HCA 3302, Critical Issues in Health Care 1

Course Learning Outcomes for Unit V

Upon completion of this unit, students should be able to:

5. Explain the impact of technology on the health care industry.
5.1 Identify a specific health technology, the financial implications, and the ethical concerns of its

meaningful use.

Course/Unit
Learning Outcomes

Learning Activity

5.1

Unit Lesson
Chapter 7
Chapter 8
Unit V PowerPoint Presentation

Required Unit Resources

Chapter 7: Ethics in the Management of Health Information Systems

Chapter 8: Technological Advances in Health Care: Blessing or Ethics Nightmare?

Unit Lesson

In this unit, we will learn about health care technology. Specifically, we will discuss the ethics and laws
surrounding the management and use of health information systems and the adoption of emerging
technologies. Health information technology is intended to enhance patient care and increase the equity,
effectiveness, and efficiency of health care delivery (Morrison & Furlong, 2014). Health care organizations are
struggling to understand if the adoption of such health care technology is beneficial. Will health care
technologies improve quality, or will they result in harm?

Health Information Technology and Management

Health information technology and health information management are a large part of effective and efficient
management of health information systems, and they are essential to the accurate treatment of patients
(Morrison & Furlong, 2019). The ethical principles of fairness and justice are the main ethical concerns
regarding health information technology (Morrison & Furlong, 2014). There are serious ethical concerns that
make health care organization leadership skeptical about the benefits of health information technology
because it is a prominent tool in health care that supports multi-professional and multi-organizational
programs. Health care organizations face many challenges that include interoperability of health information
technology and communication between health care providers in addition to ethical issues that occur.
Complying with regulations, providing confidentiality while also supporting data sharing for coding and
research are a couple of examples of ethical challenges. Advances in health information technology are on
the rise, and in parallel, there are also social and ethical concerns:

• patient privacy abuses,
• inappropriate use of patient data,
• unauthorized patient consent, and
• computer peripherals assistance during procedures (Morrison & Furlong, 2014).

UNIT V STUDY GUIDE
Health Care Technology

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Health care reform has increased the need for health information technology; however, health information
technology comes at a large monetary cost. In order for health care organizations to meet quality standards
and to provide effective quality of care, the adoption of health information technology is imperative. Due to the
high expense of health information technology, health care organizations need to truly understand the
benefits of adopting these new technologies. Some health information technology benefits include increased
productivity, lowed administrative costs, and improved health outcomes.

The American Recovery and Reinvestment Act and the Health Information Technology for Economic

and Clinical Health Act

The American Recovery and Reinvestment Act (ARRA) was signed into law in February 2009 (Office of
Inspector General, n.d.). The primary objective of ARRA was to save and create jobs, but it also aimed to
provide relief and invest in infrastructure, renewable energy, health, and education (Federal Communications
Commission, 2011).

The Health Information Technology for Economic and Clinical Health Act (HITECH), which is a piece of
ARRA, supported the use of electronic health records (EHR) and meaningful use, focused on increasing the
use of a certified EHR by hospitals and providers, as well as addressed privacy and security concerns
regarding electronic health data (Office for Civil Rights [OCR], 2009a). The HITECH Act also provided funding
for the EHR incentive program, known as meaningful use. The Centers for Medicare & Medicaid Services
(CMS) and the Office of the National Coordinator for Health Information Technology manage meaningful use,
which is a set of standards that guides the use of EHRs and allows eligible health care providers and
hospitals to earn incentives if certain measures are met (Reider & Tagalicod, 2013).

Meaningful Use

Meaningful use is built on the five pillars of health outcomes policy priorities:

• increase quality, safety, efficiency, and reduce health disparities;
• engage patients and families in their health care;
• improve care coordination;
• improve population and public health; and
• safeguard privacy and security protection for personal health information (Reider & Tagalicod, 2013).

Participation in meaningful use is completely voluntary, but CMS gives an incentive payment to any eligible
provider or hospital that can demonstrate that they have engaged in adopting, implementing, or upgrading a
certified EHR. To encourage adoption of an EHR, promote innovation, and avoid the excess burden on health
care organizations, meaningful use was rolled out in three stages.

Stage 1 of meaningful use was announced in 2010 and promotes basic EHR adoption and the gathering and
sharing of health data (OCR, 2009b). Health care organizations focused on storing health information
electronically in a standardized format that is easily accessible and authorized by providers and patients. In
2014, Stage 2 of meaningful use began, and it focused on care coordination and the exchange of patient
data. Stage 3 of meaningful use began in 2015 and focused on the advance use of EHRs, health information
exchanges, and improvement to health outcomes (Agency for Healthcare Research and Quality, 2013). As
meaningful use unfolded, Stages 2 and 3 were modified.

If an eligible provider or hospital met the meaningful use criteria, it received incentive payments ranging from
$44,000 over 5 years for the Medicare providers to $63,750 over 6 years for Medicaid providers (Agency for
Health Care Research and Quality, 2013). Meaningful use has served a valuable purpose by ensuring that
money allocated from ARRA was used meaningfully and for creating a nationwide EHR infrastructure. In
2016, more than 95% of eligible hospitals accomplished meaningful use (Office of the National Coordinator
for Health Information Technology, 2016).

Prior to the passing of the HITECH Act and the start of meaningful use, adoption rates for certified EHRs were
low and slow to rise. This is believed to be because of the cost of implementation and the lack of knowledge
concerning the return on investment. According to the Journal of Health Affairs, after the HITECH Act was
passed, the EHR adoption rate increased from 3.2% to 14.2% (Alder-Milstein & Jha, 2017). However, despite

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federal government mandates, some health care organizations have opted out of the Medicare electronic
health record incentive program and have chosen reimbursement reductions instead.

The U.S. government aims to mandate health care organizations to adopt health information technologies,
like EHRs. This is in hopes to improve health care quality, doctor-patient communication, access to health
data, and the availability of provider performance data that will reduce health disparities and increase care
coordination.

Health Insurance Portability and Accountability Act

As referenced earlier, a very important act is the Health Insurance Portability and Accountability Act, also
known as HIPAA; it supports medical history and personal medical information by protecting it from any entity
not allowed to access the information. Passed by the U.S. Congress in 1996 and enforced by the Office for
Civil Rights, HIPAA aimed to ensure that workers in the United States who had previous health insurance
coverage from an employer would not have to requalify their preexisting chronic conditions when changing
employment or between jobs (OCR, 2008). This means that there is no waiting period for insurance coverage
to begin for chronic conditions. For example, when an employee with cancer changed to a new job, he or she
would not have to wait to receive care or medication, but rather, the insurance coverage would be
immediately available. HIPAA has two main rules: the Security Rule and the Privacy Rule.

First, the HIPAA Security Rule states the minimum requirements to protect electronic personal health
information. It established national standards to protect patients’ electronic health information that was
created, received, used, or maintained by a covered entity (OCR, 2009b). The Security Rule aims to secure
and protect personal health information from destruction or unlawful disclosure or intent and also outlines the
technical, physical, and administrative safeguards that a covered entity under HIPAA must implement. The
physical safeguards protect a health care organization’s structures from natural or environmental hazards
(OCR, 2009b). Safeguards protect software, hardware, and backup data that contain electronic personal
health information. Technical safeguards include protecting access to sensitive and personal health
information by having unique user identification, auto log-off, encryption, security, etc. The administrative
safeguards manage the security of electronic personal health information and the conduct of the health care
organization’s staff. The administrative safeguards require a risk analysis and an overseer of a security
program (OCR, 2009b).

The second HIPAA rule is the Standards for Privacy of Individually Identifiable Health Information, also known
as the Privacy Rule. It established a set of national standards aiming to protect personal health information
(OCR, 2008). The HIPAA Privacy Rule aims to ensure privacy of patient information in both paper and
electronic formats. It further discusses that personal health information can only be released when allowed by
the law or an authorized individual.

Conclusion

The federal government plays a large role in the use, adoption, and regulation of health information
technologies. Specifically, the government plays an active role in the security and privacy of patient medical
information through acts like HIPAA and HITECH. The security of a health care organization’s data and
information technology systems is necessary to protect the privacy of patients. Security of a health care
organization’s data and health information technology systems is necessary to protect patient privacy and
their most sensitive data. Health information technology is working prove it is beneficial to patient care and
improves quality and efficiency of services delivered to patients.

References

Adler-Milstein, J., & Jha, A. K. (2017). HITECH Act drove large gains in hospital electronic health record

adoption. Health Affairs, 36(8). https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2016.1651

Agency for Healthcare Research and Quality. (2013). Practice facilitation handbook: Module 17. Electronic

health records and meaningful use. https://www.ahrq.gov/professionals/prevention-chronic-
care/improve/system/pfhandbook/mod17.html

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Federal Communications Commission. (2011). American Recovery and Reinvestment Act of 2009.
https://www.fcc.gov/general/american-recovery-and-reinvestment-act-2009

Morrison, E. E., & Furlong, B. (Eds.). (2014). Health care ethics: Critical issues for the 21st century (3rd ed.).

Jones & Bartlett Learning.

Morrison, E. E., & Furlong, B. (Eds.). (2019). Health care ethics: Critical issues for the 21st century (4th ed.).

Jones & Bartlett Learning.

Office for Civil Rights. (2008). Summary of the HIPAA privacy rule. U.S. Department of Health & Human

Services. https://www.hhs.gov/hipaa/for-professionals/privacy/laws-regulations/index.html

Office for Civil Rights. (2009a). HITECH act enforcement interim final rule. U.S. Department of Health &

Human Services. https://www.hhs.gov/hipaa/for-professionals/special-topics/hitech-act-enforcement-
interim-final-

Office for Civil Rights. (2009b). The security rule. U.S. Department of Health & Human Services.

https://www.hhs.gov/hipaa/for-professionals/security/index.htmlrule/index.html

Office of Inspector General. (n.d.). The American Recovery and Reinvestment Act of 2009.

https://www.hudoig.gov/arra

Office of the National Coordinator for Health Information Technology. (2016). Hospital progress to meaningful

use. https://dashboard.healthit.gov/quickstats/pages/FIG-Hospital-Progress-to-Meaningful-Use-by-
size-practice-setting-area-type.php

Reider, J., & Tagalicod, R. (2013). Progress on adoption of electronic health records.
https://www.healthit.gov/buzz-blog/electronic-health-and-medical-records/progress-adoption-
electronic-health-records