In 2009 the HITECH Act was enacted with the intent to better wellness for Americans ; nevertheless fulfilling the demands of the Act potentially reduces the quality of the attention given to the patient due to the increased loads placed on suppliers. Suppliers must buy Electronic Health Record ( EHR ) Technology and follow with Meaningful Use ( 1 ) . Initially suppliers are compensated for take parting in Meaningful Use. nevertheless. the ultimate terminal consequence is suppliers are penalized if the 15 Core Measures for which they attest to are non met.

Although the stimulus money can supply a addition in the beginning. what happens when the stimulation money is gone? Will the engineering be able to back up itself? There are costs for care and ascents of package for engineering. For a big establishment. such as Washington University. this could be 1000000s of dollars. Technology costs and coverage of Meaningful Use may outweigh the professed value ( 1 ) . Health Information Technology ( HIT ) is used today for a assortment of grounds.

It is used by an person to seek relevant information about themselves. household members. and friends. Additionally. it may be used to entree wellness services. agenda assignments. and refill medicines. One may besides utilize HIT to pass on with their supplier via a patient portal ( PP ) . seek out information on a chronic status. or use a patient wellness record ( 2 ) . Stage 1 of The Meaningful Use regulation. or Meaningless Use regulation as many named it. is the lone phase that is presently enacted and contains three aims. Merely one aim is patient-facing.

This nonsubjective requires the patient to be supplied with an electronic transcript of their wellness information. which may include diagnostic trial consequences. job list. medicine list. and allergic reactions ( 2 ) . The issue with this aim is that if there is a collaborative hospital/provider pattern such as Barnes Hospital and Washington University they each have patient portals. If a patient has a radiology trial performed and the consequences are non readily available at the terminal of the office visit the information may be in the infirmary system.

Using the hospital’s portal. the patient can entree information that has yet to be reviewed by the supplier leting for confusion and anxiousness on the portion of the patient. Another aim is “use of EHR engineering to place patient-specific instruction resources and supply those to the patient as appropriate. ” ( 2 ) Elementss from the first aim can be used for this step and can aim a patient’s specific jobs. This has found to be really disputing in Orthopedic Surgery as this is a specialised pattern and this step is focused on educating patients on disease bar. such as bosom disease and diabetes control.

The last aim for Stage 1 is directing reminders to patients for preventative and follow-up attention and supplying patients with timely electronic entree to their wellness information. Once once more. this has been a challenge to the forte patterns as they are limited on what preventative reminders they can offer. The suppliers feel as though they are supplying reminders to patients entirely to carry through authorities demands. One would inquire if the authorities is ordering how suppliers treat patients. As a professional working in this medical field. I would certify to this being the instance.

Another issue faced with engineering and the EHR is that they provide entree to patient informations ; nevertheless. providers’ face troubles with utilizing them to back up bringing and coordination of attention. ( 3 ) The HITECH Act envisions that suppliers will interchange patient informations through a common platform and protocols. Some provinces are presently implementing platforms to interchange such informations. but are still in the early stages. ( 3 ) A large concern with this is that Health Information Technology entirely can non change over our health care system and at that place needs to be some signifier of fiscal inducement for organizing attention for patients.

Secure messaging via a patient portal is another agency of pass oning with HIT between a patient and supplier. Suppliers. nevertheless. are discerning of this agency of communicating as they feel it will overpower them. It is clip devouring and adds yet another undertaking devouring their clip without compensation ( 2 ) . Does this keep the supplier apt if the patient does non relay the right information or if there was deficient information relayed to the supplier and intervention of the patient was non appropriate or delayed?

In all of the research I read I could non happen anything that addresses this issue. One would believe this would be a major concern with all suppliers. Washington University is in the pilot phases of implementing the patient portal and the suppliers for Orthopedic Surgery have raised concerns of liability issues. Undertakings are underway for wellness attention programs to counterbalance suppliers for secure messaging in hopes to minimise their hesitance to take part in this signifier of communications. However. if they do take part will this cause premiums to increase for persons in those wellness attention programs?

If premiums are increased to pay suppliers. are we genuinely profiting the wellness of the patient? The reply is no. ( 2 ) Suppliers are presently reimbursed on a fee-for-service graduated table. In our Orthopedic Surgery pattern some suppliers see on an norm of 45-50 patients a twenty-four hours. This can potentially do it hard for the supplier to take the appropriate clip to listen to each patient’s concerns with the added loads placed on the suppliers with current and future Meaningful Use demands.

Adding an EHR to each clinical brush could potentially farther distance the supplier from the patient. ( 3 ) . In category. a remark was made by Dr. DeSchryver refering a visit with her health care supplier in which the supplier was documenting in the EHR during the visit. This caused her to experience like she was non having the attending that she deserved. With the added certification demands placed on suppliers and the limited timeframe allowed to document this will go the norm in supplier patterns.

Suppliers have 72 hours from the clip of the office visit to document Meaningful Use steps. Although HIT can supply tools to assist with determination devising in respects to diagnosis. direction of disease. intervention. and bar. the current EHR’s do non hold a nexus to back up systems to assist pull off chronic attention. Primary attention patterns must now switch their focal point on healthy patients. every bit good as ague and inveterate sick patients. With HIT a supplier can efficaciously describe the quality steps. nevertheless the current EHR’s can non place which patients may necessitate peculiar services ( 3 ) .

It appears that we do non hold the engineering required or presently a sufficient figure of trained users for a successful execution of the HITECH Act. We are potentially puting suppliers up for failure either on a patient satisfaction degree or reimbursement degree. There needs to be farther probe on clinical attention processes. the executing and usage of HIT. and restructuring of reimbursement to the suppliers. The current EHRs demand to be able support both coordination of attention and results. EHR Vendors need to guarantee they can supply accurate informations for coverage.

Another step of Meaningful Use is E-Prescribe. The demands are electronic transmittal of prescriptions and care of medicine list. If this is done right and the EHR system is set up right it can better patient safety. watchful prescriber’s of drug-to-drug interactions. supply information on patient non-compliance to medicines. and drug formulary information for insurance benefits. ( 4 ) A survey was conducted with 10 physician patterns that installed stand-alone e-prescribe systems to replace antecedently manus composing prescriptions.

This survey concluded that e-prescribing will necessitate the supplier come ining accurate medicine history and prescriptions to guarantee that their formulary and benefits can be verified. This will besides necessitate wellness programs to guarantee that they have a full set of formulary information. Currently pharmacies entree this information and it will most probably remain as such. Suppliers in this survey besides relied on patients to supply medicine history information as the medicine history in the e-prescribe system was inaccurate. ( 4 )

In a big establishment such as Washington University. a patient may see multiple suppliers from different forte groups. One challenge we face with medicine history is a supplier from one section can non dispatch a medicine that a supplier from another section prescribed. even if the patient stated that they are no longer taking it. We are required to state the patient to advise that supplier. a batch of times the patient will state us that they no longer see that supplier and want us to dispatch the medicine. which our University policy does non let.

The medicine will non be removed from the medicine history list and the patient’s record therefore becomes inaccurate. The HITECH Act was enacted to let patients entree to their PHI. communicate with their health care supplier. keep their wellness record. agenda patient assignments. and request prescription refills via a patient portal ; nevertheless. there are many obstructions that suppliers and patients face through Stage 1 of Meaningful Use. Technology is one obstruction that is faced with both the patient and supplier.

There needs to be a sufficient sum of support and resources in the community for patients who do non hold the literacy needed to understand how to utilize patient portals. The authorities needs to besides guarantee that suppliers are trained and have an ample apprehension of what is required of them for Meaningful Use. The authorities besides needs to do certain that EHR Sellers are describing accurate Meaningful Use steps. E-Prescribe and hospital/provider coaction issues are two other obstructions that need to be addressed every bit good.

There needs to be a web for all of the systems to be able to “talk to each other” so that patient attention is non delayed or potentially at hazard. There besides needs to be added compensation for coordination of attention for suppliers as this may take away some of the hesitance that the suppliers have for the added load placed on them ; nevertheless. this should merely be done if this does non impact a patient’s health care premium. It is in my sentiment that the Government was pressured to go through the Healthcare Reform Policy and as a effect the American people and healthcare suppliers will endure as a consequence either through wellness or pecuniary steps