History and Development

Pre-digital Era

During a pre-digital era, patients normally suffered from inefficient and faulty clinical systems, processes, and conditions. Many medical errors happened in the past due to undeveloped health technologies. Patients who suffered from an adverse drug event was a common example of medical error in the past. Alarm fatigue was another major issue in the hospital. Alarm fatigue is caused when the alarm is repeatedly triggered or activated for many times. As the alarm was always triggered by unimportant events in the past, nurses always thought the alarm was not significant and might even feel frustrated and exhausted. Alarm fatigue was dangerous because it could lead to death and dangerous situations. As false alarms increase, the alarm fatigue increases as well. With the technological development, an intelligent program of integration and physiologic sense-making was developed and it was crucial in abolishing a great number of false alarms. Also, with investment in health technologies, fewer medical errors happened. Outdated paper records were replaced completely by electronic health records (EHR) in healthcare. This major change has brought a lot of positive impacts on healthcare. Drug administration also improved due to more efficient and secure operations. Healthcare providers can now access to medical information easier, provide better treatments and faster results, build closer relationships with patients, and save more costs. There are still a lot of downsides that electronic health records are facing, but with more investment and development, healthcare technologies will become more important and sophisticated in the healthcare industry.

Improvement

To receive financial support from the government was not easy. The HITECH act stands for Health Information Technology for Economic and Clinical Health Act. It gives the department of health and human services the authority to improve healthcare quality and efficiency through the promotion of health IT. The act provides financial incentives or penalties to organizations to motivate healthcare providers to improve healthcare. The purpose of the act is to improve quality, safety, efficiency, and ultimately to reduce health disparities.

Meaningful use was the requirement of the HITECH act. The purpose is to ensure the sharing of electronic information with patients and other clinicians are secure. It also aims to help healthcare providers to have more efficient operations and safe care to reduce medical errors. The program consisted of three phases. Meaningful use phase one aimed to ensure that healthcare providers were using computers and to see the healthcare providers’ potential. Phase two had many more requirements for providers to meet to receive financial support. Lastly, phase three improved and modified phase two to encourage healthcare providers to provide more efficient healthcare.

Phase 2 was the most complex phase and cost more money than phase 1 because some requirements were difficult. An example includes that it required more than 5% of patients who were able to view, download and transmit their electronic medical information to a third party such as an insurance company. The involved third parties included EHR vendors, hospitals, and providers. The impact is all parties had to spend a large amount of time on re-developing, re-designing, or implementing to make sure the patients could perform the required activity. Besides, hospitals must transmit discharge summaries to other facilities electronically. This requirement was hard because the action was a mutually conflicting or dependent condition. For the hospitals to meet the requirement, they must be able to send the data and also be able to accept the digital data. However, most hospitals were not able to accept the data at that time because many hospitals were adopting different systems.

Furthermore, the Core objective 13 of meaningful use was also hard. It required doctors to give educational resources to at least 10% of their patients. It required a lot of work and time to achieve this requirement. The EHR system did not prompt individuals to simply provide the handout. Instead, many providers had to create a digital copy of all of their educational resources, a database, and linked the sources to the responding health conditions. Overall, the transition was hard from phase one to phase two because a lot of requirements were more complex and hard to achieve.

Many complained that the HITECH Act and meaningful use were not well executed; however, the programs seemed to increase the adoption of health technologies rapidly in just a few years. In 2014, the implementation of electronic records in US hospitals rose from a low percentage of 10% to a high percentage of 70%.

For the current phase, at the beginning of 2018, healthcare providers who participated in the Medicare Promoting Interoperability Program needed to report on Quality Payment Program requirements. The program focused more on interoperability and aimed to improve patient access to health information.