HITECH Act Essay and EHR

To prepare:

  • Review the Learning Resources on the HITECH legislation and its primary goals.
  • Reflect on the positive and negative impact this legislation has had on your organization or one with which you are familiar.
  • Consider the incentives to encourage the use of EHRs. Focus on the definition of meaningful use and how it is measured.
  • Reflect on how the incentives and meaningful use impact the quality of patient care. HITECH Act Essay and EHR.
  • Find an article in the Walden Library dealing with one of the criteria to qualify for meaningful use and how it has been successfully met.

 
By Day 3
Post a description of how HITECH legislation has positively or negatively impacted your organization. Address how its related incentives influence the adoption of health information technology in health care and impact the quality of patient care. Provide a summary of the article you identified and explain how it demonstrates the ability of health information technology to meet the requirements of meaningful use.
 
Response# 3
HITECH
The widespread use of electronic health records (EHRs) in the United States is inevitable. EHRs will improve caregivers’ decisions and patients’ outcomes. (Bates, & Gawande, 2003) Once patients experience the benefits of this technology, they will demand nothing less from their providers. Hundreds of thousands of physicians have already seen these benefits in their clinical practice. Also HITECH’s goal is not adoption alone but “meaningful use” of EHRs — that is, their use by providers to achieve significant improvements in care. The legislation ties payments specifically to the achievement of advances in health care processes and outcomes. HITECH Act Essay and EHR.
HITECH calls on the secretary of health and human services to develop specific “meaningful use” objectives. With the Centers for Medicare and Medicaid Services (CMS) in the lead, the Department of Health and Human Services (DHHS) has used an inclusive and open process to develop these criteria, providing an extensive opportunity for public and professional input
Meaningful Use of HITECH
Core objectives comprise basic functions that enable EHRs to support improved health care. As a start, these include the tasks essential to creating any medical record, including the entry of basic data: patients’ vital signs and demographics, active medications and allergies, up-to-date problem lists of current and active diagnoses, and smoking status. (Blumenthal, & Tavenner. 2010)
Core objectives include using several software applications that begin to realize the true potential of EHRs to improve the safety, quality, and efficiency of care. These features help clinicians to make better clinical decisions — and avoid preventable errors. To qualify for incentive payments, clinicians must start employing such clinical decision support tools. They must also start using the capability that undergirds much of the value of EHRs: using records to enter clinical orders and, in particular, medication prescriptions. Only when providers enter orders electronically can the computer help improve decisions by applying clinical logic to those choices in light of all the recorded patient data. And to begin extending the benefits of EHRs to patients themselves, the meaningful use requirements will include providing patients with electronic versions of their health information.
Conclusion
The meaningful use rule strikes a balance between acknowledging the urgency of adopting EHRs to improve our health care system and recognizing the challenges that adoption will pose to health care providers. The regulation must be both ambitious and achievable. Like an escalator, HITECH attempts to move the health system upward toward improved quality and effectiveness in health care. But the speed of ascent must be calibrated to reflect both the capacities of providers who face a multitude of real-world challenges and the maturity of the technology itself. HITECH Act Essay and EHR.
References
Bates, D. W. Gawande, A. A. (2003). Improving safety with information technology. The New England Journal of Medicine, 348(25), 2526–2534
Blumenthal, D.Tavenner, M. (2010). The “meaningful use” regulation for electronic health records. The New England Journal of Medicine, 363(6), 501–504.
Murphy, J. (2010). Nursing Informatics: The Journey of Meaningful Use of Electronic Health
Records. Nursing Informatic$. 28(4). 283-286.

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Response # 2
I enjoyed reading your post

         Privacy and Security of Electronic Health Information

The HITECH Act study technical and policy approaches to improving the security and privacy of electronic health information. Developing such solutions will probably require a multifaceted strategy that involves technical, educational, legal, and policy interventions by many public and private stakeholders. (HITECH Act of 2009) Most healthcare breaches of security in health information systems result from simple human error or carelessness, not from technical failings or outside hacking. The causes include providers sharing passwords or not using them at all, failing to encrypt health data in EHRs or other storage sites, and losing laptops or flash drives containing identifiable health information. Addressing these problems will require extensive education of providers and the enforcement of meaningful penalties for failing to observe basic security precautions. HITECH Act Essay and EHR.
Also, the health care system is composed of many different structures that it is imperative for health care organizations to ensure privacy and protection of patient information and medical records at all times. There are so many different programs and technology driven sources within the health care organization that is utilized to ensure patient safety and privacy, there has to be standard levels of accessing patient information without jeopardizing their information. In the event that there is a security breech occurs, then the health care facility will be held liable and that would cause the organization to lose a lot of credibility and credentials. All organizations have a process that is used to guarantee that a patient information remain safe and secure.
As with any online digital format, concerns of breach exist. Internet hackers possess a digital power that frightens individuals looking to conceal sensitive data. There have been cases in which medical information has been accessed by unauthorized users. While this does not occur all too frequently, the occurrences are enough to plant some cynicism in the minds of physicians and patients. These are valid concerns. If private records end up in the possession of an individual not aware of the information, the penalties can be devastating. Theft of medical records can result into identity theft, which can abolish a person’s assets, credit and status. Victims could pursue lawsuit against the healthcare organization. If the incident affected numerous patients, the facility could foresee a long road of lawful misfortunes. This is why reliable records administration companies works hard to offer quality safety within their software in order to try to remove the risk of any possible security issues. There are ways to reduce the likelihood of exposing safety risks, which can include thorough background checks on employees, extensive training, and making sure that the policies and procedures remain updated at all times (Electronic Health Records Security and Privacy Concerns. 2016). The most successful methods is assigning PIN numbers and access codes to all staff, and make sure that these individuals have to log into all systems at all times. This process can monitor all authorized users and where they were and what systems they are using at all times.

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.                                  Security and Privacy of HITECH
In addition ,during the transition phase, the EHR vendor must work closely with the healthcare provider for a smooth and secure transition. The company should provide some type of comprehensive user guide for the users in the provider’s practice.
Enhance Administrative Controls-Through Updating policies and procedures, Guide employees through the stringent privacy and security training process, Run background checks on all employees HITECH Act Essay and EHR.
Monitor Physical and System Access-Create physically inaccessible systems to unauthorized individuals, Have exigencies in place for data recovery or restoration, Provide identification and verification requirements to all system users, Access the list of authorized users, Supply passwords and personal identification numbers (PINs),Provide automatic software shutdown routines, Leave data backup and recovery to the professionals, Businesses should leave data backup and recovery to the professionals
Identify Workstation Usage -Set privacy filters at each workstation, Distinguish the different capabilities of different workstations
Audit and Monitor System Users-Identify any weakness in the system, detect any security breach or attempt at a breach, regularly audit all authorized users, Issue specified punishments to employees not following compliance guidelines
Employ Device and Media Controls-Construct a security plan for data disposal, remove data from reusable hardware, Track all reprocessed hardware, Back up all data from all hardware
Apply Data Encryption-Disguise all data inside medical files through cryptography
Summary
Reliable electronic health records companies apply these enhanced security and privacy protocols. Perhaps the most important security protocol is data encryption, which causes data to become unreadable to outside sources.

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References
Greene AH. HHS steps up HIPAA audits. J AHIMA. 2011; 82:58–9.
HITECH Act of 2009, 42 USC sec 139w-4(0)(2) (February 2009), part 2, subtitle C, sec 13301, subtitle B, sec 3014: Competitive grants to States and Indian tribes for the development of loan programs to facilitate the widespread adoption of certified EHR technology.
Electronic Health Records Security and Privacy Concerns. (2016). Retrieved from http://www.ironmountain.com/Knowledge-Center/Reference-Library/View-by-Document-Type/General-Articles/E/Electronic-Health-Records-Security-and-Privacy-Concerns.aspx
 
Great post ,to add to your points here  are some great  points
 
                                    Advantages and Disadvantages of HITECH 
There are several advantages and disadvantages associated with an HITECH adoption.
Advantages of EHRs include clinical outcomes improved quality, reduced medical errors, increase organizational outcomes financial and operational benefits, and societal outcomes improved ability to conduct research, improved population health, reduced costs. Despite these benefits, studies in the literature highlight drawbacks associated with EHRs, which include the high upfront acquisition costs, ongoing maintenance costs, and disruptions to workflows that contribute to temporary losses in productivity that are the result of learning a new system
Potential drawback of EHRs is the risk of patient privacy violations, which is an increasing concern for patients due to the increasing amount of health information exchanged electronically (Zurita & Nohr, 2004) to relieve some of these concerns, policymakers have taken measures to ensure safety and privacy of patient data. For example, recent legislation has imposed regulations specifically relating to the electronic exchange of health information that strengthen existing Health Insurance Portability and Accountability Act privacy and security policies. (Westin, 2005) Although few electronic data are 100% secure, the rigorous requirements set forth by the new legislation make it much more difficult for electronic data to be accessed inappropriately. Many hospitals and physicians are implementing strict, no tolerance penalties for employees who access files inappropriately. Although privacy will likely continue to be a concern for patients, many steps are being taken by policymakers and individual organizations to ensure that EHRs comply with the strict laws and regulations intended to ensure the privacy of clinical information HITECH Act Essay and EHR.
.                                                     Conclusion
However, nationwide implementation of HITECH is necessary, although not sufficient, part in transforming the US health care system for the better. EHR adoption must be considered one of many approaches that diversify our focus on quality improvement and cost reduction.In the long run, providers and researchers will be eager to quantify the returns that are expected from these investments into HITECH implementation.
                                                            References
Zurita L, Nohr C. (2004) Patient opinion: EHR assessment from the user’s perspective. Student Health Technology Information. 107(2):1333–1336
Westin A. F (2005). Public attitudes toward electronic health records. Privacy and American Business. ; 12(2):1–6.
Parver C. (2009) How the American Recovery and Reinvestment Act of 2009 Changed HIPAA’s privacy requirements. CCH Health Care Compliance Letter.4–7. HITECH Act Essay and EHR.

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Thanks for reading my Post ,
                                                     HITECH    Implementation
HITECH  functionalities, including  support clinical decision support systems, computerized order entry systems,  health information exchange., improved quality of care, reduced medical errors,  promotes organizational outcomes (e.g., financial and operational benefits), and societal outcomes (e.g., improved ability to conduct research, improved population health, reduced costs). Despite these benefits, studies in the literature highlight drawbacks associated with EHRs, which include the high upfront acquisition costs, ongoing maintenance costs, and disruptions to workflows that contribute to temporary losses in productivity that are the result of learning a new system.(IOM, 2010) Moreover, EHRs are associated with potential perceived privacy concerns among patient
There are several advantages and disadvantages associated with an HITECH adoption. Many of the benefits accrue to patients and society overall. For these benefits to be realized, the US Government has embarked on an ambitious journey to transition a maximum number of providers toward HITECH adoption and “meaningful use”. (Blumenthal $ Tavenner 2010) Without ubiquitous use of EHR technologies, experts believe that many efficiencies in the US health care system cannot be realized. The financial incentives built into the HITECH Act are designed to defray some of the costs associated with EHR adoption, especially for smaller organizations where these expenses serve as a major barrier. (Menachemi, et al 2007.)The financial incentives in HITECH, which are made available through the Medicare and Medicaid programs, are also an attempt to correct some of the misalignment of incentives associated with HITECH, especially because the US Government, through the Medicare and Medicaid programs, is the largest insurer in the country that is further addressed legislatively in the HITECH Act. HITECH Act Essay and EHR.
                                                             Conclusion
Most of the times, the authors evaluate the cost, money and outcomes of using HITECH. However, nationwide implementation of HITECH is a necessary, although not sufficient, part in transforming the US health care system for the better. EHR adoption must be considered one of many approaches that diversify our focus on quality improvement and cost reduction. The current major legislative and political support for EHRs represents the greatest investment in health information technologies in US history. In the long run, providers and researchers will be eager to quantify the returns that are expected from these investments into HITECH implementation.

          References

IOM (2010). Crossing the quality chasm: a new health system for the 21st century. Washington, DC: Institute of Medicine
Dexter P.R, Perkins S, Overhage JM, et al. (2001) A computerized reminder system to increase the use of preventive care for hospitalized patients. New England Journal Medicine. ; 345(13):965–970.
Blumenthal D, Tavenner M. (2010) The “meaningful use” regulation for electronic health records. New England Journal Medicine. 2010; 363(6):501–504.
Menachemi N, Ford EW, Beitsch LM, Brooks RG. (2007)Incomplete EHR adoption: late uptake of patient safety and cost control functions. American Journal of Medicine Quality. 2007; 22(5):319–326 HITECH Act Essay and EHR.
 

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INITIAL DISCUSSION
HITECH Legislation
The Health Information Technology for Economic and Clinical Health (HITECH) Act was enacted by President George Bush announced in 2004 during a State of the Union Address that all health care professionals need to participate in the health information technology (HIT). (Murphy, 2010). The passing of this Act and subsequent definition of meaningful use encourages physicians and hospitals to use EHR to gain incentives from the government. Those incentives are paid out yearly as long as the hospital or physician follows guidelines exactly passing of the Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009 was implemented to promote the adoption and meaningful use of health information technology (US Department of Health and Human Services, 2017. Since part of the HITECH Act focuses on healthcare financial strategies, just like MEDICARE and MEDICAID, it expects providers to show meaningful use of EHRs in order to get paid (Arlotto, 2010. p. 90).
For this requirement to be easy for healthcare professionals to adopt, the HITECH provided $19.2 billion for healthcare providers who took Medicaid and Medicare patients and also funded Medicare with $44,000 to give each provider over 5 years for implementing “meaningfully use” certified EHRs (Shin and Sharac, 2013 The purpose of this discussion post is to describe how HITECH legislation has positively impacted my organization .It will also address how the incentives of HITECH influence the adoption of health information technology (HIT) in health care and impact the quality of patient care. Finally, an article that explains how the ability of health information technology meets the requirements of meaningful use, will be summarized HITECH Act Essay and EHR.
Influence Healthcare Incentives on HITECH Adoption
The introduction of a HIT as a tool in the workplace has been challenging for most, and some have been skeptical about its usage have seen the benefits of using HIT to improve the quality of care and reduce medication errors in my practice. The future of using HIT will continue to reduce these errors and improve the quality of care that is provided to patients in the healthcare setting. The opportunity was to create a system that will arouse the economy while healthcare delivery is being improved (McGonigle and Mastrian. 2015). Meaningful use requires both hospitals and providers to have certain percentages of the following, computerized medication, laboratory and radiology orders, computerized vital sign entries, patients who have online access to their health information and actually access it, smoking status and demographic data recorded (CMS Releases Stage 2 Meaningful Use Requirements. 2012. p. 11). “The intent of meaningful use was to provide incentives to providers not only to adopt EHRs but also to use them in ways that would improve quality, safety, and efficiency” (Classen and Bates, 2011, p. 855). In my institutions, they implemented EPIC to fulfill one of the meaningful use criteria of “improving quality, safety, efficiency, and reduce health disparities” (Health IT, 2017). The physicians were able to access medical information from EPIC-using hospitals to make better clinical decisions and efficiently treat each patient.
HITECH Healthcare Impact on Patient Care
One of the purposes of HITECH focuses on how chronic diseases can be prevented, detected early and managed which in turn promotes the improvement of human health (McGonigle and Mastrian. 2015). On the medical-surgical floor, where I work pre-op doses of antibiotic is ordered for each patient who is going to surgery. Another dose starts running in the operating room before the surgery starts and documented on the anesthesiologist’s sheet. The third dose is given after surgery, within 24 hours. All this is done to prevent post-op infection which is common with complications of surgery and some end up with amputation. The benefit of qualifying for financial incentives such as Medicare and Medicaid payments for six years is positive when healthcare providers reach certain achievements and can prove the use of an EHR. To be certified to receive this incentive health care provider must show compliance with having greater than 50% of their patient records are involved and part of the EHR (Brown, 2010). The problem of EHR is the ease of access, which is still an issue with slow systems, but the benefits of medication safety and much more are obvious. The benefits of using the HITECH require healthcare providers and organizations to stay up-to-date on the technology and system improvements to optimize the advantages and outcomes to patients and the healthcare corporation. (Classen & Bates, 2011).

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Research Article and Meaningful Use of HITECH
The article titled Readiness for Meaningful Use of Health Information Technology and Patient-Centered Medical Home Recognition was a survey conducted by Shin and Sharac, (2013) from the University Of George Washington University in conjunction with the National Association of Community Health Centers. The survey was done to check the readiness of community health centers based on factors that impact the use of HIT and meaning use (Shin and Sharac, 2013). The survey showed there was a progression towards fully implementing electronic health records. After three years of using EHRs, 98% patient demographics were recorded, they maintained 97% of their medication list and recorded 98% of their vital signs. (Shin and Sharac, 2013). They met other meaningful-use requirements with high percentages.This shows that the Clinicians included in this study were using the EHR meaningfully and had results to prove it. In order to obtain reimbursement from the government, physicians need to provide attestation statements in accordance with the Centers for Medicare and Medicaid Services (Brown, 2010) HITECH Act Essay and EHR
                                                       Summary       
In my present the organization, I have seen the benefits of meaningful use of HITECH. Among which is the use of electronic transfer of vital signs to our patient’s EHR, our physician electronically enter medications into MAR, lab and radiology orders, we have individuals who come to patients to assist them in registering in order for them to access their health records online. HIT provides safe, fast and easy, care to patients if used appropriately The HITECH act provided an incentive program to cover some of the costs of implementing HIT. Incentives for being certified to receive Medicare and Medicaid reimbursement also encourage compliance with using an EHR for greater than 50% of patient records. Maintenance and information system updates are essential for the HIT to be beneficial to healthcare providers, and used to improve patient outcomes. Having a system to prevent medication errors, reduce costs, improve health care safety and patient outcomes will be the greatest benefit of all.
References
Brown, B. (2010). The final rules for meaningful use of EHRs. Journal of Health Care Compliance, 12(5), 49-50, 79-80.
Classen, D.C. & Bates, D.W. (2011). Finding the meaning in meaningful use. New England Journal of Medicine, 36(9), 855-858.
Murphy, J. (2010). Nursing Informatics. The journey to the meaningful use of electronic health records. Nursing Economics$, 28(4), 283-286.
Arlotto, P. (2010). 7 strategies for improving HITECH readiness. Hfm (Healthcare Financial Management), 64(11), 90-96.
CMS Releases Stage 2 Meaningful Use Requirements. (2012). hfm (Healthcare Financial Management), 66(4), 11.
McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge (3rd ed.). Burlington, MA: Jones and Bartlett Learn
Shin, P., & Sharac, J. (2013). Readiness for Meaningful Use of Health Information Technology and Patient-Centered Medical Home Recognition Survey Results.Medicare & Medicaid Research Review, 3(4), E1-E9. doi:10.56 HITECH Act Essay and EHR

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INITIAL DISCUSSION
HITECH Legislation
The Health Information Technology for Economic and Clinical Health (HITECH) Act was enacted by President George Bush announced in 2004 during a State of the Union Address that all health care professionals need to participate in the health information technology (HIT). (Murphy, 2010). The passing of this Act and subsequent definition of meaningful use encourages physicians and hospitals to use EHR to gain incentives from the government. Those incentives are paid out yearly as long as the hospital or physician follows guidelines exactly passing of the Health Information Technology for Economic and Clinical Health Act (HITECH) of 2009 was implemented to promote the adoption and meaningful use of health information technology (US Department of Health and Human Services, 2017. Since part of the HITECH Act focuses on healthcare financial strategies, just like MEDICARE and MEDICAID, it expects providers to show meaningful use of EHRs in order to get paid (Arlotto, 2010. p. 90). For this requirement to be easy for healthcare professionals to adopt, the HITECH provided $19.2 billion for healthcare providers who took Medicaid and Medicare patients and also funded Medicare with $44,000 to give each provider over 5 years for implementing “meaningfully use” certified EHRs (Shin and Sharac, 2013 The purpose of this discussion post is to describe how HITECH legislation has positively impacted my organization .It will also address how the incentives of HITECH influence the adoption of health information technology (HIT) in health care and impact the quality of patient care. Finally, an article that explains how the ability of health information technology meets the requirements of meaningful use, will be summarized
Influence Healthcare Incentives on HITECH Adoption
The introduction of a HIT as a tool in the workplace has been challenging for most, and some have been skeptical about its usage have seen the benefits of using HIT to improve the quality of care and reduce medication errors in my practice. The future of using HIT will continue to reduce these errors and improve the quality of care that is provided to patients in the healthcare setting. The opportunity was to create a system that will arouse the economy while healthcare delivery is being improved (McGonigle and Mastrian. 2015). Meaningful use requires both hospitals and providers to have certain percentages of the following, computerized medication, laboratory and radiology orders, computerized vital sign entries, patients who have online access to their health information and actually access it, smoking status and demographic data recorded (CMS Releases Stage 2 Meaningful Use Requirements. 2012. p. 11). HITECH Act Essay and EHR. “The intent of meaningful use was to provide incentives to providers not only to adopt EHRs but also to use them in ways that would improve quality, safety, and efficiency” (Classen and Bates, 2011, p. 855). In my institutions, they implemented EPIC to fulfill one of the meaningful use criteria of “improving quality, safety, efficiency, and reduce health disparities” (Health IT, 2017). The physicians were able to access medical information from EPIC-using hospitals to make better clinical decisions and efficiently treat each patient.
HITECH Healthcare Impact on Patient Care
One of the purposes of HITECH focuses on how chronic diseases can be prevented, detected early and managed which in turn promotes the improvement of human health (McGonigle and Mastrian. 2015). On the medical-surgical floor, where I work pre-op doses of antibiotic is ordered for each patient who is going to surgery. Another dose starts running in the operating room before the surgery starts and documented on the anesthesiologist’s sheet. The third dose is given after surgery, within 24 hours. All this is done to prevent post-op infection which is common with complications of surgery and some end up with amputation. The benefit of qualifying for financial incentives such as Medicare and Medicaid payments for six years is positive when healthcare providers reach certain achievements and can prove the use of an EHR. To be certified to receive this incentive health care provider must show compliance with having greater than 50% of their patient records are involved and part of the EHR (Brown, 2010). The problem of EHR is the ease of access, which is still an issue with slow systems, but the benefits of medication safety and much more are obvious. The benefits of using the HITECH require healthcare providers and organizations to stay up-to-date on the technology and system improvements to optimize the advantages and outcomes to patients and the healthcare corporation. (Classen & Bates, 2011).

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Research Article and Meaningful Use of HITECH
The article titled Readiness for Meaningful Use of Health Information Technology and Patient-Centered Medical Home Recognition was a survey conducted by Shin and Sharac, (2013) from the University Of George Washington University in conjunction with the National Association of Community Health Centers. The survey was done to check the readiness of community health centers based on factors that impact the use of HIT and meaning use (Shin and Sharac, 2013). The survey showed there was a progression towards fully implementing electronic health records HITECH Act Essay and EHR. After three years of using EHRs, 98% patient demographics were recorded, they maintained 97% of their medication list and recorded 98% of their vital signs. (Shin and Sharac, 2013). They met other meaningful-use requirements with high percentages.This shows that the Clinicians included in this study were using the EHR meaningfully and had results to prove it. In order to obtain reimbursement from the government, physicians need to provide attestation statements in accordance with the Centers for Medicare and Medicaid Services (Brown, 2010)
                                                       Summary       
In my present the organization, I have seen the benefits of meaningful use of HITECH. Among which is the use of electronic transfer of vital signs to our patient’s EHR, our physician electronically enter medications into MAR, lab and radiology orders, we have individuals who come to patients to assist them in registering in order for them to access their health records online. HIT provides safe, fast and easy, care to patients if used appropriately The HITECH act provided an incentive program to cover some of the costs of implementing HIT. Incentives for being certified to receive Medicare and Medicaid reimbursement also encourage compliance with using an EHR for greater than 50% of patient records. Maintenance and information system updates are essential for the HIT to be beneficial to healthcare providers, and used to improve patient outcomes. Having a system to prevent medication errors, reduce costs, improve health care safety and patient outcomes will be the greatest benefit of all.
References
Brown, B. (2010). The final rules for meaningful use of EHRs. Journal of Health Care Compliance, 12(5), 49-50, 79-80.
Classen, D.C. & Bates, D.W. (2011). Finding the meaning in meaningful use. New England Journal of Medicine, 36(9), 855-858.
Murphy, J. (2010). Nursing Informatics. The journey to the meaningful use of electronic health records. Nursing Economics$, 28(4), 283-286.
Arlotto, P. (2010). 7 strategies for improving HITECH readiness. Hfm (Healthcare Financial Management), 64(11), 90-96.
CMS Releases Stage 2 Meaningful Use Requirements. (2012). hfm (Healthcare Financial Management), 66(4), 11.
McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge (3rd ed.). Burlington, MA: Jones and Bartlett Learn
Shin, P., & Sharac, J. (2013). Readiness for Meaningful Use of Health Information Technology and Patient-Centered Medical Home Recognition Survey Results.Medicare & Medicaid Research Review, 3(4), E1-E9. doi:10.56 HITECH Act Essay and EHR.
 

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