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How the American Recovery & Reinvestment Act of 2009 Will Affect EMS

EMS is an important component of healthcare and the practice of medicine. As such, it’s important for EMS to track and understand requirements in other areas of healthcare that will eventually work their way into our EMS operations and clinical care.

In this brief overview, let’s look at some of the requirements associated with the federal healthcare reform process under the American Recovery and Reinvestment Act of 2009 (ARRA), specifically the implementation of the “meaningful use” requirements associated with electronic health records (EHRs). These requirements are now being rolled out within hospitals and physicians’ offices with 2012 and 2013 implementation deadlines.

Currently, there’s no federal timeline for EMS to implement the meaningful use requirements. But at some point in the future, all healthcare providers will be required to be “meaningful users” of electronic health records. In many ways, EMS has led the healthcare industry in the development of a standards-based electronic health record system. These meaningful use requirements will result in some changes to our EMS EHR systems, but these changes should be minimal for those EMS agencies using EHR software that’s compliant with the National EMS Information System (NEMSIS) Version 3.

Let’s take a closer look at what “meaningful use” is and learn how we can all become “meaningful users” of electronic health records.

Criteria & Components
Meaningful use requirements call for the implementation and use of electronic health records to demonstrate quality of care, improve the process of care and anticipate health information exchange. The overall goals of meaningful use are to:
>> Improve quality, safety and efficiency of patient care;
>> Engage patients and families to participate in their healthcare process;
>> Improve care coordination;
>> Ensure privacy and security of personal health information; and
>> Improve public and population-based health.

Without going into extreme detail, let’s explore how EHR systems can be used to meet these goals.

Trust: Security is an important component to any health records system; however, a meaningful user of health information must earn and have the trust of its patients and customers. Meaningful users of health information must have information technology measures in place to ensure health information is safe and secure. They must also ensure the information is available to healthcare providers as they provide and coordinate clinical care. The meaningful use criteria were created to assure patients that their health information is secure yet available for use by their healthcare providers.

EHRs: A goal of ARRA is for every person’s current health record to be converted into an electronic health record by 2014. This was a mandate by both the Bush and Obama administrations and is the foundation for health information exchange as well as healthcare reform.

Health information exchange: To successfully complete the meaningful use requirements, hospitals and clinics must implement an EHR system and participate in health information exchange. Health information exchange is formally defined in ARRA as the movement of patient healthcare data (or documents) across healthcare organizations regardless of the software or information system used by the organization. Simply put, this is a requirement for hospitals and healthcare providers to be able to exchange patient-level health information with each other in a timely fashion based on the current healthcare needs of the patient.

Information security and information disclosure: The security requirements in the Health Insurance Portability and Accountability Act (HIPAA) of 1996 requires all personal health information to be protected and secured. This includes securely authenticating access to the information, encrypting the information during the exchange process, securely storing the information and releasing the information based on an appropriate need. Meaningful use strengthens HIPAA with specific requirements to track, monitor and disclose how health information has been used and disclosed.

Read the full article in JEMS online.

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