Module 5

What, if any relationship do you see between the information available on this webpage and regulatory, accreditation, and reimbursement issues and healthcare information system use and design? Post your ethical considerations as a message in your blog.

The relationship between the AHRQ website and health information system use and design in regards to regulatory, accreditation, and reimbursement issues is informational and integral.

AHRQ describes itself as “the Nation’s lead Federal agency for research on health care quality, costs, outcomes, and patient safety” (Agency for Healthcare Research and Quality (AHRQ), 2002). In a speech from the Annual Conference of the Health Information and Management Systems Society (HIMSS) in 2005, by Carolyn M. Clancy, M.D., Director of the Agency for Healthcare Research and Quality described AHRQ and their predecessor agencies as supporting health informatics products for 30 years (Clancy, 2005a). In fact, an AHRQ Health Information Technology Programs Fact Sheet from 2005-2006 noted millions upon millions of dollars in contracts and grants to promote the use of health IT with admirable goals to: “improve patient safety by reducing medical errors; increase health information sharing between providers, laboratories, pharmacies, and patients; help patients transition between health care settings; reduce duplicative and unnecessary testing; increase our knowledge and understanding of the clinical, safety, quality, financial, and organizational value and benefits of health IT; foster partnerships and collaboration, especially in small or rural areas” (Agency for Healthcare Research and Quality (AHRQ), 2008b).

Regulation
In a testimony before Senate Committee in 2005, the AHRQ Director, described AHRQ as “complementing the efforts of the Department of Health and Human Services (HHS) efforts by harnessing the power of IT to improve the effectiveness, efficiency, quality, and safety of health care”(Clancy, 2005b). The director, Carolyn M. Clancy, described; the importance of health IT; AHRQ’s current health IT activities; and AHRQ’s creation of the National Resource Center for Health IT (Clancy, 2005b). Clancy describes that in order to answer the call of many wrestling with health IT implementation and to rapidly and widely disseminate AHRQ research, AHRQ established the National Resource Center for Health IT in order to promote the successful adoption and implementation of health IT (Clancy, 2005b). As Curtin (2005) noted, healthcare IT enlarges ethical problems. I would surmise that although not directly involved in the regulatory process, AHRQ is and has been instrumental in laying the foundation for that process through pointed research.

Accreditation
AHRQ does not serve in the capacity of an accreditation agency. I did find consumer information and links to some accreditation agencies such as JCAHO and American Accreditation HealthCare Commission/Utilization Review Accreditation Commission (URAC). On the AHRQ Health Care Report Card Compendium, a searchable directory of “report cards” from which to compare information on the quality of health plans, hospitals, medical groups, individual physicians, nursing homes, and other providers of care could be accessed; the AHRQ was careful to state that inclusion on this compendium was not an endorsement by the AHRQ. Overall, AHRQ does not appear to be directly involved in accreditation, but does provide links to valuable information for health information systems use and design.

Reimbursement
Through AHRQ funded research, questions surrounding reimbursement have been investigated and health IT has been facilitated. Charged with summarizing and synthesizing findings of e-prescribing pilot projects, the AHRQ National Resource Center for Health IT advised the Federal Government on standards for adoption. This directly related to reimbursement. This new law was an example: “…Medicare physicians who e-prescribe will receive a 2-percent payment bonus in 2009 and 2010, a 1-percent bonus in 2011 and 2012, and a 0.5-percent bonus in 2013. In addition, payments to Medicare physicians who do not e-prescribe will be reduced by 1 percent in 2012, 1.5 percent in 2013 and 2 percent in subsequent years (Agency for Healthcare Research and Quality (AHRQ), 2008a).”

Ethical Considerations
In my review of the AHRQ website, I found numerous research projects surrounding ethical considerations in healthcare. This and other research adds to the foundation of regulations and can lead to ties with reimbursement.

All in all, it is tempting to accept this plethora of information at face value, but a critical eye is always in our best interest when such a volume has been filtered through one source, no matter how objective that source has been touted to be.

As far as ethical copywrite considerations, information gleaned from government information is within public domain; however, subsequent use should be given appropriate acknowledgment. (National Institute of Health, 2008).

Agency for Health Research and Quality (AHRQ). (2008a). AHRQ. Retrieved July 31, 2009, from AHRQ National Resource Center for Information Technology: http://healthit.ahrq.gov/portal/server.pt?open=514&objID=5554&mode=2&holderDisplayURL=http://prodportallb.ahrq.gov:7087/publishedcontent/publish/communities/k_o/knowledge_library/key_topics/health_briefing_03282006124741/electronic_prescribing.html

Agency for Healthcare Research and Quality (AHRQ). (2008b). AHRQ health information technology programs facts sheet. Retrieved July 31, 2009, from Agency for Healthcare Research and Quality (AHRQ): http://www.ahrq.gov/research/hitfact.htm

Agency for Healthcare Research and Quality (AHRQ). (2002). What is AHRQ? Retrieved July 31, 2009, from Agency for Healthcare Research and Quality: http://www.ahrq.gov/about/whatis.htm

Clancy, C. M. (2005). Health information technology: the road ahead. Annual Conference of the Healthcare Information and Management Systems Socieity (HIMSS). Dallas: Agency for Health Research and Quality.

Curtin, L. L. (2005). Ethics in information: The intersection of nursing, ethics, and information technology. Nursing Administration Quarterly, 29(4), 349-352.

National Institute of Health. (2008). NCBI Copywrite and Disclamers. Retrieved July 31, 2009, from National Center for Biotechnology Information: http://www.ncbi.nlm.nih.gov/About/disclaimer.html

Testimony on Health Information Technology Activities at the Agency for Healthcare Research and Quality. Statement of Carolyn M. Clancy, before the Senate Committee on Commerce, Science and Transportation Subcommittee on Technology, Innovation, and Competitiveness, United States Senate, June 30, 2005b. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/news/test63005.htm