The modern health care industry is significantly transforming in terms of decision making, workflow, and information management. These changes are motivated by a federal policy focusing on building an electronic infrastructure that supports patient safety, service quality, and other healthcare initiatives. The National Strategy for Quality Improvement in Healthcare (further referred to as National Quality Strategy or NQS) has three primary purposes: to provide better and more affordable care and pursue healthy communities and populations (McBride & Tietze, 2018). Health information technology (HIT) is promoted as a critical element in this context. It implies the application of informatics as a tool for improving the health of populations served and the care delivered to them.
Several legislations have been implemented to achieve NQS goals. Most notable of them are the Affordable Care Act (ACA), the HITECH Act, and an incentive program for electronic health records (EHR) (McBride & Tietze, 2018). ACA was first implemented in 2009 to combat the uncontrollably escalating prices in the healthcare field (Zhao et al., 2020). The main idea is to manage the cost and simultaneously improve the quality of care services. An example of such control tools is the creation and support of accountable care organizations (ACO). These organizations supervise savings accounts for contracts at risk, which oblige the provider companies to fixate the rate of provided services.
Meanwhile, ACA establishes the general framework for qualitative performance evaluation. Its measures are systematized under five domains: patient and caregiver experience, safety, preventive health, at-risk population health, and care coordination (McBride & Tietze, 2018). To fulfill the requirements to be considered an ACO, organizations must implement sophisticated technology. In particular, ACOs require EHRs and health information exchange (HIE) data to be translated into actionable information representing comprehensive data management and extensive reporting capability. Consequently, HIT infrastructure is vital for advancement within the ACA healthcare delivery system.
The HITECH act holds responsibility for the promotion, adoption, and meaningful use (MU) of the HIT. It was implemented in 2009 with a focus on HIT support, college programs offering HIT training, and various grants supporting the research (Lin et al., 2019). In the context of HIT MU, HITECH developed three phases to accomplish the goals defined by the NQS. Each phase of MU emphasizes the technology it is designed to improve, which results in robust infrastructure and reliable outcomes (McBride & Tietze, 2018). Phase one focuses on implementing certified EHRs’ basic requirements, such as the ability to assess and report quality metrics and information exchange using electronic prescriptions. MU’s phase two targets consumer engagement (also referred to as “patient-centeredness”) and increases the assessing and reporting capacity of the data exchange concerning certified products. Phase three further expands the data exchange capacity requirement (more structured data, higher quality reporting) using HIEs at a more significant scope – within and across regions and states.
In the context of MU phases, the organizations that adhere to MU’s established standards are financially supported with payments from the EHR incentive program. In other words, the organization receives incentives when using a certified EHR and adhering to specific certified products’ criteria (McBride & Tietze, 2018). Starting in 2011, the incentive program extended over the years, with its timetable determined by the provider’s choice to either adhere to Medicaid or Medicare incentive programs. In the meantime, hospitals have access to both Medicaid and Medicare incentives; in many cases, these incentives can equate to millions of dollars.
References
Lin, Y. K., Lin, M., & Chen, H. (2019). Do electronic health records affect quality of care? Evidence from the HITECH Act. Information Systems Research, 30(1), 306-318. Web.
McBride, S., & Tietze, M. (2018). Nursing informatics for the advanced practice nurse: Patient safety, quality, outcomes, and interprofessionalism (2nd ed.). Springer Publishing Company.
Zhao, J., Mao, Z., Fedewa, S. A., Nogueira, L., Yabroff, K. R., Jemal, A., & Han, X. (2020). The Affordable Care Act and access to care across the cancer control continuum: a review at 10 years. CA: a cancer journal for clinicians, 70(3), 165-181. Web.