The Meaningful Use Program for Nurses

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Introduction

Technology is at the center of modern growth. Particularly, it has affected how we communicate and interact in today’s globalized world. Its importance in the health care sector is similar. Phones, faxes and emails have traditionally been the common modes of communication among health care service providers. Broadly, they have been useful in transferring patient records and sharing test results (Kruse et al., 2015; Jacobsen & Juste, 2010). However, the government has changed these modes of communication, in the health care sector, by requiring service providers to adopt Electronic Health Records (EHR) (Kruse, Bolton, & Freriks, 2015). The government has introduced this change through the meaningful use program, which provides incentives to health care service providers to use EHR. Observers say this process could take months, or years, to complete (Kruse et al., 2015). This paper delves deeper into the details surrounding the meaningful use program by outlining its implications and explaining why we need more criteria to implement it successfully. However, to understand the contents of this essay, it is, first, essential to understand the program.

Overview of Meaningful Use

In the last five years, the term “meaningful use” has been a popular word in the health care sector. It refers to a unique set of standards for transforming health services to mirror technological developments in patient care delivery (Kruse et al., 2015). Started by the Centers for Medicare and Medicaid Services, the meaningful use program aims to give financial incentives to health care service providers if they use electronic data management methods to provide health services (Chin & Sakuda, 2012). The American Recovery Act has promoted its adoption by providing millions of dollars, in incentives, to encourage nurses and eligible health care facilities to adopt it (Chin & Sakuda, 2012). The goals of meaningful use are to improve doctor-patient engagements, improve care coordination, secure private engagements between health care agents and patients, and improve population and population health (Chin & Sakuda, 2012; Kruse et al., 2015; Jacobsen & Juste, 2010). According to the Recovery Act, the meaningful use program has only three main components – use of EHR in a “meaningful” way, use of EHR for information exchange, and the use of EHR to give clinical quality measures (Jacobsen & Juste, 2010). According to Chin and Sakuda (2012), a conceptual approach of meaningful use has only three main parts – data capture and sharing, advanced clinical processes, and improved outcome.

Implications of Meaningful Use

When experts first introduced the term “meaningful use,” few health care practitioners understood what it stood for (Jacobsen & Juste, 2010). Furthermore, even fewer people knew its impact on different health sectors. For example, nurses did not understand that meaningful use would imply the digitization of health processes, such as the electronic recording of vital signs (Jacobsen & Juste, 2010). They also did not understand that the program would affect health care recording requirements by changing the nursing documentation process (Jacobsen & Juste, 2010). This observation aligns with the views of Kruse et al. (2015) because they believe that changes in the documentation rules (for a physician) will have a “spillover” effect on nurses. Physicians experience an even greater impact from adopting meaningful use because legal changes require them to order at least 30% of their purchases using the program (Chin & Sakuda, 2012). The following issues highlight the broader implications of the program to nurses

Financial Motivation

Through increased requirements by the nursing fraternity for its members to use meaningful use, hospitals are bound to get financial benefits from adopting meaningful use. For example, a hospital facility that has 275 beds could be eligible for $6,000,000 financing from authorities (Chin & Sakuda, 2012). Under the same arrangement, nurses could benefit from the same program by receiving more than $63,000 in Medicaid relief (Kruse et al., 2015). Some reports show that all registered nurses could receive more than $80,000 in annual benefits if they provide health care services to patients who use federal health care programs (Jacobsen & Juste, 2010). However, these benefits vary according to state rules. Therefore, the best way to know individual benefits offered under this model is to visit the CMS of every state (Chin & Sakuda, 2012). Those who do not adopt meaningful use and continue to provide health services to their patients are likely to suffer reduced reimbursements by authorities (Jacobsen & Juste, 2010).

Nurses will have a better view of what is missing

Patient engagement is a critical part of the nursing role. Traditionally nurses have engaged with patients through narrow constructs of patient care. This interactive platform has denied them the opportunity to view their role holistically. Meaningful use could provide nurses with a “birds-eye” view of their data management processes by providing better information about tests and screening tools (Chin & Sakuda, 2012). Similarly, it could provide health care workers with accurate information about treatments that they may overlook. Particularly, the technology would help nurses detect lapses in screening, thereby making sure that they consider all necessary treatments (Jacobsen & Juste, 2010).

Increased Integration among Care Provider Roles

Health care service provision is a broad network of activities that involve different players in the sector. Some of these players include doctors, nurses, and health administrators. The meaningful use program could change how these players interact because it would give them real-time information on one digital platform. This platform would help them to discuss possible health strategies and establish which treatment method suits a patient. In line with this assertion, one director of clinical product management believes that most health care service providers will rely on nurses to support their activities through electronic data management, as expected in the meaningful use program (Jacobsen & Juste, 2010). Research also shows that meaningful use affects the workflow processes that define nurse-doctor interactions (Kruse et al., 2015). This change comes from increased reliance on nurses (by doctors) to make health data entries using electronic health records. This change in workflow processes has led to a growing use of scribes in the health sector.

The Emergence of Hands-on patients

Adopting the meaningful use program will change the course of health care service provision because there will be a new crop of hands-on patients who will thrive on making informed decisions about their health by using available integrated health information. Using online tools, the patients will have digital access to their health information, such as laboratory test results and medication lists (Jacobsen & Juste, 2010). Consequently, they will become hands-on.

Why we need other Criteria

The creators of meaningful use criteria proposed two stages of its implementation. The first stage ended in 2012. It focused on finding ways to generate consistent data and analyzing health trends (Chin & Sakuda, 2012). The first stage had only five parts – a 90-day reporting period for the first one year, reporting through attestation, objectives and clinical quality measurement, numerator/denominator attestation, and the introduction of more than 80% of patients’ health records to HER (Chin & Sakuda, 2012). The second stage of meaningful use promoted the use of advanced information sharing procedures, such as e-prescribing and free information exchange among health care service providers (Kruse et al., 2015). There is a need for an additional criterion because the first two stages do not address improvements in outcomes and the provision of self-management tools (Chin & Sakuda, 2012). Having an additional criterion for monitoring and engagement is essential when adopting meaningful use because all new technologies need proper monitoring, especially during their first stages of adoption. Indeed, since the meaningful use program is a relatively new addition to health data management, it requires consistent monitoring. The first two stages do not consider this fact (Chin & Sakuda, 2012). They are more preoccupied with getting consistent data and creating more incentives for eligible health care service providers to use the program (Chin & Sakuda, 2012). An additional criterion would make sure that early adopters implement the service well and reap its associated benefits (Kruse et al., 2015).

Recommendations

Based on the facts highlighted in this paper, data documentation is an important part of the nursing practice. Many professionals believe that (only) nurses could value the documentation process (Jacobsen & Juste, 2010). Meaningful use has dramatically changed this perception. Concisely, it has changed nursing practices by demonstrating that better health care services do not only come from adopting technology-based health tools, but also from the new interactive platforms of health care practitioners who use them (Chin & Sakuda, 2012). As such, nurses need to understand the meaning of meaningful use and its effects on the profession. In line with this need, nurses should also know that the meaningful use program is not only bound to change how nurses conduct their duties, but also improve how other medical practitioners manage data. Medical facilities and health care personnel need to change their documentation procedures if they intend to meet the criteria for meaningful use adoption, as outlined by CMS. To realize positive results, they need to show flexibility. Furthermore, they need to make sure they undertake their data management procedures correctly. Lastly, effectively adopting the meaningful use program depends on the government’s conviction to eliminate the barriers to adoption. So far, researchers have identified high costs, poor software quality, usability deficiencies, and lack of semantic interoperability as common impediments to adopting the program (Kruse et al., 2015; Jacobsen & Juste, 2010). Minimizing these barriers through policy and fiscal changes would increase the uptake of the program among eligible entrants because, so far, the level of adoption is low (Kruse et al., 2015).

Conclusion

Adopting the meaningful use program could seem like a daunting task for health care service providers because some of them see it as another government project they need to comply. Although this challenge exists, meaningful use is beneficial to health care service providers because it offers them an opportunity to give consistent and quality health care services. Furthermore, it allows them to do so by involving patients in the process. Through improved communication, nurses are likely to provide better health outcomes and improved service quality. Meaningful use is a tool that allows them to do so.

References

Chin, B., & Sakuda, C. (2012). Transforming and Improving Health Care through Meaningful Use of Health Information Technology. Hawaii J Med Public Health, 71(4), 50–55.

Jacobsen, T., & Juste, F. (2010). Information Technology: Nursing in the era of meaningful use. Nursing Management, 41(1), 11-13.

Kruse, C., Bolton, K., & Freriks, G. (2015). The Effect of Patient Portals on Quality Outcomes and Its Implications to Meaningful Use: A Systematic Review. J Med Internet Res, 17(2), 44-47.

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