In 2009, Congress designated $19.2 billion for investment in health care IT through the Health Information Technology for Economic and Clinical Health Act, or the HITECH Act. Specifically, the act authorizes the Centers for Medicare & Medicaid Services to provide incentive payments to eligible providers who “adopt, implement, upgrade, or demonstrate meaningful use of certified electronic health record (EHR) technology.”
The Office of the National Coordinator for Health Information Technology was charged with setting guidelines designed to improve the quality, safety and efficiency of the U.S. health care system. Those “meaningful use” rules, (which began to take effect in 2011 and are being phased in in three stages over five years), are already having an impact on coordinated care in the United States.
The use of EHR technology for care coordination is one of the main goals of the meaningful use guidelines, according to the U.S. Department of Health and Human Services. In fact, many objectives of the Stage 1 meaningful use guidelines dealt with improving care coordination, including:
• Exchanging key clinical information among providers of care electronically
• Reconciling medications prescribed across setting of care
• Offering summary of care records to other providers
In 2011 and 2012, as the meaningful use provisions were beginning to take effect, many providers complained about the new regulations, citing concerns such as the purchase and maintenance costs of EHR systems and the initial loss of productivity as staffs struggled to get up to speed with the new technology. Said one anonymous physician, quoted in a 2012 National Conference on Health Statistics brief, “I tried to use an [EHR] and due to a sense of slowing of the workflow caused by [it], I have abandoned it for now.”
Much of that early resistance has faded away now that Stage 2 of the meaningful use guidelines is well underway. A national survey of the guidelines’ early adopters found that EHRs helped most providers improve efficiency and save money. Findings included:
• 79 percent of providers reported that their practice functioned more efficiently with an EHR
• 82 percent said they saved time by sending prescriptions to pharmacies electronically
• 75 percent received lab results faster
• 70 percent reported enhanced data confidentiality
In a report published in the journal Computers Informatics Nursing , the authors offered several real-world examples of how the meaningful use guidelines can positively impact coordinated care. In one example, an advanced practice registered nurse care coordinator was able to capture a screen shot of a pediatric patient over video conferencing. She emailed the photo to an offsite physician whose team was able to diagnose the child and manage his symptoms remotely, thus avoiding a costly clinic visit.
As hospitals, physicians and pharmacists continue to embrace EHRs, expect to see many more meaningful uses of technology like the one above.