The Meaningful Use Program in Nursing - Special Academic Support

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Meaningful Use is the Centers for Medicare & Medicaid Services (CMS) Electronic Health Records (EHR) Incentive Program. Initially, the program aimed to provide incentives for accelerating the adoption of EHR for meeting its established requirements. The program originated from the efforts of the Centers for Medicare & Medicaid Services (CMS) HER Incentive Program in 2011 and evolved over the course of three stages. At Stage 1, base requirements for electronic capturing of clinical data were established. At Stage 2, EHR were encouraged to be used for increasing the exchange of information and the continued quality improvement at the point of care. At the modified Stage 2, Stages 1 and 2 were consolidated into a new program that enabled physicians to follow specific rules. Therefore, all physicians who participate in Meaningful Use from 2016 onward are required demonstrating the ten new Modified Stage 2 requirements.

Today, physicians failing to participate in Meaningful Use (MU) are expected to get a penalty in the form of reduced reimbursements in Medicare. This means that healthcare providers are expected to use certified electronic health records technology (CEHRT), showing meaningful use through the process of attestation at the end of each MU period of reporting. When it comes to the relationships between different types of information system records, EHRs represent computer records that originate from the use by doctors, personal health records (PHR) can be generated by physicians, hospitals, pharmacies, and other sources but are controlled by patients (Lite et al., 2020). As to electronic medical records (EMR), they offer a much narrower view of a patients medical history, while EHRs offer a broader report of the overall health of the patient in question. For nursing and primary care physicians (PCP) there can be issues in the program taking meaningful time away from essential patient care. On the bright side, it does help reduce the occurrence of preventable adverse drug events and increases medication safety measures.

In the workplace context, MU is encountered on a regular basis, with nurses are expected to follow the guidelines of the MU in order to avoid penalties associated with it. The main goals of MU programs include the standardization of the electronic capturing of health information, such as demographics or clinical results and orders, the improvement of quality at the point of care, and the use of clinical decisions support and patient self-management tools. In the workplace context, nurses are expected to follow the guidelines of the MU in order to avoid penalties associated with it. Thus, the implications for nurses are concerned with the need to meet the criteria of eligibility to support the implementation and adoption of EHR technologies (Reisman, 2017). As suggested in the evidence-based study by Reisman (2017), the program is affordable and works because it allows improving care quality. However, efficiency does not always reach the desired high level because of systems capability limitations. Due to the clearly-defined objectives, MU makes it so that patient outcomes are enhanced through the clear following of procedures while policymakers have a clearer idea as to the critical limitations of policies that need to be addressed.

The core requirements of MU include the use of certified EHR in a meaningful way, the exchange of electronic information for improving healthcare quality, and the use of certified EHR technologies for submitting the measures of clinical quality. Under MU, e-prescribing becomes easier because all the technologies are being used meaningfully according to CMS standards (Porterfield et al., 2014). Besides, patient reminders become more effective when there is a structure in the use of information. For providers, if they fail to meet the MU criteria, it can result in a 1% reduction of Medicare payments, which drives personnel to make more informed decisions and be more efficient to ensure that the criteria are met. Despite this, nurses may find it challenging to adhere to the set criteria because system capabilities do not always meet the needed requirements. In terms of nursing, MU allows to comprehensively address the challenges of duplicate testing and negative drug reactions. As to population health, MU does require providers to submit electronic data to immunization registries and other public health institutions for improved data management.

As to the strengths of MU, it promotes the adoption and the effective use of EHRs, allows retaining measures for several years, enables aligning with Medicare measures in guiding principles. For example, in the study by Porterfield et al. (2014), it was shown that MU significantly improved e-prescribing, thus facilitating the increased effectiveness of EHRs. As to the weaknesses, the performance of the measure depends on system capabilities, challenges with determining the improvement on the measures, and the sole dependence on Medicare beneficiaries. To improve MU implementation, it is recommended to consider establishing a 90-day period of reporting, enabling greater flexibility in the use of EHRs, and expanding the stages of MU to at least three years.

To conclude, the purpose of the Meaningful Use Program is to use technologies to ensure coordinated and improved patient care. When providers have broad access to as much information as possible, it is easier to prescribe medication, order tests, as well as store and update data electronically, which saves some time. Even though cost efficiency is also a great advantage, MU presents such challenges such as decreased flexibility and penalties for healthcare providers who fail to meet the relevant criteria.

References

Lite, S., Gordon, W. J., & Stern, A. (2020). Association of the meaningful use electronic health record incentive program with health information technology venture capital funding. JAMA Network Open, 3(3), e 201402.

Porterfield, A., Engelbert, K., & Coustasse, A. (2014). Electronic prescribing: Improving the efficiency and accuracy of prescribing in the ambulatory care setting. Perspectives in Health Information Management, 11(Spring).

Reisman M. (2017). EHRs: The challenge of making electronic data usable and interoperable. P&T: A Peer-Reviewed Journal for Formulary Management, 42(9), 572-575.

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