The Health Care Delivery System and Nursing Practice
In recent years, the U.S. government has been actively involved in restructuring and reforming its healthcare sector amid rising healthcare costs and worsening healthcare outcomes, such as increasing incidences of chronic diseases, rising incidences of homicides, bulging cases of patient safety, as well as reduced quality of care. In fact, it is estimated that the cost of care in the U.S. has snowballed significantly compared to other OECD-developed countries. For instance, in 2018, The Commonwealth Fund estimated that the United States spent a record-high 16.9 percent of its GDP on health care, nearly twice as high as the standard OECD nation (Tikakanen & Abrams, 2020). In comparison, the second-highest-ranked country, Switzerland, spent just 12.2 percent of its GDP on health care.
Despite spending more, The Commonwealth Fund report indicates that the U.S. has the worst healthcare outcomes compared to its peers, with fewer Americans visiting physicians and the country recording the highest number of hospitalizations from needless causes and escapable deaths. For those reasons, the country has recently actively reformed its healthcare sector to improve these healthcare outcomes. One way the country has restructured its approach is through policy and by empowering nurses to take up professional management and leadership roles. Thus, this paper will specifically explore the HITECH Act and its impact on nursing responsibility, role, and practice. Furthermore, how quality measures and pay for performance impact patient outcomes will be discussed, as well as the professional nursing management and leadership roles that have arisen and their contribution to emerging trends and promotion of quality of care and patient safety in the diverse healthcare environment. The last part will predict two ways in which the nursing roles and practice of nursing will transform or grow within the next five years in response to predicted issues or forthcoming trends in health care.
Current or Emerging Health Care Law or Federal Regulation and Effect on Nursing Practice, Role, and Responsibility
One of the few emerging and revolutionary laws in the U.S. is the Health Information Technology for Economic and Clinical Act (HITECH), passed in 2009 as part of the American Recovery and Reinvestment Act. This legislation made it mandatory for the U.S. HHS to pump nearly $25.9 billion to spur and support the implementation of health information technology (HIT), such as electronic health records (EHRs). HITECH was implemented to augment the 1996 HIPAA (Health Insurance Portability and Accountability Act), which faced the problem of enforcement due to relatively mild penalties for violations.
The first and major role of the HITECH Act is to promote and support the expansion and funding of health information technology. Under Part 1 of Subtitle A, the Act stipulates the creation of electronic health records (EHRs) and other HIT to enhance efficiency, safety, and quality of care. Specifically, the legislation prioritizes the meaningful application and adoption of interoperable electronic health records in the care system. The primary goal is to spur meaningful adoption by nurses, physicians, and other healthcare providers. The two main components of ‘meaningful use’ include the application of licensed HIT in a useful way, such as e-prescribing, and the application of licensed HIT for electronic exchange to boost the quality of healthcare. Overall, the HITECH Act incentive programs aim to improve public and population health, promote patient engagement and their families, lower healthcare disparities, spur care coordination, and boost adequate security and privacy. In addition to the meaningful use of HIT, under this legislation, nurses and other healthcare providers must serve to maintain the privacy and security of patient data and information. A breach of this rule is, therefore, defined as:
The unauthorized acquisition, access, use, or disclosure of protected health information, compromises the security or privacy of such information, except where the unauthorized person to whom such information is disclosed would not reasonably have been able to retain such information (Anderson, 2010).
How Quality Measures and Pay for Performance Affect Patient Outcomes and Effect on Nursing Practice
The core health performance metrics the HITECH Act targets to improve through the meaningful implementation of health information technology include security and privacy of patient data, quality of care, patient safety, cost of care, and several others. One such way the U.S. Department of Health and Human Services aims to improve quality and performance is by rewarding providers (including physicians, nurses, hospitals, clinics, and other care facilities) that actively implement certified HIT. Specifically, during the first phase of the program implementation in 2011, Title IV of the HITECH Act pledged to compensate a maximum of $63,750 of Medicaid funds to healthcare providers that execute and adopt “certified electronic health records” (Habib, 2010). The initiative was supposed to run for six years and was meant to motivate nurses and other healthcare professionals to actively adopt ‘certified’ health information technology to improve patient outcomes, including quality of care and safety. The effects of this ‘pay for performance’ and quality requirements of the HITECH Act have seen an improvement in the absorption of EHRs and other health information technologies and their meaningful implementation. Today, the clinical outcomes of the HITECH Act can be measured in terms of improved efficiency and transparency, as well as enhanced population outcomes (Gold & McLaughlin, 2016).
Professional Nursing Leadership and Management Roles
In recent years, nursing roles have changed, with nurses required to take more proactive leadership responsibilities. In response, universities and colleges have introduced advanced nursing courses, such as BSN and MSN, to try to equip nurses with the professional leadership skills and knowledge required to drive the delivery of quality and safe care in tandem with the needs of patients. As professionals, BSN-trained nurses are required to be intimately aware of the protocols and safety standards of the nursing profession. They are required to supervise and organize other subordinates to ensure that patients receive quality and safe care without discrimination. Nurse leaders must also participate in lobbying and implementing new policies/laws to improve care delivery to patients. For example, nurse leaders must ensure that health information technologies, such as EHRs and e-prescribing systems, are fully and meaningfully implemented to boost patient safety, reduce medication errors, advance the quality of care, and lower the cost of care. They are at the forefront of encouraging effective collaboration, communication, and coordination of care (McKay & Vanaskie, 2018).
Emerging Trends: Predicting Change in Nursing Roles and Nursing Practice
Mobile and digital technologies are arguably changing the healthcare sector significantly today, influencing issues such as patient outcomes, cost of care, the safety of care, privacy of data, and so on. Some of the innovative trends that are now gaining momentum and are more likely to shape the future include machine learning and artificial intelligence, the Internet of Things, augmented reality, electronic health records, data security and blockchain, health-tracking applications, telehealth, therapeutic apps, and so on (Syberscribe, 2020). However, to effectively respond to these technological advancements, nursing roles, and practices are more likely to undergo significant modifications within the next five or more years. For example, telehealth (the use of digital communication and information technologies to remotely access and deliver care services) will impact the nursing practice by addressing the problem of staff shortage. Telehealth is going to improve access to geographical areas that were previously inaccessible, such as rural areas. Additionally, new technologies, such as EHRs as well as telehealth, will also more likely address the problem of nurse burnout due to physical and mental exhaustion that has been responsible for high turnover rates.
References
Anderson, H. (2010). The essential guide to the HITECH Act. Health Information Security, https://www.healthcareinfosecurity.com/essential-guide-to-hitech-act-a-2053
Gold, M., & McLaughlin, C. (2016). Assessing HITECH implementation and Lessons: 5 years later. The Milbank Quarterly, 94(3), 654-687.
Habib, J. L. (2010). EHRs, meaningful use, and model EMR. Drug Benefit Trends, 22(4), 99-101.
McKay, C., & Vanaskie, K. (2018). Partnering for success: The role of the nurse leader in health information technology implementation for coordination of care. Nurse Leader, 16(6), 385-388.
Syberscribe. (2020). 10 emerging trends in healthcare technology for 2020 and beyond. Syberscribe, https://www.syberscribe.com.au/blog/10-emerging-trends-healthcare-technology-2019-beyond/
Tikkanen, R., & Abrams, M. K. (2020). U.S. health care from a global perspective, 2019: Higher spending, worse outcomes? The Commonwealth Fund, https://www.commonwealthfund.org/publications/issue-briefs/2020/jan/us-health-care-global-perspective-2019#:~:text=Data%3A%20OECD%20Health%20Statistics%202019.&text=In%202018%2C%20the%20U.S.%20spent,%2C%20Switzerland%2C%20spent%2012.2%20percent.
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Question 
The Health Care Delivery System and Nursing Practice
Examine changes introduced to reform or restructure the U.S. healthcare delivery system. In a 1,000-1,250 word paper, discuss action taken for reform and restructuring and the role of the nurse within this changing environment.
Include the following:
- Outline a current or emerging healthcare law or federal regulation introduced to reform or restructure some aspect of the healthcare delivery system. Describe the effect of this on nursing practice and the nurse’s role and responsibility.
The Health Care Delivery System and Nursing Practice
- Discuss how quality measures and pay for performance affect patient outcomes. Explain how these affect nursing practice and describe the expectations and responsibilities of the nursing role in these situations.
- Discuss professional nursing leadership and management roles that have arisen and how they are important in responding to emerging trends and in the promotion of patient safety and quality care in diverse healthcare settings.
- Research emerging trends. Predict two ways in which the practice of nursing and nursing roles will grow or transform within the next five years to respond to upcoming trends or predicted issues in health care.
You are required to cite a minimum of three sources to complete this assignment. Sources must be published within the last 5 years appropriate for the assignment criteria and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.
RUBRIC
Maximum Points: 165.0