Electronic Health Records and the Affordable Care Act - Term Paper Example

Electronic Health Records and the Affordable Care Act Introduction There have been many health reforms in the United s, most of which are geared towards making healthcare more effective in the United States. From the healthcare reforms of the mid 1960s which saw the implementation of Medicare and Medicaid, to the recent Affordable Care Act which has been dubbed the Obamacare due to the fact that is has been implemented by the Obama administration. These healthcare reforms are geared towards the improvement of healthcare in the United States. Other reforms and legislations such as the Health Information Technology for Economic and Clinical Health Act (HITECH) have also been implemented to achieve some positive progress in the United States of America with regard to healthcare delivery. These programs and reforms cost the United States government a lot of taxpayer money, sometimes going up to tens or hundreds of billions of dollars. The important question that must be answered with regard to these reforms is whether they are effective and whether they really do lead to better healthcare (Copeland, 2011). Past performance such as in the Medicaid and Medicare indicates that the success rate may be low. The low success rate may be indicated by the fact that these reforms such as Medicaid and Medicare end up being scrapped off due to poor performance. Affordable care act The affordable care act is a health reform legislation that has led to many controversies in the United States. The implementation of the reform is estimated to cost billions of US dollars. The purpose and intention of this act was to ensure that the cost of health insurance was lowered while at the same time improving healthcare to the many people who could not afford health insurance (Schreiber, 2011). It was geared towards reducing the rates of non-coverage and this would be helpful in making sure that healthcare in the United States was equalized for all, poor and rich. The act is still under implementation in the United States and it is estimated to be fully implemented by the year 2020. Reports indicate that the affordable healthcare act has made it possible to minimize the number of uninsured people in the United States from about 18 percent to about 15 percent (Foster, 2010). This is a significant figure considering that it has not been fully implemented yet. However, the problem is with regard to how this act relates to other health reforms such as the Health Information Technology for Economic and Clinical Health Act, the question that must be answered as to how these two acts relate with each other and how they support, or otherwise, each other. The HITECH Act (Electronic Heath Records) As Murphy (2010) says, under this reform, the intention was to promote the adoption of information technology in the health sector. The reform targets healthcare providers such as health institutions and healthcare workers. Even those in private practice are targeted by this healthcare reform with regard to encouraging them to implement the electronic healthcare records systems. The act intends to promote the adoption of the healthcare technology, specifically the electronic health records (EHR), by giving incentives to healthcare institutions and private practitioners to adopt the technology (Murphy, 2010). The incentives are given due to the fact that there are some costs related to implementing these systems. As a result, those who implement the electronic health records and prove that they have used these records to achieve the intended goals of better care to patients because of the use of these systems are eligible for some compensation and some subsidization. The government is careful make sure that these healthcare records technologies have been acquired because it believes that they have some benefits that help in improving the delivery of healthcare to the people. These advantages include the following; Non duplication of records One of the main issues with non-electronic records is the fact that they are not centralized and this implies that it is possible for some records to be duplicated. This affected the quality of the healthcare delivered to the patient because that the records can be updated independently. Better tracking of patient information The other advantage of the electronic health records is the fact that the tracking of patient information is easier and this improves the way a doctor or healthcare practitioner is able to give high-quality care to patients. Doctors need a lot of information with regard to each patient and having an electronic health record is necessary to make sure that the doctor is able to get information on such issues as the drug-drug interaction and human factors. He is also able to get other health information about the particular patients thus helping in making more informed clinical decisions about a specific patient (Peden, 2011). Other benefits acquired by the use of electronic records include the mitigation of loss of patient records and easier tracking of information. Meaningful use and incentives For doctors and health institutions to be able to get the incentives, they must be able to do more than just implement the electronic health records systems; they must prove that the implementation of these systems in their offices or institutions has led to the achievement of the above described benefits. They must prove that their use of these systems have improved the quality of care they give to the patient. In this regard the implementation takes three major phases that are necessary. Phase 1:Adoption of the system This involved implementing the system and installing all hardware and software to be used. It also involved data capture because eventually, the usefulness of a system can only be achieved when the system has acquired data. Phase 2: advanced clinical procedures This involves the use of the system data and tools to improve the clinical procedures in the healthcare institution or the practitioner’s office. The data informs the practitioners about the patients health history while the tools (such as decision support systems) will help in aiding in making better clinical decisions. Phase 3: evidence of positive outcome At the end of the process, the doctor or healthcare institution must be able to show that the implementation and use of the system has improved the delivery of healthcare services to the patient. At this point, the physician is able to now apply for the incentives. The doctors must also be able to prove that other issues such as the privacy of the medical health of the patient have been taken care of. EHR adoption facts By 2011, the rate of EHR adoption was about 55%. More than 75% of the physicians who adopted the systems reported that their systems met the meaningful use as required by the US federal government (Pennic, 2012). Over 85% of those who have adopted the system argue that they have seen evidence that the system has increased the quality of care they are able to give to the patients. At the same time, of the 45% of practitioners who have not yet adopted the system say that they are planning to own one sooner than later. Additionally, it is clear from the patients’ point of view that the systems are playing an important role in creating systems that are able to better the delivery of healthcare. In fact, according to Pennic (2012), the percentage of the patients who are eager to be treated by a doctor who uses the electronic health records are always higher than the rate of the doctors who have already adopted one. For instance, according to the CDS centre for national statistics, despite there being 62% of patients who are willing to use internet-enabled electronic health systems, only 42% of physicians who have adopted the EHR systems have internet-enabled EHR. Still, despite the fact that 65% of the patients are willing to receive reminders from the EHR through means like email and phone, only 40% of the physicians have EHR systems that have this capability. This shows that the rate of adoption of EHR is much lower than the expectations of both the government of the patients who are supposed to be the beneficiaries of these systems. Problems with adoption Less than 50% of practitioners who have not adopted the electronic health records systems cite cost of the system as the main barrier. However, about 40% cite the implementation process as a hurdle that prevents the adoption of the EHR systems. The implementation of the HITECH Act has a number of challenges, some of which are imminent and others are not. Some of the challenges include the fact that there are various challenges that are unforeseen. These include unforeseen costs which the practitioners and hospitals are have to deal with after they have adopted he electronic heath records. As Healthcare Information and Management Systems Society (2008) say, there are a number of costs that come up after the implementation of the system. These costs can be so high and repetitive that even the incentives that have been given to such a practitioner may not be enough to offset them. This is very important if the success of these systems and the eventual success of the reform are to be achieved. The adoption of the health technology should not increase the cost of delivering the healthcare to the patient. In this regard, this is something that must be considered in a more critical way. How to measure the outcomes The other problem that needs to be addressed is the measure of the outcome to determine how effective the system use has been. There are no clear ways to measure the outcome and determine that the patients have actually benefited from getting services from an institution or a private practitioner who is using the electronic health records systems. As identified already, the incentives are supposed to be given upon the evidence that the use of these systems have led to better service. But it is definitely not easy to determine this and this causes another loophole in the implementation of the HITECH act systems. The issue of IT expertise Most of the practitioners, whether private or those attached to a healthcare institution, are not well trained on IT and especially on how to use management systems such as the electronic health records systems. This also acts as a risks favor because this lack of IT knowledge can deter how they are able to use these systems (Ferenc, 2013). It is even worse in cases where the practitioner is a private practitioner whiteout the support of a firm. It is necessary for this to be considered so as to ensure that this does not hinder the adoption of the electronic heath records. Continuous growth of the EHR The other challenge with the adoption of IT is the fact that the HER market is still going through growth and development (Healthcare Information and Management Systems Society, 2008). Vendors continue to develop newer products with newer features. This causes confusion among users because sometimes they do not know whether to wait for newer products or to go for the already developed ones. Often cases, the doctors can adopt a system, learn how to use it but as soon as they have done this, the vendors of the system have come up with an upgrade of the system which means going back to step one to learn the system. The dilemma in this case is the fact that although this continuous upgrade provide a challenge in the adoption of these electronic health records systems, they also are necessary because they guarantee continuous quality assurance. These upgrades are necessary to make sure that the systems are better and that in the future, they can serve a bigger and better purpose in the improvement of healthcare delivery. The fact that there are numerous vendors also brings in more confusion to the users and it is in itself a challenge in the way the electronic health records systems are adopted. Due to market dynamics, there are a number of issues that come up which also affect the way in which the ways in which the users are able to adopt the systems. These market dynamics involve mergers and buyouts between vendors of these systems. Vendors of electronic health records systems continue to firm mergers in response to market conditions, some are bought while others buy and acquire other vendors. Although this does not affect the technical aspects of the systems, it affects the ways in which the users of these systems are able to competitively utilize the systems. This is because the utility of these systems goes beyond just the technical aspects but actually goes beyond the technical bits. The relationships and support by the vendors of the system also presents a major role in making sure that the system users are able to not only adopt the system but to effectively use it to meet the intended purposes of improving healthcare delivery. In this regard, as the ownership or structure of the vendor companies change, it becomes harder for the users to get the parallel services they require in order to use these systems effectively. How HITECH Act relates with affordable care act Since these two acts are geared towards improving healthcare in the United States but from different fronts, it is absolutely necessary to identify how they interrelate or if they support each other. Some argue that the two either in some instances work against each other or they have some overlapping aspects. This is something that must be addressed, due to the fact that these reforms cost a lot of tax payer dollars and that they also have a fundamental impact on healthcare delivery. Conclusion It is quite clear that the adoption of health records has gained some success. This success has been gained in two ways. First, in terms of how the patients have received this idea and their wiliness and eagerness to receive healthcare from physicians who use the electronic health records. The second aspect from which the success of the electronic heath records can be viewed is the rate of adoption which stands at over 55%. There are also claims of these systems improving the quality of healthcare. However, the main problem affecting this is that it is not easy to measure this aspect of the electronic health records. In this regard, it is necessary for better standards and benchmarks to be laid out so that the success of the electronic heath records to be measured in a benchmark way and in a way that provides understandable data. The other issue is the fact that the rate of adoption by the physicians is much lower than the expectation of the government and the demand by the patients. This has been caused by a number of factors that must be addressed in detail in order to guarantee that the goals of the electronic health records have been done successfully. Issues such as hidden cost and the costs that come after implementation have to be taken care of. At the same time, the problem of the numerous vendors of health IT systems must also be taken care on order to help in making sure that the physicians can successfully adopt these systems. References: Copeland, C. (2011). Upcoming Rules Pursuant to the Patient Protection and Affordable Care Act (PPACA). New York, NY: DIANE Publishing. Ferenc, D. (2013). Understanding Hospital Billing and Coding. New York, NY: Elsevier Health Sciences. Foster, R. (2010). Estimated Financial Effects of the Patient Protection and Affordable Care Act, as Passed by the U. S. Senate on December 24 2009. New York, NY: DIANE Publishing. Healthcare Information and Management Systems Society. (2008). Key Issues in EHR Adoption and Sustainability Whitepaper. New York, NY: Healthcare Information and Management Systems Society (HIMSS). Murphy, M. (2010). The New Hipaa Guide for 2010: 2009 Arra Act for Hipaa Security and Compliance Law and Hitech Act Your Resource Guide to the New Security and Privacy Requirements. New York, NY: AuthorHouse. Peden, A. (2011). Comparative Health Information Management. London, UK: Cengage Learning. Pennic, R. (2012, October 30). 80 Mind Blowing EMR and Meaningful Use Statistics & Trends. Retrieved October 26, 2014, from HIT Consultants: http://hitconsultant.net/2012/10/30/80-mind-blowing-emr-and-meaningful-use-statistics-trends/ Schreiber, N. (2011). Health Care Reform: What It Is, Why Its Necessary, How It Works. New York, NY: Farrar, Straus and Giroux. Read More