The Centers for Medicare & Medicaid Services (CMS) defines meaningful use as a set of criteria established under the HITECH Act of 2009 that healthcare providers must meet to demonstrate they are accurately using electronic health records (EHRs) to improve the quality, safety, and efficiency of patient care. The program was developed to encourage the use of EHRs to also reduce disparities in healthcare while also offering patients the ability to become more engaged in their healthcare by accessing mobile health apps and telemedicine. The program was implemented in three stages, the first focused on data capture and sharing. The second emphasized advanced clinical processes with more rigorous health information exchange and increased requirements for E-prescribing. The third concentrated on improving outcomes with a focus on improving patient care coordination, patient engagement, and population health.
The daily functions of demonstrating meaningful use include electronic documentation, E-prescribing, clinical decision support systems (CDSS), health information exchange (HIE), patient engagement, reporting and data submission, secure messaging, and public health reporting. The impact of daily meaningful use functions helps providers improve the quality of care by the ability to view up-to-date patient information to reduce errors, enhance care coordination, and to engage patients in their care. Meaningful use has been the primary driver of transitioning from paper to digitizing health information in healthcare.
I find the most interesting dynamic of meaningful use are the ethical dilemmas which exist. While the framework is in place for meaningful use criteria, it is important to consider ethics. The adoption of EHRs has increased our ability to share information with other providers but has also increased the risk of a breach. It is the organization’s responsibility to ensure their IT security is robust and sufficient for the level of security needed. I find it very perplexing that many organizations are sometimes unsure about the details of how IT information is contained, protected, and maintenance. Patients naturally assume their medical information is safe with their healthcare providers, but there continues to be a threat of information being accessed and used for unintentional purposes. For example, a healthcare provider with access to protected patient information can access a record to learn details about a patient for personal gain. This is not ethical and can result in a HIPAA violation if it is discovered.