Module 1 chapter 1 Flashcards
Health Information Technology (HIT) promoted as key element in the National quality strategy (NQS)
3 aims: better care, affordably care Healthy populations and communities Recently added fourth aim (include care of the provider within inter professional teams)
Patient Protection and Affordable Care Act (PPACA or ACA) passes in 2009
ACA providing access to all Americans health quality and affordable health care
The Health Information Technology for Economic and Clinical Health (HITECH) act passed in 2009
2 Sets of standards
First standard defined meaningful use (MU) of electronic health records (EHRs)
Second standard specified development and certification of EHRs to meet MU criteria
Meaningful use MU
Ensure EHR across nation meet adequate standards for performance
How EHR are to be developed and certified to meet MU criteria
ACA put in place Mechanisms to improve care and decrease cost
Accountable care organizations (ACOs)
Metrics to Measures organized into five domains to monitor performance
- patient/caregiver experience
- care coordination
- patient safety,
- preventive health,
- At risk population/frail elderly health pg 5)
HITECH Act
To establish HIT infrastructure, several programs were implemented
Three phases of meaningful use (MU), with each phase escalating in what the technology is designed to achieve
Phase 1: implementation of certified EHRs meeting basic requirements (example electronic information “electronic prescriptions”)
Phase 2: “patient-centeredness” and increased capacity to capture and exchange data
Phase 3 is now a component of Medicare Access and CHIP(children health insurance programs) Reauthorization Act (MACRA) programs
EHR Incentive Program
incentivized payments from CMS
Previously, providers and hospitals implementing EHRs meeting federal standards received payments from CMS
Requirements for incentives now aligned with Quality Payment Programs or Value-Based Incentive Programs
Payment adjustments for failing to reach meaningful use
Electronic clinical quality measures (eCQMs)
Healthcare Reform and HIT
In 2017, Quality Reporting Program came into effect
Patient engagement is essential to realize the full impact of technology for health
Collective impact initiatives for nongovernmental, private sector
Four main components for structured form of collaboration
Five conditions to produce true alignment and success
1. common agenda,
2. shared measurements system,
3. mutually reinforcing activities,
4. continues communication,
5. backbone support organizations)
Lowering Costs and Improving Safety
Recent studies report the impact of HIT on patient safety and quality outcomes
E.g., a study that assessed the output of grants from the Agency for Healthcare Research and Quality (AHRQ)
Concluded notable contributions on the impact of the information system usage in healthcare
E.g., a study focused on structured and/or coded EHRs and associated direct patient care benefits or value noted
Concluded that the evidence for the impact of EHR-based structured data is not well documented
Patient Safety and Quality in Technology-Driven Environments
“Bold on applications” to meet special needs
Potentially serious harm to patients when technology systems are deployed without proper strategies
Department of Health and Human Services’ guide for implementing safe HIT systems
Expanded in 2015 to develop a Health IT Safety Center road map
Nursing’s Diverse Role in HIT Advances
Informatic nurses and informatics nurse specialists provide important direction
Revised definition of nursing informatics in 2015 Nursing Informatics: Scope and Standards of Practice
Research needs for the nursing informatics community
Nursing involvement in the development of EHR products leads to improved and safer product
Nursing informatics
integrates nursing science with multiple information and analytical sciences to identified, define, manage and communicate data, information, knowledge and wisdom in nursing practice
Nursing Education for the Healthcare Informatics Model
Role of nurse expanding to include information technology
(Also true for doctor of nursing practice (DNP) role)
Conceptual framework for advanced practice registered nurse roles in the information technology environment
Nursing Education for the Healthcare Informatics (NEHI) Model Three main content domains 1. patient safety/quality 2. data management and analytics 3. point of care technology)
Nursing Education for the Healthcare Informatics (NEHI) Model
- Point-of-care technology : use of technology on safe care delivery
- Data management and analytics: transform data and information into improved health care delivery
- Patient safety/quality and population health: Quality improves tools applied to individuals and public health initiatives
Serves as an organizational structure for this book
