Widespread clinical implementation of Electronic Health Records (EHRs) resulted in a significant amount of data that healthcare organizations have to process. Policies such as the 21st Century Cures Act aim at increasing the efficiency of the information technology (IT) application in a clinical setting. The policy signed by President Barack Obama on December 12, 2016, was a joint effort by Republican and Democratic policymakers (Hudson & Collins, 2017, p. 111). The policy focused on enhanced data sharing, improved support of medical research initiatives, and updates on privacy protection. Additionally, the goal of the 21st Century Cures Act was to minimize bureaucracy and lift research-related restrictions allowing quick and easy information exchange.
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The 21st Century Cures Act affects system implementation in general and the use of EHRs in particular. For instance, the policy promotes “the usability of the health information, the interoperability of the health information technology, and the security of the health information technology” (21st century Cures Act, 2016, p. 1160). Section 4005 of the Act also states that in order to be certified, EHRs should be able to transmit and accept data from registries according to the standards recognized by the Office of the National Coordinator for Health Information Technology (21st Century Cures Act, 2016, p. 1180). According to the Act, the National Coordinator should encourage the public to report on any HIT products or care provider’s actions, which result in information blocking. Thus, the policy improves the transparency of information processing, provides national standards for EHR implementation, and prevents information blocking.
The Act attempts to address the problems related to the quality of clinical care unsolved by the Health Information Technology for Economic and Clinical Health (HITECH) Act, which was adopted in 2009. In order to achieve its goals, the Cures Act “encourages partnerships between health information exchange organizations and networks and healthcare organizations to promote patient access to their electronic health information” (Lye et al., 2018, p. 1218). Moreover, the requirement for certified EHRs to use application programming interfaces (APIs) improves the workflow as it allows the data “to be accessed, exchanged, and used without special education” (Lye et al., 2018, p. 1219). Finally, the Act directed the U.S. Department of Health and Human Services (DHHS) and the Office for Civil Rights to provide education for healthcare professionals on the issues of EHRs use. Thus, the measure regulated patient/ provider interactions by emphasizing the importance of patients’ rights to receive proper guidance and education by their healthcare provider, as well as free access to their medical data.
There are several organizational policies that should be implemented at the healthcare organization to address the 21st Century Cures Act. Firstly, the healthcare provider should guarantee the usability, interoperability, and security to receive EHR certification. The participation of the interdisciplinary team consisting of data analysts, programmers, and nurse informaticists in the development or improvement of EHR is crucial for its effective implementation and compliance with the national standards. Secondly, the specialist with medical and I.T. knowledge should be appointed by the management of the organization to ensure transparency and prevent information blocking. For instance, nurse leaders might collaborate with the I.T. security team to regularly monitor the condition and functioning of EHR. Finally, since the 21st Century Cures Act provides support for research initiatives, the healthcare organization should be able to offer financial incentives and encourage its employees to participate in or to conduct their own research. The incentives for healthcare professionals might be in the form of monetary rewards, wage increase, or research grants.
21st Century Cures Act. H.R. 34, 114th Congress. (2016). Web.
Hudson, K. L. & Collins, F. S. (2017). The 21st Century Cures Act – A view from the NIH. N Engl J Med, 376, 111–113. Web.
Lye, C. T., Forman, H. P., Daniel, J. G., & Krumholz, H. M. (2018). The 21st Century Cures Act and electronic health records one year later: Will patients see the benefits? JAMIA, 25(9), 1218–1220. Web.