25_Policy, Practice, and Regulatory Issues 2016

Terms in this set (73)

In 1999, the IOM released a report titled "To Err Is Human," which stated that medical errors claim as many as 98,000 lives a year. The 2004 IOM report titled "Patient Safety: Achieving a New Standard for Care" revealed the high incidence of adverse events occurring in hospitals.

It Encourages health care providers and organizations to voluntarily report and share patient safety information without fear of legal action
ii. Authorized the creation of patient safety organizations (PSOs)
(a) PSOs can be private or public entities, pro t or not-for-pro t entities, provider entities such as a health system, or other entities.
(b) PSOs provide a secure mechanism for the collection, aggregation, and analysis of data to identify and reduce risks and hazards that may occur with patient care delivery.
(c) The ACA charges PSOs to assist health systems with a high rate of risk-adjusted readmission rates to decrease readmission rates and improve transitions of care.
iii. The Agency for Healthcare Research and Quality (AHRQ) created the Patient Safety Organization Privacy Protection Center to support the implementation of the Patient Safety Act. The Privacy Protection Center provides technical assistance to PSOs to ensure that data on patient safety events submitted to the Network of Patient Safety Databases are non-identi able.
iv. Data are submitted to PSOs through Common Formats, developed by AHRQ for acute care hos- pitals and skilled nursing facilities. Common Formats provide a systematic process for reporting adverse events, near misses, and unsafe conditions, and they allow a hospital to report harm from all causes.
(a) In March 2013, CMS communicated that although the use of Common Formats is not required for CoP for Quality Assessment and Performance Improvement surveys, hospi- tals that use them will be in a better position to meet Quality Assessment and Performance Improvement requirements.
(b) CMS surveyors were also encouraged to become familiar with Common Formats.
HITECH Act authorizes the U.S. DHHS to create programs to improve health care quality, safety, and ef ciency through the promotion of health information technology, including electronic health records (EHRs) and health information exchanges (HIEs). The goal of HITECH is to facilitate and expand the secure, electronic movement and use of health information among organizations according to nationally recognized standards.


i. Created the Office of the National Coordinator for Health Information Technology (ONC) to coordinate nationwide standards and implementation efforts
ii. The Standards and Certi cation Criteria Final Rule is the initial approach to adopting standards, implementing speci cations, and providing certi cation criteria to increase the interoperability, func- tionality, utility, and security of health information technology and to support its meaningful use.
iii. The Electronic Health Records Incentive Programs was issued by CMS to provide a nancial incentive to eligible professionals, eligible hospitals and critical access hospitals, and Medicare Advantage Organizations that are "meaningful users" of EHRs. ARRA 2009 speci ed three main components for "meaningful use":
(a) Use of certified EHRs in a meaningful manner (e.g., e-Prescribing)
(b) Use of certi ed EHR technology for electronic exchange of health information to improve
the quality of health care
(c) Use of certi ed EHR technology to submit clinical quality and other measures
iv. Incentive payments began in scal year 2011 and will gradually decrease until scal year 2015, when penalties are to be put into effect.
v. HITECH also affects research because it imposes new penalties for breaches in HIPAA and PHI; the Of ce for Civil Rights within DHHS will audit for compliance.
vi. An HIE is de ned as a process for exchanging health information, and an HIO (health infor- mation organization) is a model for exchanging information at local, regional (known as
RHIO [regional health information organization]), or state levels. ONC's goal for HIE is for patient information to be accessible across organizational, vendor, and geographic boundaries. Regulations related to HIE are aimed at increasing interoperability, increasing consumer and provider trust to mobilize information, and decreasing the cost and complexity of the exchange.
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