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In the age of high technologies, nurses have become particularly sensitive to questions of IT and their implications for the quality of patient care. For years, the state was promoting numerous initiatives to encourage nurses and health care facilities to adopt technologies more decisively. Today, the health information technology (HIT) field becomes more heavily regulated, but even in the presence of solid regulatory mechanisms, many controversies surrounding the use of technologies in nursing care continue to persist. Some of these difficulties are related to the costs of implementation, whereas others do not allow achieving an ideal fit of the new system and the existing strategies, decisions, and frameworks. Therefore, it is important to understand whether at all the Health Information Technology (HITECH) legislation has any potential to improve the quality of health care in the organization.
Like any other technology or IT phenomenon, the HITECH legislation is likely to have positive and negative impacts on medical care. Nurses must be objective, as they are trying to understand the good and bad sides of new technologies. On the positive side, the organization will invariably experience a reduction in the incidence and scope of medical errors. On the negative sides, the costs of implementation and the existing gaps between the law and technological advancements may become a serious barrier to implementing these techniques. In this paper, these positive and negative implications of HITECH for the quality of patient care are reviewed in detail, and an article summary is provided to add to the current knowledge of the HITECH legislation in the context of nursing care.
As the state is trying to improve the quality and reduce the costs of health care, the use of medical technologies remains one of the top organizational priorities. The body of legislation regulating the use of information systems in health care constantly expands. The legislative aspects of informatics in health and nursing care are numerous and quite complicated. Gialanella (2010) writes that, apart from the Health Insurance Portability and Accountability Act, nurses must be aware of the benefits and possible problems brought by HITECH legislation. The effects of HITECH on the quality of patient care are likely to be enormous, but only if nurses and health care facilities are ready to overcome barriers to effective implementation and meaningful use.
The federal Health Information Technology for Economic and Clinical Act was passed and enacted in 2009 to ensure effective conditions for the implementation of the American Recovery and Reinvestment Act (ARRA) (McGonigle & Mastrian, 2012). The HITECH Act was intended to motivate health care facilities to adopt information technologies more actively for the purpose of improving the quality of patient care and reducing its costs. Today, information technologies are believed to make a huge contribution to dealing with various health care problems. More importantly, health information technologies under the HITECH legislation have an enormous potential to improve the quality of care delivered to patients.
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McGonigle and Mastrian (2012) use the example of hospital-associated infections to illustrate how technologies impact medical and nursing care. Given that wound infections represent one of the most serious problems that patients in hospitals face, technologies could alleviate the burden of such risks, by ensuring that all patients receive their first dose of an antibiotic no later than within the first hour after the surgery (McGonigle & Mastrian, 2012). Beyond surgical operations, the HITECH legislation offers viable opportunities for implementing electronic health records and accessing/managing patient information more easily (McGonigle & Mastrian, 2012). For instance, it can become much easier for patients to obtain consultations from more than one specialist before they make the final decision about treatment. Eventually, the use of such technologies is the best way towards reducing the scope and incidence of medical errors (McGonigle & Mastrian, 2012). Yet, not everything is easy with the use of HITECH.
Classen and Bates (2011) state, “success in improving care with EHRs may be related to the types of EHRs that are used. […] All these organizations, however, struggles to maintain these systems, since doing so requires substantial development, and certification further raised the bar” (p. 856). The organization in question has experienced serious difficulties implementing its systems, mostly due to the costs involved and the problems associated with finding the most appropriate fit between the new system and the existing technologies, strategies, and solutions. Therefore, Classen and Bates (2012) write that future applications will, most likely, involve only vendor applications. The incentives provided as part of the meaningful use initiative within the HITECH legislation hold a promise to improve the quality of patient care, but their real benefits are yet to be defined (Classen & Bates, 2012). Moreover, as Estabrooks et al (2012) suggest, a significant gap between the current legislation and the development of EHR technologies continues to persist. The most problematic are behavioral and psychological interventions, where special technologies are required to meet the goals of quality care (Estabrooks et al, 2012).
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Actually, it is the article by Estabrooks et al (2012), which offers an insight into the nature of information technologies and their implications for nursing care. More specifically, the researchers discuss how meaningful use incentives could be supported by using key psychosocial factors to facilitate healthy behaviors (Estabrooks et al, 2012). The results of this analysis suggest that stakeholders are willing to include patient-reported elements in their EHR systems, but their effectiveness and feasibility should be tested in actual organizational environments (Estabrooks et al, 2012).