NUR 621 Topic 4 DQ 2
There are many indications that meaningful use has improved care coordination. Some of these include: Meaningful use established standards for using clinical data to improve care; it also emphasized care coordination and risk adjustment to improve clinical quality. For example, the ability of EHRs to fit into an overall quality assessment framework was a top priority for meaningful use. Meaningful use also standardizes the definition of “trusted exchange,” which allows for seamless electronic transfer of information between EHRs and other software systems used within a healthcare organization.
Meaningful use stage 2 encouraged providers and hospitals to implement EHRs, but these systems were only as useful as their ability to exchange data. There were two key priorities when meaningful use was developed: exchanging health information between providers, and enabling the rapid transition of care. To improve care coordination, providers needed to exchange comprehensive medical information that included patient demographics, medications, allergies, lab results, and procedures in a single document. Moreover, to transition care quickly and efficiently among providers, every practitioner needed immediate access to the right type of visit history so he or she could proceed with treatment. When building their EHR software , providers can ensure it includes features that enable both types of data sharing.
Earlier this year, we had the opportunity to examine some of the priorities when meaningful use was being developed. The meaningful use program has been part of the Medicare requirement since July 1, 2011. This program requires physicians’ offices to adopt and employ certified electronic health records (EHRs) in order to improve care coordination and quality of care for patients .
One indication of meaningful use is improving the way providers work together to provide quality care for patients. The priority for meaningful use was to increase the number of providers in a health care network who can exchange electronic information. This a valuable informational designed to improve patient care.
As the healthcare industry shifts focus from inpatient to outpatient services, the United States Department of Health and Human Services has declared that interoperable EHRs are a top priority. To that end, meaningful use provides a set of criteria to be accessed by certain providers, but research has indicated that while they have some inherent value, they appear to need work in terms of practicality. While some of the priorities were in ensuring coverage for every patient, improving care coordination with other healthcare providers, and creating a bridge between data centers when switching from one EHR to another to ensure continuity of care and accuracy, providers need access to guidance on how to navigate these waters. They also need support for ensuring an adequate amount of funding for successful implementation.
Improved care coordination is a major priority for healthcare providers, clinicians and patients. By collecting data from a variety of sources, providers can provide better coordinated patient care. The Centers for Medicare & Medicaid Services (CMS) report that HFs that completed their meaningful use requirements, showed significant improvements in the following measures: Percent of insured patients who’ve seen an EHR-enabled provider: 73% − 12% Difference (2011 vs. 2010); Percent of patients with asthma who had preventive care or an exacerbation or crisis management plan reviewed by their provider: 10% − 4% Difference (2011 vs. 2010); Percent of diabetic patients with hemoglobin A1c values > 9 that were tracked and managed: 33% − 19% Difference (2011 vs. 2010); Percent of Medicaid pediatric patients age 2 – 21 who “had personal health record features available to them”: 26% − 11% Difference (2011 vs. 2010).
As we were implementing Meaningful use, we knew that our quality goals were aligned with meaningful use objectives. Achieving meaningful use was a challenge. It required us to assess organizational readiness and set the vision for the journey. The first step was to review the state of care coordination in our organization.
“Despite the clear potential of EHRs to promote care coordination, the evidence is mixed on whether EHRs actually increase care coordination. In their 2012 report, the Advisory Panel to the CMIO cited a set of conditions that must be in place for meaningful use support and care coordination:”
The MACRA reforms are intended to improve the quality of care throughout a provider’s practice, not just in its patient population. Practice-level measures could be designed to track referral patterns, communication with specialists, and patient access to subspecialists, for example.