHR adoption levels; larger practices typically have more substantial capital, dedicated staff, and organizational structures conducive to EHR implementation (DesRoches et al., 2019). Conversely, solo practices often encounter barriers including high upfront costs, lack of technical expertise, and limited administrative capacity. Practice type also influences compliance; for example, hospital-based clinics tend to adopt EHRs swiftly due to regulatory pressures and integration mandates, whereas outpatient solo clinics may prioritize other operational aspects over extensive IT investments (HIMSS, 2021).

Governmental Policies and Incentive Programs

The HITECH Act’s meaningful use incentive program provided substantial financial benefits for early adopters, progressively tying reimbursement to EHR utilization and data exchange capabilities (Menachemi & Collum, 2011). Penalties for non-compliance—including reduced Medicare reimbursements—further incentivize adoption. Over time, additional policies such as the 21st Century Cures Act have aimed to strengthen interoperability and reduce barriers to health information exchange (HIE). These policies collectively aim to improve healthcare quality through the seamless exchange of patient data, but their efficacy depends on widespread implementation and overcoming ongoing barriers.

Barriers to Health Information Exchange (HIE): Financial, Technical, and Administrative

Despite progress, significant barriers hinder the full realization of HIE at regional and national levels. Financially, the cost of establishing interoperable systems, maintaining connection infrastructure, and ensuring security remain substantial (Weiner et al., 2019). Technically, differences in standards, data formats, and systems interoperability impair seamless information exchange (Adler-Milstein et al., 2018). Administratively, issues around data ownership, legal liabilities, and privacy regulations complicate data sharing, with concerns over patient consent and jurisdictional authority creating legal uncertainty (Sood et al., 2019).

Plans to Overcome Barriers

To address these challenges, both government and private initiatives have proposed solutions. These include standardizing data formats via adoption of Fast Healthcare Interoperability Resources (FHIR), providing grants for infrastructure development, and establishing legal frameworks clarifying data ownership and liability (HL7, 2020). Recommendations include creating financial incentives specifically aimed at smaller practices to improve interoperability, developing national standards for legal issues to simplify compliance, and investing in training programs to build technical capacity.

Stakeholder Impact

If implemented, these plans will influence diverse stakeholders. Smaller practices could benefit from targeted financial support, thus reducing disparities in HIE participation. Patients and providers would experience improved access to comprehensive health information, enhancing care coordination and outcomes. Policymakers and health IT vendors would need to collaborate closely to ensure standards are universally applicable and legally sound. Revenue models for vendors might shift towards more flexible, cloud-based solutions that support interoperability without significant capital expenses for practices.

SDLC Process in Healthcare IT Development

The Software Development Life Cycle (SDLC) is vital in designing healthcare management information systems (HMIS) and healthcare information systems (HIS). The SDLC involves phases such as planning, analysis, design, development, testing, implementation, and maintenance (Sommerville, 2016). When applied to healthcare systems, the steps remain similar, focusing heavily on compliance, security, and stakeholder needs. Unlike generic software projects, healthcare SDLCs often need additional emphasis on regulatory requirements like HIPAA, patient safety, and data integrity.

Differences and Omissions in the SDLC Step

Organizations lacking internal IT resources might omit the initial feasibility study phase, relying instead on external vendors to conduct this analysis. This approach can potentially risk misaligned system goals; thus, clear contractual specifications are crucial to maintain system integrity. The cyclic nature of SDLC ensures continuous improvement, which is essential in evolving healthcare environments where new standards, technologies, and patient needs continuously emerge.

Managerial Requirements for HMIS/HIS Acquisition

Key steps include defining precise user and technical requirements through stakeholder consultations, evaluating economic feasibility (cost-benefit analyses), and considering workforce implications. A decision-making model such as the Analytic Hierarchy Process (AHP) can guide whether to acquire a ready-made system or develop in-house solutions. This model assesses factors like total cost of ownership, scalability, compliance, and internal capabilities, ensuring aligned strategic choices.

In conclusion, while policies under HITECH have significantly advanced EHR adoption, barriers in interoperability, legal frameworks, and practice size disparities remain. Addressing these through targeted recommendations and robust project management methodologies, including refined SDLC practices, will be vital in advancing a fully integrated national health information infrastructure.

References

  • Adler-Milstein, J., DesRoches, C. M., & Kvedar, J. (2018). Digital health innovations in health IT. Journal of Medical Internet Research, 20(2), e24.
  • Blumenthal, D., & Tavenner, M. (2010). The "meaningful use" regulation for electronic health records. New England Journal of Medicine, 363(6), 501-504.
  • Health Information Technology for Economic and Clinical Health (HITECH) Act: Impact on HIPAA Privacy and Security Provisions. (asha.org)
  • HIMSS. (2021). State of healthcare IT adoption. Healthcare Information and Management Systems Society.
  • HL7. (2020). Fast Healthcare Interoperability Resources (FHIR). Health Level Seven International.
  • Menachemi, N., & Collum, T. H. (2011). Benefits and drawbacks of electronic health record systems. Risk Management and Healthcare Policy, 4, 47-55.
  • Office of the National Coordinator for Health Information Technology (ONC). (2020). 2020 Annual Report.
  • Sommerville, I. (2016). Software Engineering (10th ed.). Pearson.
  • Sood, S., et al. (2019). Legal and ethical issues in health information exchange. Journal of Medical Systems, 43, 52.
  • Weiner, J. P., et al. (2019). Addressing barriers to health information exchange. Health Affairs, 38(2), 266-273.

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