Obtaining Electronic Health Records
A hospital and an independent physician association (IPA) comprising 600 physicians have elected to apply to participate in the accountable care organization (ACO) program sponsored by the Centers for Medicare & Medicaid Services. The hospital and IPA will agree to provide healthcare to a minimum of 5000 Medicare beneficiaries. Because the individual entities are required to report to Medicare as one entity on 33 quality metrics, including seven patient encounter caregiver experience elements, the ACO is interested in facilitating the widespread adoption of electronic medical records within the ACO. Accordingly, the hospital intends to provide assistance to the individual physicians to obtain electronic health records. In addition, the individual physicians will be required to achieve Meaningful Use and comply with policies and procedures of the ACO. Regardless of the electronic health record they would like to purchase, the individual physicians will be required to exchange health information electronically to improve effective communication between healthcare providers, reduce duplicate visits, and lower the overall cost of delivering care to the Medicare beneficiaries.
1. Explain how the arrangement should be established to permit the hospital to assist the healthcare providers in obtaining electronic health records.
2. Describe the timeline and the potential financial impact to the individual healthcare providers who are involved in Meaningful Use of the program.
3. Discuss the benefits of using health IT within the ACO program.
4. Discuss the implementation specifications that each individual healthcare provider as a member of the ACO must implement within his or her own facility and as part of a larger ACO to protect the security, confidentiality, privacy, and integrity of patient information.
5. Identify what federal administrative, physical, and technical safeguards that apply can be used to prevent unauthorized access
- Explain how the arrangement should be established to permit the hospital to assist the healthcare providers in obtaining electronic health records.
The healthcare providers working under the hospital must have electronic health records. In complying with the ACO requirements, the hospital healthcare providers and the hospital can agree for the physicians to register as independent physicians while maintaining their employment contracts. According to Finnegan (2017), employment negotiations help physicians attain the independent physician status while employed. This arrangement would thus necessitate the hospital to acquire EHRs for the physicians.
- Describe the timeline and the potential financial impact to the individual healthcare providers involved in Meaningful Use of the program.
The Meaningful use program is on stage three that requires interoperability of the electronic health records in sharing among healthcare providers and allowing the patients to access healthcare records. The potential financial benefits to the individual healthcare providers include the payment of incentives for fulfilling the objectives of the EHR system in impacting patient care. The incentives are determined by using the EHR system in sharing and coordinating patient care.
- Benefits of Using IT within the ACO program
The ACO program focuses on offering quality healthcare services at a reduced cost using IT tools such as the EHR system. The IT tools improve communication among physicians and hospitals for coordinated care, consequently improving the quality of healthcare delivered. The other benefit is financial benefits. The ACO benefits by reducing the cost of care and thus using electronic health records, among other technologies; the organization limits some unnecessary services such as unnecessary hospital visits.
- Implementation Specifications
Data security, privacy and confidentiality are key in the healthcare practice. Each member of the ACO should implement the limited access codes in their systems that require people using the information technology system to sign in using passwords for accessibility. This allows the members to be core managers of the patient data, not exposing it to others. The members should also ensure that they seek the patient’s consent in sharing their data for privacy and confidentiality considerations.
- Federal, Administrative, Physical and Technical Safeguards
Various safeguards can be applied in preventing unauthorized access. The federal law disallows unauthorized sharing of patient data, and this Act prevents the ACO members from interfering with the patient’s privacy. The administrative role in preventing unauthorized data access is through policies differentiating roles and levels of entry, thus disallowing the other people from using the computers or even accessing the room. Physical safeguards may be applied in physically closing the doors to prevent the vicinity’s physical access that would necessitate unauthorized access. The technical safeguards include using unique technological identifiers, automatic logoffs, encryption and decryption, and access alerts in preventing unauthorized access (CMS, 2017).
Centers for Medicare and Medicaid Services. (2017). Security standards: Technical safeguards. HIPAA Secur. Ser, 2, 1-17. https://www.hhs.gov/sites/default/files/ocr/privacy/hipaa/administrative/securityrule/techsafeguards.pdf
Finnegan, J. (2017). 3 ways hospital-affiliated physicians can maintain some of their independence. Fierce Healthcare. https://www.fiercehealthcare.com/practices/3-ways-hospital-affiliated-physicians-can-maintain-some-independence