What are EHRs and EMRs? How do they compare and differ? (~100 words, 0.2 points) EMRs stands for electronic medical records. They are an electronic version of paper processes that a provider creates for internal practice consumption (ONC, 2011). While they are electronic, they are not necessarily easily shared.
They provide a benefit over paper forms by easing sharing within a practice. EHRs stands for electronic health records (CMS, 2012). While also electronic, these records are designed to be shared.
Many conform to one or more standard export/import formats. The goal behind EHRs care coordination between multiple healthcare providers. EHRs can contain the data found within the EMRs and more (Fusion, 2017). In detail, define the ONC. How does ONC impact healthcare vendors and EHRs? (~150 words, 0.
3 points) ONC stands for Office of the National Coordinator for Health Information Technology (Federal Register, 2014). Their goal is to ensure that both public and private health entities pursue technological advancement to achieve better patient outcomes. It’s was created within the Department of Health and Human Services as “legislatively mandated in the Health Information Technology for Economic and Clinical Health Act..
.of 2009″ (About ONC). ONC impacts vendors of health care services via two mechanisms. The first is financial incentives to adopt a certified EHR system. According to Blumenthal, a practice could pay for the cost its EHR through the incentives. The second mechanism is by fee reduction if the provider fails to use an EHR in time. ONC impacts EHRs by establishing and executing the certification process. Certification provides assurance that the software complies with interoperability, privacy, and security standards.
What is Meaningful Use? (~200 words, 0.3 points) Meaningful use is a three stage approach to EHR leverage that aims to improve patient outcomes. The driving force behind meaningful use is the government’s desire to make sure that companies a) use EHRs that could talk with outside system (certification program), and b) actually use those systems to talk to outside systems. The CDC (CDC, 2017) says that meaningful use rests on “‘5 pillars’ of health outcomes policy priorities”: security of patient data, improve quality of outcome, patient engagement (through portals for example), improved general public health, and improve care coordination. In stage 1 meaningful use focuses on data capture and sharing between providers. EHRs require certification and auditing to prove they meet these criteria. Stage 2 builds on stage 1 by adding process flows and iterative improvement.
Stage 3 focuses on proving that outcome improved as a result of the new technology and processes established in the prior stage. There is some dispute about the pace of these milestones. In response the government has done at least two things. First, it relaxed the auditing and certification process for the 2015 targets (healthcareitnews, 2017, September 21). Second, it’s conducting internal reviews and listening to outside experts in order to get tangible, realistic success from the meaningful use program and its $37 billion expenditure to date (healthcareitnews, 2017, September 07).
Should patients be the aggregation point for all or any of their health data? Why or why not? (~200 words, 0.2 points) Patients should be a point of data aggregation. They may even become a super node as medical providers adopt systems that support standardized electronic document interchange. They are in the best position to have credentials, and by extension sharing rights, to various medical portals. Thanks to new tools like personal activity and meal trackers, a patient may generate a wealth of data electronically that would otherwise go unreported and therefore unused by their medical providers. If they allow a central tool, like HealthVault or Felicity Health, to aggregate the information into a common place, the patient can then share that aggregation to the other medical providers. They should not be the point of aggregation. Not all patients have access to Internet based communications.
Many don’t have the skill set required act as an ongoing data integrator, even if they have initial help by a friend or family member. Finally, even if they have both access and skill, they are a single point of failure. If their centralized data health solution service goes down, it could ripple through the entire care chain.
Their physicians and specialists might lose the ability see across the patient’s full health record. Redundancy provides safety. Centralization allows the patient to have direct history when asking questions about care.Describe the challenges around PHRs? (~200 words, 0.3 points)Explain the Blue Button on FHIR Project and how the idea was formulated. (~100 words, 0.1 points)How does Interoperability and Meaningful Use relate? (~150 words, 0.2 points) Interoperability is the major focus of all stages of meaningful use.
Stage 1 focused on getting EHRs into the hands and heads of practices. This entailed creating software that could interchange with other systems. Stage 2 requires increasing electronic transactions between systems with a focus on care coordination within and between provider practices. Stage 3 continues the trend by requiring patients interact with the EHRs in some form, either directly or by linking another provider or a health tool to the provider’s EHR. While Scheidlinger lists multiple meaningful use stage 3 requirements that require interoperability, I want to look at three: “More than 80% of all permissible prescriptions are…
transmitted electronically using CEHRT”; the majority of medication, labs, and imaging orders must come through computerized provider order entry; 80% of unique patients have to either manually visit providers EHR system or allow a 3rd party to access it within 24 hours of a visit.What is the Health Information Exchange? How does Privacy, Security and Trust relate to the Health Information Exchange? References4 former national coordinators, a CIO and a CEO weigh in on how to fix meaningful use. (2017, September 07). Retrieved January 24, 2018, from http://www.healthcareitnews.com/news/4-former-national-coordinators-cio-and-ceo-weigh-how-fix-meaningful-useBlumenthal, D. (2009).
Stimulating the Adoption of Health Information Technology. New England Journal of Medicine, 360(15), 1477-1479. doi:10.1056/nejmp0901592Centers for Disease Control and Prevention. (2017, January 18). Introduction Meaningful Use.
Retrieved January 24, 2018, from https://www.cdc.gov/ehrmeaningfuluse/introduction.htmlCenters for Medicare and Medicaid Services.
(2012, March 26). Electronic Health Records . Retrieved January 23, 2018, from https://www.
cms.gov/Medicare/E-Health/EHealthRecords/index.htmlFederal Register. (2014, June 03). Statement of Organization, Functions, and Delegations of Authority; Office of the National Coordinator for Health Information Technology. Retrieved January 24, 2018, from https://www.federalregister.
gov/documents/2014/06/03/2014-12981/statement-of-organization-functions-and-delegations-of-authority-office-of-the-national-coordinatorFusion, P. (2017, January 01). EHR vs. EMR | Definition, Benefits and Usage Trends | Practice Fusion. Retrieved January 24, 2018, from https://www.practicefusion.com/blog/ehr-vs-emr/ONC dials back meaningful use certification program.
(2017, September 21). Retrieved January 24, 2018, from http://www.healthcareitnews.
com/news/onc-dials-back-meaningful-use-certification-programScheidlinger, S. (2016, July 30). Meaningful Use Stage 3 | Practice Fusion. Retrieved January 24, 2018, from https://www.practicefusion.com/blog/meaningful-use-stage-3/The Office of the National Coordinator for Health Information Technology (ONC). (2011, August 26).
EMR vs EHR – What is the Difference? Retrieved January 24, 2018, from https://www.healthit.gov/buzz-blog/electronic-health-and-medical-records/emr-vs-ehr-difference/The Office of the National Coordinator for Health Information Technology (ONC) . (n.d.).
About ONC. Retrieved January 24, 2018, from https://www.healthit.gov/newsroom/about-onc