Health Act (HITECH)

Health Act (HITECH). HITECH strengthened HIPAA security and privacy rules and provided monies and incentives to increase the adoption of EHRs that meet eligibility requirements for Meaningful Use. The underlying idea was that financial incentives would encourage the adoption of EHR systems, moving the United States closer to a national infrastructure that would support an EHR for every American and provide information via Meaningful Use core criteria that could be used to collect information that could be used to improve population health. Providers that comply with Meaningful Use requirements qualify for additional reimbursement monies over a period of several years. Penalties will be imposed for providers that do not use approved technology to comply with Meaningful Use requirements. Providers have some latitude on the core criteria that are met from a prescribed set. Funds allocated by HITECH also support regional centers that guide providers as they adopt EHRs and offer technical support.

Meaningful Use and the HITECH Act

Meeting the criteria for meaningful use (MU) of an EHR is one of the methods of Medicare and Medicaid reimbursement associated with the HITECH Act. The Centers for Medicare & Medicaid Services (CMS) serves as the primary regulator, with each individual state dictating the Medicaid operations within its jurisdiction (Health Information Technology for Economic and Clinical Health Act, 2009). This statute identifies the eligible providers, including APNs, for the Medicare and Medicaid reimbursement structure. Such prescriptive language does not recognize, embrace, or support the interprofessional team and the critical and collaborative work completed by such an entity to improve access, improve health care, and reduce costs.

The third and final stage of MU is currently underway and entails a single set of criteria focused on the advanced use of EHR systems. CMS decided to move away from the staged approach and will require all providers (including first-time participants) to satisfy the objectives and measures of Stage 3 by 2018. Beginning in 2019, the MU program will transition into a new merit-based incentive payment system (MIPS) program established by the Medicare Access and CHIP (Children’s Health Insurance Program) Reauthorization Act. The Stage 3 requirements and objectives will be maintained (Resnick, Meara, Peltzman, & Gilley, 2016).

Stage 3 Meaningful Use objectives:

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Actively engage in public health

Meaningful Use Objectives

Protect electronic protected health information

Generate and transmit prescriptions electronically

Implement clinical decision

Use computerized provider order

Provide patients with electronic access to their health information and patient-specific education

Use Certified EHR Technology (CEHRT) to support coordination of care

Use health information exchange to support care transitions and referrals

Actively engage in public health

Meaningful Use Objectives

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To learn more, please review the Meaningful Use Stage 3 Recommendations (Links to an external site.)

Throughout the MU phases, providers and hospitals that implement EHRs meeting federal standards outlined under the meaningful use regulatory requirements are financially incentivized with payments from CMS. The incentive program started in 2011 and extends over several years with the time table determined by whether a provider elects to access the Medicaid or Medicare incentive program. Hospitals can access both Medicaid and Medicare incentives, and in many cases these incentives equate to millions of dollars.

What APNs Need to Know

As noted, the role of the nurse is expanding to include information technology. This is also true of the advanced practice role and Doctor of Nursing Practice (DNP) role (McBride, Tietze, & Fenton, 2013). McBride et al. (2013) developed a conceptual framework, which addresses the major roles that APNs play within the information technology environment. This framework is the Nursing Education for the Healthcare Informatics (NEHI) Model. The framework is targeted to advanced practice care delivery and is composed of three main content domains: (a) patient safety/quality, (b) data management and analytics, and (c) point-of-care technology (McBride et al., 2013).

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Health Act (HITECH)

Health Act (HITECH)

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