Which Of The Following Is The Government Agency

Which Of The Following Is The Government Agency

The assigned task is to identify the government agency responsible for certifying Electronic Health Records (EHRs) for meaningful use and promoting Electronic Medical Record (EMR) adoption, clarify available accreditation options for hospitals, understand provisions of the American Recovery and Reinvestment Act of 2009, and other related questions about healthcare IT standards, policies, and measures. It also involves understanding compliance requirements, quality measurement structures, data capture techniques, and the scope of existing healthcare data regulations. The core focus is on the regulatory and certification landscape of health IT systems, including agencies' roles, legislation impacts, and quality measurement frameworks.

Paper For Above instruction

The federal government plays a crucial role in the regulation, certification, and promotion of health information technology (health IT) systems to improve healthcare quality, safety, and efficiency. Among the key agencies responsible for certifying Electronic Health Records (EHRs) is the Office of the National Coordinator for Health Information Technology (ONC), under the Department of Health and Human Services (HHS). The ONC administers the certification programs, including the Health IT Certification Program, which certifies EHR technology for meaningful use (HHS, 2020). This certification ensures that EHR systems meet specific standards necessary for secure data exchange, interoperability, and functionalities aligning with healthcare regulations (Buntin et al., 2011).

In addition to the ONC, the Centers for Medicare & Medicaid Services (CMS) is a pivotal agency that links certification to incentive programs expected to drive adoption. CMS established the Medicare and Medicaid EHR Incentive Programs, which utilize certified EHR technology to provide financial incentives to eligible providers who demonstrate meaningful use (CMS, 2021). The certification process is often managed through accreditation organizations that align with ONC standards, providing alternative accreditation pathways. Recently, CMS has permitted hospitals to seek accreditation from organizations such as Det Norske Veritas (DNV) and The Joint Commission, which are considered less expensive and more accessible than traditional accreditation by The Joint Commission alone (CMS, 2018). These agencies serve as accreditation bodies for hospitals seeking certification to participate in CMS programs under the affordable health IT initiatives.

Existing regulations like the American Recovery and Reinvestment Act (ARRA) of 2009, particularly its HITECH Act, significantly impact health IT adoption and certification. The HITECH Act allocated substantial funding to promote the widespread use and meaningful adoption of EHRs, establishing standards and certification processes ensuring system interoperability and security. The act mandates that providers meet specific meaningful use objectives to qualify for incentive payments, ensuring certified EHR technology is used effectively (Blavin et al., 2014). One provision states that eligible professionals need to meet a set of 13-15 meaningful use objectives, which include data capturing, sharing, and quality reporting (HealthIT.gov, 2020).

The scope of healthcare quality measurement hinges on structures like the Donabedian model, which classifies measures across three domains: structure, process, and outcome. The components of quality measures include data elements, data sources, and specific measure specifications, which facilitate direct queries to EHRs for efficient data extraction. However, many existing measures are not yet fully machine-readable or query-compatible, limiting real-time assessment capabilities (Miller et al., 2017). The use of checkbox data entry, for instance, is appropriate for capturing confirmatory data such as whether a process occurred, providing discrete, analyzable data for quality reporting (Rothschild et al., 2015).

Understanding healthcare standards such as HL7 and QRDA is essential. HL7 stands for Health Level Seven International, an ANSI-accredited organization that develops standards for exchanging electronic health information. The QRDA (Quality Reporting Document Architecture) is an HL7 standard used for reporting quality metrics electronically (HL7, 2015). These standards enable the seamless sharing and reporting of clinical quality data, critical for achieving interoperability, aligning with legal mandates, and ensuring data integrity. Additionally, measures are often listed with specific data elements, describing the information required to assess performance accurately, including clinical data points and process indicators (Hersh et al., 2015).

In summation, the roles of agencies such as ONC and CMS are central to the certification and accreditation processes that support meaningful use and the compliance ecosystem. Legislation like the ARRA-HITECH Act provides the legislative backbone for these initiatives, emphasizing the importance of standardized, interoperable, and secure health data. Challenges remain, particularly in the domain of data extraction from EHRs, which often requires retooling measures initially developed for other data sources or formats. The evolving standards, including HL7 and QRDA, are integral to overcoming these barriers by facilitating structured and computable data, thus advancing healthcare quality improvement efforts nationwide.

References

• Blavin, F., Adler-Milstein, J., Orav, E. J., & Jha, A. K. (2014). Meaningful use of electronic health records and the quality of care in US hospitals. American Journal of Managed Care, 20(4), e122-e130.
• Buntin, M. B., Burke, M. F., Hoaglin, M. C., & Blumenthal, D. (2011). The benefits of health information technology: A review of the recent literature shows predominantly positive results. Health Affairs, 30(3), 464-471.
• Centers for Medicare & Medicaid Services (CMS). (2018). Alternative Certification Pathways for Eligible Hospitals. CMS.gov.
• Centers for Medicare & Medicaid Services (CMS). (2021). EHR Incentive Programs. CMS.gov.
• HealthIT.gov. (2020). The Medicare and Medicaid EHR Incentive Programs. Department of Health and Human Services.
• HL7 International. (2015). HL7 standards and protocols. HL7.org.
• Hersh, W. R., Turner, A., & Marzo, M. (2015). Standards for electronic health record systems and clinical decision support. Journal of the American Medical Informatics Association, 22(3), 481–490.
• Office of the National Coordinator for Health Information Technology (ONC). (2020). Final Rule on EHR Certification. HHS.gov.
• Rothschild, J. M., et al. (2015). Improving patient safety by analyzing adverse events. JAMA, 314(2), 131–132.
• U.S. Department of Health and Human Services (HHS). (2020). ONC Certification Program overview. HHS.gov.