ApplicationPLEASE MAKE SURE IT’S IN APA STYLE FORMAT. CITE ACCURATELY.

The Nurse’s Role in Supporting the Organization’s Strategic Agenda

As hospitals seek to reduce the incidence of Never Events and improve the overall quality of health care provided, it is apparent that ultimate success will require the effort of the entire medical staff. Consider the nurse’s role in supporting the organization’s strategic agenda as it relates to improving clinical outcomes. For this application you are asked to interview a quality manager in an acute care or long-term care agency of your choice. Your goal is to determine the manager’s view regarding the impact of the direct care nurse’s role in clinical outcomes for the organization. How does this influence the ability of the organization to achieve its strategic agenda? Before you attend the interview, create a list of relevant questions that will help you better understand the effect a nurse can have on the successful treatment of the patient. Write a 3-page paper discussing what you learned from this interview. How will what you learned impact how you approach your nursing responsibilities?

nursing

Order Description

Half of page per response to my peers, with references, use first person, thank you. Discussion attached.
Respond in one or more of the following ways:
1)Ask a probing question, substantiated with additional background information, evidence, or research using an in-text citation in APA format.
2)Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
3)Validate an idea with your own experience and additional research.
4)Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

(Darinka)

HITECH Legislation
The federal Health Information Technology for Economic and Clinical Health Act (HITECH) was enacted in 2009 as part of the American Recovery and Reinvestment Act (ARRA) (Gialanella, 2012). The purpose of the ARRA was to stimulate the economy and improve health care (Gialanella, 2012). As a result, health information technology policies and standards, privacy and security, and meaningful use were developed to meet the requirements to protect patient health information and receive financial incentives tied to reimbursement initiatives (Gialanella, 2012).
HITECH Impact on my Organization
My facility recently implemented computerized physician order entry (CPOE) as a result of the new legislation. The for-profit facility is part of the Hospital Corporation of America (HCA), the largest provider of health services in America. The implementation of a large computer system, or any business or clinically associated improvement, is enacted throughout all organizations and most hospitals are not given a choice regarding which technology to implement. As a result, all facilities utilize the same computer systems. Although this is considered a wise business strategy, due to cost benefits and improved patient care coordination, most organizations would rather have input regarding decisions that affect clinicians and workflow processes.
The implementation of CPOE had a positive impact on the organization because it helped to meet compliance regulations associated with reimbursement, but it was not met with enthusiasm by clinicians. I am not sure that my facility would have chosen to implement the technology if it were not related to long-term financial incentives and reimbursement. The act essentially forced one of the largest providers of health care to implement the computer system and comply with meaningful use criteria. As a for-profit organization, HCA values the profit margins it generates and although it strives to ensure high-quality care, meeting financial goals across hospital divisions is equally as important to stakeholders. My facility is an excellent example of how the legislation forced facilities to start to comply with the requirements and mandated the necessary infrastructure to support the proper use to obtain meaningful data.
Address how its related incentives influence the adoption of health information technology in health care and impact the quality of patient care
How Incentives Influence Adoption of Health Information Technology
The HITECH provision was created to provide financial incentives for hospitals to implement necessary tools to provide meaningful information and care coordination across providers (Murphy, 2010). Five initiatives meet meaningful use criteria:
1.    Improve quality, safety, and efficiency, and reduce health disparities.
2.    Engage patients and families.
3.    Improve care coordination.
4.    Improve population and public health.
5.    Ensure adequate privacy and security protections for personal health information (Murphy, 2010).
The federal government allocated $19 billion to incentivize providers to implement electronic health records (EHR) (Murphy, 2012). According to Brown (2010) the final ruling surrounding meaningful use has three stages and criteria associated core requirements. There are 14 eligibility core requirements for hospitals to meet and 15 core requirements for healthcare providers (Brown, 2010). Ten additional objectives are required, and both hospitals and providers must chose five. As long as hospitals/providers meet and submit the measures within the specified year, then they will receive the incentive payments (Murphy, 2010).
Technology and reporting requirements will have a large impact on patient care are projected to be extensive. Clinical research is perhaps one of the biggest benefits of HIT implementation (Gialanella, 2012). Specified quality measures are reported to Medicare and Medicaid and will impact the delivery of care affecting cost, and improve quality through tracking data that lead to evidence-based care. The measures will also enhance coordination of patient care among providers to reduce repeat testing and decrease medical errors (Gialanella, 2012). Health care reform is focusing on promoting prevention, early detection, and improved management of chronic diseases through health information technology. Promoting wellness will be enhanced through the use of HIT for early detection of disease states, rapid responses to pandemics, and identify at risk-patient populations (Gialanella, 2012).
Provide a summary of the article you identified and explain how it demonstrates the ability of health information technology to meet the requirements of meaningful use.
Summary of Article and Demonstration of Technology to Meet Meaningful Use
Authors Jones, Heaton, Friedberg, and Schneider (2011) investigated meaningful use as it relates to decreasing hospital mortality in three areas – heart attack, heart failure, and pneumonia by using electronic medication order entry systems. There is uncertainty whether meaningful use standards will improve care, reduce errors, and improve patient safety. Evaluating the benefit of electronic order entry is sought to provide data to support the assertion (Jones et al., 2011). Stage one meaningful use requires facilities to use computer order entry systems for approximately 30% of patients to be eligible for reimbursement. The percentage of use requirements would increase with subsequent stages eventually requiring 80% use of computer order entry for eligible patients by stage three (Jones et al., 2011). The authors obtained data from the Association Annual Survey database.  The database provided data on 4,156 acute care facilities included in the Hospital Compare Database of which 2,543 had responded to the 2007 American Hospital Association Information Technology Supplement. 2,543 represented the cohort size (Jones et al., 2011).
The authors reported 61% of the hospitals studied did not use electronic medication order entry, 13% of the hospitals reported ordering from one to 25%, four percent of hospitals reported ordering 26 to 50%, and six percent of hospitals reported using electronic ordering from 51 to 90% of patients (Jones et al., 2011). Despite the small number of facilities utilizing computer order entry in any capacity the benefit of its use was appreciated with improved mortality rates in heart attack and heart failure categories (Jones et al., 2011). Significantly improved mortality was seen with higher use of computer order entry systems and a much better statistics.
Overall, the authors reported that hospitals meeting stage one requirements could appreciate 1.2% reduction in mortality rates, but this is not statistically significantly because estimated thresholds were not met (Jones et al., 2011). With stage 2 requirements, reduced mortality could be as high as 2.1% (Jones et al., 2011). The study was beneficial in proving that greater use of computer order entry has the potential in reducing mortality rates.
References
Brown, B. (2010). The final rules for meaningful use of EHRs. Journal of Health Care Compliance,12(5), 49–50. Retrieved from http://sfxhosted.exlibrisgroup.com/waldenu?url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&ctx_enc=info:ofi/enc:UTF-8&ctx_ver=Z39.88-2004&rfr_id=info:sid/sfxit.com:azlist&sfx.ignore_date_threshold=1&rft.object_id=111030132863024&rft.object_portfolio_id=&svc.fulltext=yes
Gianlanella, K. M. (2012). Legislative aspects of nursing informatics: HITECH and HIPPA.  In McGonigle, D., & Mastrian, K. G. (Eds.). Nursing informatics and the foundation of knowledge. (pp. 161-184). (Laureate Education, Inc., custom ed.). Burlington, MA: Jones & Bartlett Learning
Jones, S. S., Heaton, P., Friedberg, M. W., & Schneider, E. C. (2011). Today’s ‘Meaningful Use’ Standard For Medication Orders By Hospitals May Save Few Lives; Later Stages May Do More. Health Affairs, 30(10), 2005-2012. doi:10.1377/hlthaff.2011.0245
Murphy, J. (2010b). Nursing informatics. The journey to meaningful use of electronic health records.Nursing Economic$, 28(4), 283–286.
Retrieved from http://search.proquest.com/openview/a5ca4c04a06bbb25597728fa8424c252/1?pq-origsite=gscholar

(Linsey)

HIT , HIPPA, and HITECH
The Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009 was in acted to improve the quality of healthcare, reduce cost, and improve communication across the healthcare community (McGonigle, & Mastrian, 2012). The HITECH has had both positive and negative impact on my current organization. The positive has been strengthening Health Insurance Portability and Accountabilty Act (HIPPA), “The HITECH Act has improved privacy and security of patient health information by applying the requirements of HIPPA directly to the business associates of covered entities” (McGonigle, & Mastrian, 2012, p. 179). It also helps with decreasing disparities between health facilities and quality of care.  “All patients, regardless of race, ethnicity, or socioeconomic status should receive care that is effective, safe, and timely. With the national health information technology (HIT) infrastructure contemplated by the HITECH Act, such disparities are bound to decrease” (McGonigle, & Mastrian, 2012, p.167).  The implementation of electronic health records and HIT the HIPPA compliance has strengthened and also verification of patient’s information is easier.  The negatives of the HITECH is the expense, “the size, complexity, and capabilities of the covered entity or business associate; the technical infrastructure, hardware, and software security capabilities of the covered entity or business associate;  the financial costs of implementing security measures; and the probability and criticality of potential risks to electronic protected health information( ePHI) security breaches” (Kempfert & Reed, 2011, p.261).
Incentives and Meaningful Use
Incentives from the HITECH have been overall favorable in the adopting of electronic health records (EHR); however, due to the cost of buying equipment, software, and training, the benefits of the incentives are not seen until later. The HITECH act also provides significant monetary incentives for providers who engage in meaningful use of HIT. Meaningful use (MU) is the new standard that has entered healthcare. This week in my practice there is a meaningful use meeting. We are going through all the things we must address in every patient’s note to get incentives for meaningful use. The physician’s are tracked on if they are meeting the criteria and us, as their nurses honestly must do most of the work to comply.
Summary of Article
MU means that you’re digital records in a way that provides improved patient care-not just that you’ve moved from paper files to computer files. The best way to improve patient care is to make sure that medical staff always has the right information at the right time. Automated document and reports management are key components to achieving MU” (Colpas, 2013, p. 11). The article Contemplating Meaningful Use overviews that steps of MU and the steps that facilities must take to achieve compliance and incentives. Steps such as patient portal implementation, security measures, information collection, and HIPPA compliance are discussed and several information specialists (IT) explain why meaningful use is important in patient safety and quality care improvement. This article was interesting as is gave a guideline to the many ways for facilities to implement their meaningful use programs for success.

References

Colpas, P. (2013). Contemplating meaningful use. Health Management Technology, 34(8), 8-11.

Kempfert, A. E., & Reed, B. D. (2011). Health Care Reform In the United States: HITECH Act and HIPAA Privacy, Security, and Enforcement Issues. FDCC Quarterly, 61(3), 240-273.

McGonigle, D., & Mastrian, K. G. (2012). Nursing informatics and the foundation of knowledge (Laureate Education, Inc., custom ed.). Burlington, MA: Jones and Bartlett Learning.

(Starr)

HITECH Act
The Health Information Technology for Economic and Clinical Health Act (HITECH) enacted February 17, 2009, is part of the American Recovery and Reinvestment Act (ARRA) (McGonigle, & Mastrian, 2012). “The ARRA was enacted to stimulate various sectors of the US economy during the most severe recession this country has experienced since the Great depression of the late 1920s and early 1930s” (McGonigle, & Mastrian, 2012, p.161). The HITECH act addresses the development, adoption and implementation of Health Information Technology (HIT) policies, standers, and provides enhanced privacy and security for patient’s information (McGonigle, & Mastrian, 2012, p.162).
Currently in my facility computerized physician order entry (CPOE) is implemented; a few years ago this was a positive impact on my facility due to meeting compliance regulation associated with reimbursement with the government. However, with this positive impact was negative impact related to staff moral in learning the new computerized program.
Effects of HITECH Act
HITECH Act has had many positive and negative effects, like any new legislation implemented. One of the positive contributions noted from the HITECH ACT is increased strength and enforcement of Health Information Privacy act (HIPA) (McGonigle, & Mastrian, 2012). HITECH Act also contributes to patients explanation of care and billing; “existing accounting rules are enhanced under this act, giving patient the right to access electronic health record (EHR) and receive an accounting of all disclosures” (McGonigle, & Mastrian, 2012, p.179). Most would agree that the expense of HITECH has been a negative. The complexity and time spent of the HITECH act has been a burden for many businesses, and lack of nurse implementation can also cause some negativity.
Meaningful definition
According to Healthit.gov meaningful use is using certified electronic health record (EHR) technology to:
•Improve quality, safety, efficiency, and reduce health disparities
•Engage patients and family
•Improve care coordination, and population and public health
•Maintain privacy and security of patient health information (Healthit.gov, 2015).
The Healthit.gov also states “to receive an EHR incentive payment, providers have to show that they are “meaningfully using” their certified EHR technology by meeting certain measurement thresholds that range from recording patient information as structured data to exchanging summary care records” (Healthit.gov, 2015).
Summary of article
Kruse, Bolton, & Freriks conducted a systemic review study attempting to answer whether the use of patient portals increase patient outcomes. The conclusion of this study stated the ability of the patients to be able to view their health information electronically meets the intent of Meaningful use (Kruse, Bolton,  & Feriks, 2015).  Patient portals use is intertwined with many of the meaningful use bullets, such as engaging patients and families, and improve care coordination. Patient portals are very helpful with encouraging patient to be apart of their own care.

Reference
HealthIT.gov. (2015, February 1). Meaningful Use Regulation. Retrieved July 27, 2015,
from http://www.healthit.gov/policy-researchers-implementers/meaningful-use-
regulations
Kruse, C. S., Bolton, K., & Freriks, G. (2015). The effect of patient portals on quality
outcomes and its implications to meaningful use: a systematic review. Journal Of
Medical Internet Research, 17(2), e44. doi:10.2196/jmir.3171
McGonigle, D., & Mastrian, K. G. (2012). Nursing informatics and the foundation of knowledge (Laureate Education, Inc., custom ed.). Burlington, MA: Jones and Bartlett Learning.

(Lowell)

HITECH Legislation and Hospital-Acquired Infections
One of the main purposes of the federal Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009 is to improve healthcare quality by enhancing coordination of services between and among the various healthcare providers a patient may have, fostering more appropriate healthcare decisions at the time and place of delivery of services, and preventing medical errors and advancing the delivery of patient-centered care (McGonigle & Mastrian, p.163). The goals of this Act are to insure that each patient has the safest, and most appropriate medical care possible. My hospital has been influenced greatly by the HITECH Act when it comes to reimbursement from Medicare and Medicaid services. The tracking and documentation of hospital-acquired infections is a main topic of observation at my organization.
At my hospital, when a patient obtains a hospital-acquired infection, or a hospital-acquired pressure ulcer, it is documented with our Risk Management department. The data is continuously reported to Medicare and Medicaid. After evaluation of the documentation, reimbursements are either deducted, or held entirely, depending on the severity of the situation. Reporting hospital-acquired infections is extremely important in meeting criteria for meaningful use. According to Judy Murphy (2010), one of the criteria for meeting meaningful use is the initiative to improve quality, safety, and efficiency, and reduce health disparities. The main focus of reporting these incidents is not to get hospitals in trouble, but rather to determine actions that need to be put in place in order to improve patient care. Working to provide a safer environment for patients ensures that hospitals will continue to grow.
Article Review
In the article Mandatory Reporting of Hospital-Acquired Infections: Steps for Success, authors Cardo, Brennan, and Peaden (2005) examine the benefits of reporting infections to a national database. They state that the overall goal is to examine the cause for the infections, and implement a system to prevent them. The state of Pennsylvania mandates that all hospital-acquired infection information be public record. This is to reinforce the strategy by giving information to health care providers so that they can identify opportunities to contain costs and improve the quality of care they deliver (Cardo, et al. 2005). This article reflects the use of health information technology by acquiring data, and using it to improve patient safety, and reduce the risks of complications with hospitalizations.

References
Cardo, D., Brennan, P., & Peaden, D. J. (2005). Mandatory reporting of hospital-acquired infections: steps for success.Journal of Law, Medicine & Ethics, 33(4), 86-88.
McGonigle, D., & Mastrian, K. G. (2012). Nursing informatics and the foundation of knowledge (Laureate Education, Inc., custom ed.). Burlington, MA: Jones and Bartlett Learning.
Murphy, J. (2010b). Nursing informatics. The journey to meaningful use of electronic health records. Nursing Economic$, 28(4), 283–286.
Retrieved from the Walden Library databases.

nursing

Order Description

Half of page per response to my peers, with references, use first person, thank you. Discussion attached.
Respond in one or more of the following ways:
1)Ask a probing question, substantiated with additional background information, evidence, or research using an in-text citation in APA format.
2)Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.
3)Validate an idea with your own experience and additional research.
4)Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

(Darinka)

HITECH Legislation
The federal Health Information Technology for Economic and Clinical Health Act (HITECH) was enacted in 2009 as part of the American Recovery and Reinvestment Act (ARRA) (Gialanella, 2012). The purpose of the ARRA was to stimulate the economy and improve health care (Gialanella, 2012). As a result, health information technology policies and standards, privacy and security, and meaningful use were developed to meet the requirements to protect patient health information and receive financial incentives tied to reimbursement initiatives (Gialanella, 2012).
HITECH Impact on my Organization
My facility recently implemented computerized physician order entry (CPOE) as a result of the new legislation. The for-profit facility is part of the Hospital Corporation of America (HCA), the largest provider of health services in America. The implementation of a large computer system, or any business or clinically associated improvement, is enacted throughout all organizations and most hospitals are not given a choice regarding which technology to implement. As a result, all facilities utilize the same computer systems. Although this is considered a wise business strategy, due to cost benefits and improved patient care coordination, most organizations would rather have input regarding decisions that affect clinicians and workflow processes.
The implementation of CPOE had a positive impact on the organization because it helped to meet compliance regulations associated with reimbursement, but it was not met with enthusiasm by clinicians. I am not sure that my facility would have chosen to implement the technology if it were not related to long-term financial incentives and reimbursement. The act essentially forced one of the largest providers of health care to implement the computer system and comply with meaningful use criteria. As a for-profit organization, HCA values the profit margins it generates and although it strives to ensure high-quality care, meeting financial goals across hospital divisions is equally as important to stakeholders. My facility is an excellent example of how the legislation forced facilities to start to comply with the requirements and mandated the necessary infrastructure to support the proper use to obtain meaningful data.
Address how its related incentives influence the adoption of health information technology in health care and impact the quality of patient care
How Incentives Influence Adoption of Health Information Technology
The HITECH provision was created to provide financial incentives for hospitals to implement necessary tools to provide meaningful information and care coordination across providers (Murphy, 2010). Five initiatives meet meaningful use criteria:
1.    Improve quality, safety, and efficiency, and reduce health disparities.
2.    Engage patients and families.
3.    Improve care coordination.
4.    Improve population and public health.
5.    Ensure adequate privacy and security protections for personal health information (Murphy, 2010).
The federal government allocated $19 billion to incentivize providers to implement electronic health records (EHR) (Murphy, 2012). According to Brown (2010) the final ruling surrounding meaningful use has three stages and criteria associated core requirements. There are 14 eligibility core requirements for hospitals to meet and 15 core requirements for healthcare providers (Brown, 2010). Ten additional objectives are required, and both hospitals and providers must chose five. As long as hospitals/providers meet and submit the measures within the specified year, then they will receive the incentive payments (Murphy, 2010).
Technology and reporting requirements will have a large impact on patient care are projected to be extensive. Clinical research is perhaps one of the biggest benefits of HIT implementation (Gialanella, 2012). Specified quality measures are reported to Medicare and Medicaid and will impact the delivery of care affecting cost, and improve quality through tracking data that lead to evidence-based care. The measures will also enhance coordination of patient care among providers to reduce repeat testing and decrease medical errors (Gialanella, 2012). Health care reform is focusing on promoting prevention, early detection, and improved management of chronic diseases through health information technology. Promoting wellness will be enhanced through the use of HIT for early detection of disease states, rapid responses to pandemics, and identify at risk-patient populations (Gialanella, 2012).
Provide a summary of the article you identified and explain how it demonstrates the ability of health information technology to meet the requirements of meaningful use.
Summary of Article and Demonstration of Technology to Meet Meaningful Use
Authors Jones, Heaton, Friedberg, and Schneider (2011) investigated meaningful use as it relates to decreasing hospital mortality in three areas – heart attack, heart failure, and pneumonia by using electronic medication order entry systems. There is uncertainty whether meaningful use standards will improve care, reduce errors, and improve patient safety. Evaluating the benefit of electronic order entry is sought to provide data to support the assertion (Jones et al., 2011). Stage one meaningful use requires facilities to use computer order entry systems for approximately 30% of patients to be eligible for reimbursement. The percentage of use requirements would increase with subsequent stages eventually requiring 80% use of computer order entry for eligible patients by stage three (Jones et al., 2011). The authors obtained data from the Association Annual Survey database.  The database provided data on 4,156 acute care facilities included in the Hospital Compare Database of which 2,543 had responded to the 2007 American Hospital Association Information Technology Supplement. 2,543 represented the cohort size (Jones et al., 2011).
The authors reported 61% of the hospitals studied did not use electronic medication order entry, 13% of the hospitals reported ordering from one to 25%, four percent of hospitals reported ordering 26 to 50%, and six percent of hospitals reported using electronic ordering from 51 to 90% of patients (Jones et al., 2011). Despite the small number of facilities utilizing computer order entry in any capacity the benefit of its use was appreciated with improved mortality rates in heart attack and heart failure categories (Jones et al., 2011). Significantly improved mortality was seen with higher use of computer order entry systems and a much better statistics.
Overall, the authors reported that hospitals meeting stage one requirements could appreciate 1.2% reduction in mortality rates, but this is not statistically significantly because estimated thresholds were not met (Jones et al., 2011). With stage 2 requirements, reduced mortality could be as high as 2.1% (Jones et al., 2011). The study was beneficial in proving that greater use of computer order entry has the potential in reducing mortality rates.
References
Brown, B. (2010). The final rules for meaningful use of EHRs. Journal of Health Care Compliance,12(5), 49–50. Retrieved from http://sfxhosted.exlibrisgroup.com/waldenu?url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&ctx_enc=info:ofi/enc:UTF-8&ctx_ver=Z39.88-2004&rfr_id=info:sid/sfxit.com:azlist&sfx.ignore_date_threshold=1&rft.object_id=111030132863024&rft.object_portfolio_id=&svc.fulltext=yes
Gianlanella, K. M. (2012). Legislative aspects of nursing informatics: HITECH and HIPPA.  In McGonigle, D., & Mastrian, K. G. (Eds.). Nursing informatics and the foundation of knowledge. (pp. 161-184). (Laureate Education, Inc., custom ed.). Burlington, MA: Jones & Bartlett Learning
Jones, S. S., Heaton, P., Friedberg, M. W., & Schneider, E. C. (2011). Today’s ‘Meaningful Use’ Standard For Medication Orders By Hospitals May Save Few Lives; Later Stages May Do More. Health Affairs, 30(10), 2005-2012. doi:10.1377/hlthaff.2011.0245
Murphy, J. (2010b). Nursing informatics. The journey to meaningful use of electronic health records.Nursing Economic$, 28(4), 283–286.
Retrieved from http://search.proquest.com/openview/a5ca4c04a06bbb25597728fa8424c252/1?pq-origsite=gscholar

(Linsey)

HIT , HIPPA, and HITECH
The Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009 was in acted to improve the quality of healthcare, reduce cost, and improve communication across the healthcare community (McGonigle, & Mastrian, 2012). The HITECH has had both positive and negative impact on my current organization. The positive has been strengthening Health Insurance Portability and Accountabilty Act (HIPPA), “The HITECH Act has improved privacy and security of patient health information by applying the requirements of HIPPA directly to the business associates of covered entities” (McGonigle, & Mastrian, 2012, p. 179). It also helps with decreasing disparities between health facilities and quality of care.  “All patients, regardless of race, ethnicity, or socioeconomic status should receive care that is effective, safe, and timely. With the national health information technology (HIT) infrastructure contemplated by the HITECH Act, such disparities are bound to decrease” (McGonigle, & Mastrian, 2012, p.167).  The implementation of electronic health records and HIT the HIPPA compliance has strengthened and also verification of patient’s information is easier.  The negatives of the HITECH is the expense, “the size, complexity, and capabilities of the covered entity or business associate; the technical infrastructure, hardware, and software security capabilities of the covered entity or business associate;  the financial costs of implementing security measures; and the probability and criticality of potential risks to electronic protected health information( ePHI) security breaches” (Kempfert & Reed, 2011, p.261).
Incentives and Meaningful Use
Incentives from the HITECH have been overall favorable in the adopting of electronic health records (EHR); however, due to the cost of buying equipment, software, and training, the benefits of the incentives are not seen until later. The HITECH act also provides significant monetary incentives for providers who engage in meaningful use of HIT. Meaningful use (MU) is the new standard that has entered healthcare. This week in my practice there is a meaningful use meeting. We are going through all the things we must address in every patient’s note to get incentives for meaningful use. The physician’s are tracked on if they are meeting the criteria and us, as their nurses honestly must do most of the work to comply.
Summary of Article
MU means that you’re digital records in a way that provides improved patient care-not just that you’ve moved from paper files to computer files. The best way to improve patient care is to make sure that medical staff always has the right information at the right time. Automated document and reports management are key components to achieving MU” (Colpas, 2013, p. 11). The article Contemplating Meaningful Use overviews that steps of MU and the steps that facilities must take to achieve compliance and incentives. Steps such as patient portal implementation, security measures, information collection, and HIPPA compliance are discussed and several information specialists (IT) explain why meaningful use is important in patient safety and quality care improvement. This article was interesting as is gave a guideline to the many ways for facilities to implement their meaningful use programs for success.

References

Colpas, P. (2013). Contemplating meaningful use. Health Management Technology, 34(8), 8-11.

Kempfert, A. E., & Reed, B. D. (2011). Health Care Reform In the United States: HITECH Act and HIPAA Privacy, Security, and Enforcement Issues. FDCC Quarterly, 61(3), 240-273.

McGonigle, D., & Mastrian, K. G. (2012). Nursing informatics and the foundation of knowledge (Laureate Education, Inc., custom ed.). Burlington, MA: Jones and Bartlett Learning.

(Starr)

HITECH Act
The Health Information Technology for Economic and Clinical Health Act (HITECH) enacted February 17, 2009, is part of the American Recovery and Reinvestment Act (ARRA) (McGonigle, & Mastrian, 2012). “The ARRA was enacted to stimulate various sectors of the US economy during the most severe recession this country has experienced since the Great depression of the late 1920s and early 1930s” (McGonigle, & Mastrian, 2012, p.161). The HITECH act addresses the development, adoption and implementation of Health Information Technology (HIT) policies, standers, and provides enhanced privacy and security for patient’s information (McGonigle, & Mastrian, 2012, p.162).
Currently in my facility computerized physician order entry (CPOE) is implemented; a few years ago this was a positive impact on my facility due to meeting compliance regulation associated with reimbursement with the government. However, with this positive impact was negative impact related to staff moral in learning the new computerized program.
Effects of HITECH Act
HITECH Act has had many positive and negative effects, like any new legislation implemented. One of the positive contributions noted from the HITECH ACT is increased strength and enforcement of Health Information Privacy act (HIPA) (McGonigle, & Mastrian, 2012). HITECH Act also contributes to patients explanation of care and billing; “existing accounting rules are enhanced under this act, giving patient the right to access electronic health record (EHR) and receive an accounting of all disclosures” (McGonigle, & Mastrian, 2012, p.179). Most would agree that the expense of HITECH has been a negative. The complexity and time spent of the HITECH act has been a burden for many businesses, and lack of nurse implementation can also cause some negativity.
Meaningful definition
According to Healthit.gov meaningful use is using certified electronic health record (EHR) technology to:
•Improve quality, safety, efficiency, and reduce health disparities
•Engage patients and family
•Improve care coordination, and population and public health
•Maintain privacy and security of patient health information (Healthit.gov, 2015).
The Healthit.gov also states “to receive an EHR incentive payment, providers have to show that they are “meaningfully using” their certified EHR technology by meeting certain measurement thresholds that range from recording patient information as structured data to exchanging summary care records” (Healthit.gov, 2015).
Summary of article
Kruse, Bolton, & Freriks conducted a systemic review study attempting to answer whether the use of patient portals increase patient outcomes. The conclusion of this study stated the ability of the patients to be able to view their health information electronically meets the intent of Meaningful use (Kruse, Bolton,  & Feriks, 2015).  Patient portals use is intertwined with many of the meaningful use bullets, such as engaging patients and families, and improve care coordination. Patient portals are very helpful with encouraging patient to be apart of their own care.

Reference
HealthIT.gov. (2015, February 1). Meaningful Use Regulation. Retrieved July 27, 2015,
from http://www.healthit.gov/policy-researchers-implementers/meaningful-use-
regulations
Kruse, C. S., Bolton, K., & Freriks, G. (2015). The effect of patient portals on quality
outcomes and its implications to meaningful use: a systematic review. Journal Of
Medical Internet Research, 17(2), e44. doi:10.2196/jmir.3171
McGonigle, D., & Mastrian, K. G. (2012). Nursing informatics and the foundation of knowledge (Laureate Education, Inc., custom ed.). Burlington, MA: Jones and Bartlett Learning.

(Lowell)

HITECH Legislation and Hospital-Acquired Infections
One of the main purposes of the federal Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009 is to improve healthcare quality by enhancing coordination of services between and among the various healthcare providers a patient may have, fostering more appropriate healthcare decisions at the time and place of delivery of services, and preventing medical errors and advancing the delivery of patient-centered care (McGonigle & Mastrian, p.163). The goals of this Act are to insure that each patient has the safest, and most appropriate medical care possible. My hospital has been influenced greatly by the HITECH Act when it comes to reimbursement from Medicare and Medicaid services. The tracking and documentation of hospital-acquired infections is a main topic of observation at my organization.
At my hospital, when a patient obtains a hospital-acquired infection, or a hospital-acquired pressure ulcer, it is documented with our Risk Management department. The data is continuously reported to Medicare and Medicaid. After evaluation of the documentation, reimbursements are either deducted, or held entirely, depending on the severity of the situation. Reporting hospital-acquired infections is extremely important in meeting criteria for meaningful use. According to Judy Murphy (2010), one of the criteria for meeting meaningful use is the initiative to improve quality, safety, and efficiency, and reduce health disparities. The main focus of reporting these incidents is not to get hospitals in trouble, but rather to determine actions that need to be put in place in order to improve patient care. Working to provide a safer environment for patients ensures that hospitals will continue to grow.
Article Review
In the article Mandatory Reporting of Hospital-Acquired Infections: Steps for Success, authors Cardo, Brennan, and Peaden (2005) examine the benefits of reporting infections to a national database. They state that the overall goal is to examine the cause for the infections, and implement a system to prevent them. The state of Pennsylvania mandates that all hospital-acquired infection information be public record. This is to reinforce the strategy by giving information to health care providers so that they can identify opportunities to contain costs and improve the quality of care they deliver (Cardo, et al. 2005). This article reflects the use of health information technology by acquiring data, and using it to improve patient safety, and reduce the risks of complications with hospitalizations.

References
Cardo, D., Brennan, P., & Peaden, D. J. (2005). Mandatory reporting of hospital-acquired infections: steps for success.Journal of Law, Medicine & Ethics, 33(4), 86-88.
McGonigle, D., & Mastrian, K. G. (2012). Nursing informatics and the foundation of knowledge (Laureate Education, Inc., custom ed.). Burlington, MA: Jones and Bartlett Learning.
Murphy, J. (2010b). Nursing informatics. The journey to meaningful use of electronic health records. Nursing Economic$, 28(4), 283–286.
Retrieved from the Walden Library databases.