Medication Interactions and the Elderly, Research Paper Example

Health Problem

Elderly and disabled patients with multiple medications are at risk of medication interactions and potential drug safety concerns. This is problematic because elderly and disabled individuals are likely to suffer from more intense health outcomes as a consequence of medication errors. Elderly and disabled patients are less likely to be able to remember the types of prescriptions they have been provided, as the patient interview process will require them to recall a large number of prescription details. Furthermore, these groups are likely to have several physicians that engage in their regular care that may not coordinate treatments. This provides a strain on health care organizations who have potential to incur monetary damages for errors related to the provision of theses prescriptions. In addition, elderly and disabled individuals are typically covered under Medicare or Medicaid. As a consequence, negative drug interactions will impact the expenses that these government programs must cover to compensate for treatment errors made.

Healthy People 2020

Healthy People 2020 provides a provision for an adverse event reporting system that would help reduce the extent of medication errors that are made. According to the website,

“The FDA uses AERS to monitor for new adverse events and medication errors that might occur with these marketed products. Reporting of adverse events from the point of care is voluntary. FDA receives some adverse event and medication error reports directly from health care professionals (such as physicians, pharmacists, nurses and others) and consumers (such as patients, family members, lawyers and others)” (Healthy People 2020, n.d.).

 These measures could reasonably address the concerns put forth by physicians and the public regarding medication interactions because creating a system that reports adverse events will allow doctors to have a greater understanding of detrimental drug reactions that could be implemented to advanced practice. Ultimately, even though many issues could contribute to the creation of negative drug interactions, the most preventable cause is related to developing a certainty of these reactions. Once more information is obtained about the effects caused by combination prescriptions, doctors could more actively prevent these effects while still treating the necessary combination of disorder and symptoms. This technology is related to the implementation of electronic health record systems, which is promoted by HITECH laws. Ultimately, it is reasonable that the integration of these two healthcare systems will positively contribute to the reduction of medication errors in elderly patients (FDA, n.d.).

It is reasonable that the fact that the concern over elderly and disabled patients with multiple medications are at risk of medication interactions and potential drug safety concerns was removed from this Healthy People 2020 entry due to uncertainty related to the resolution of this specific problem. While action could be taken to reduce medication errors for members of the general population, it is challenging to determine how these errors could be reduced in a manner that specifically applies to this group. The implementation of technology will help contribute to the ability of physicians to track medications and reported medication interaction data, but it will continue to be challenging for medical professionals to have a complete understanding of the medications that these individuals are prescribed.

Official Title and Citation of the Legislation

According to the HITECH Act Enforcement Interim Final Rule, “Subtitle D of the HITECH Act addresses the privacy and security concerns associated with the electronic transmission of health information, in part, through several provisions that strengthen the civil and criminal enforcement of the HIPAA rules” (HITECH Act, n.d.). Section 13410(d) of the HITECH Act was added to indicate penalty information for the failure of physicians and hospitals to adhere to these provisions. Under this legislation, it is essential for doctors to enforce the security of health data that is transmitted. This applies to the need to reduce the medication errors made for the elderly and disabled because it could reasonably restrict information that is needed to support the health of these patients. Therefore, it is necessary for health professionals to determine how to support the unique health needs of these individuals while adhering to recent information technology laws.

Describe the Public Policy Response

The HITECH Act and associated legislation such as HIPAA were put in place to ensure that the privacy of patients would be protected. Furthermore, HITECH was created to establish the meaningful use of technology in health care across the country. Therefore, it is reasonable to begin implementing technology in a manner that will allow physicians to more readily report medication interactions that could then immediately be used for the purposes of evidence-based practice. Doing so will reduce the incidence of medication errors that are made. Furthermore, technology could be used in a manner that could contribute to the documentation of medication history for elderly and disabled patients. In this manner physicians could collaborate with one another to contribute to effective care for their patients. Using electronic health record systems is a reasonable way to ensure that all physicians that care for elderly and disabled individuals are able to coordinate and manage their prescriptions in a manner that would prevent adverse events. Furthermore, utilizing reported knowledge of medication interactions would positively contribute to this form of patient care.

Status

The HITECH Act was signed into law on February 17, 2009 and continues to direct patient care. The adverse event reporting system utilizes data from 1969 onwards and is updated regularly. While infrastructure is in place to allow for the enhanced care that elderly and disabled patients receive as it pertains to their prescription, it is the responsibility for physicians to coordinate the information technology they have access to in a manner that provides a solution to this problem.

Conclusion

The health policy does not adequately address the problem identified. While the infrastructure is in place according to the HITECH Act and government funded insurance, there is still a need to contribute to the existing evidence and develop a mechanism that would be better able to assist the needs of elderly and disabled patients. While health care law currently recommends such practices, the law is not specific enough in order to ensure related progress.

Resources for Updates

It would be beneficial for health care organizations to check on updates to HIPAA, the HITECH Act, and Medicare and Medicaid participation requirements (HIPAA, n.d.). They will be required to follow this legislation as it pertains to information systems and the provision of care for elderly and disabled patients. Since these laws and regulations are constantly changing, it would be beneficial for the administration to check in with these updates regularly to ensure that their institution is equipped to follow the necessary provisions that these standards announce.

Agency Responsible

Broadly, the Department of Health and Human Services is responsible for ensuring that all qualified individuals are able to access Medicaid and Medicare. Furthermore, they are given the power to regulate health care requirements on the federal level. This organization has partnered with insurance companies and private agencies to ensure that health insurance issued in an effective manner. Funding for these programs are provided by federal and state funds. Therefore, states are mandated to contribute to these programs at the local level. It is also state health agencies that are required to determine whether health care law is being followed or whether violations are being made. While the fines issued are typically federal in nature, fines for failure to comply with health care laws can be issued by the state. The federal government is typically responsible for dealing with high level concerns, such as refusal to administer certain patient services, while the state is often responsible for regulating the licencing of health care professionals and relevant establishments. Each state has its own agency that regulates health care on this level.

Enforcement

Because enforcement of these laws need to occur at the local and federal level, the offense indicates the type of enforcement that will be necessary. The Department of Health and Human Services has the power to directly issue fines to violating institutions, as do local state equivalents (Sack, 2013). However, a major consideration is the ability for these institutions to arrest individuals at fault. Individuals that violate federal codes must therefore be sentenced in federal court, while the individuals that violate state rules will be sentenced in state court. Arrests work in this manner as well. Typically, however, fines are utilized because they can more reasonably target the health care institution instead of the individual. It therefore falls to the administrations responsibility to determine how to pay for these costs, while individual health care professionals are generally not considered liable. This helps to better ensure that the care of patients are being maintained, while the appropriate party is provided with sufficient pressure to make changes.

Implementation

Legislation must be implemented by a vote from Congress. Therefore, it must be drafted in the House of Representatives, approved by this body, and then voted on and approved in Congress. It must then avoid being vetoed by the President. When this happens, the law is put into place. While this is the case on the federal level, state laws are approved in a similar manner, although the roles of the state House and state Congress become more relevant. The Department of Health and Human Services is able to provide recommendations to representatives to better be able to implement and refine health practices. Typically, committee members in each house are expected to draft relevant health related bills. Local public health departments are involved in the implementation process because they are required to police local health care institutions (FDA, n.d.).

When a new health care policy is implemented, it is posted online to bring the law to the attention of health care facilities. It is the responsibility of individual facilities to become aware of these laws and to implement these requirements into practice during the amount of time allotted. Therefore, at the most local level, administrative teams are responsible for putting these plans into place. These individuals are directly responsible for monitoring the actions of staff members to determine if their actions deem them as compliant. In addition, they must facilitate training programs to make relevant members of the staff aware of new legal changes.

It is apparent that implementation of health care law occurs on many levels. In the case of Medicaid and Medicare programs, it is the federal government that is responsible for setting up the program and determining logistics, while it becomes necessary for the state government to determine who is and who is not eligible for these benefits and to approve them on this basis. With regards to the HITCH Act, it is the responsibility of the federal government to post legal requirements online, the state must add its own requirements if applicable to their own adaptation of this report, and the health care administration must understand and implement the legislation (HITECH, n.d.). To do so properly, they must recruit or develop an information technology team that is able to effectively appeal to the needs of patients in a manner that positively contributes to patient care.

Citizens are not typically involved in the implementation procedure. As a consequence, very few individuals are aware of their rights. Some health care institutions require all patients to complete consent forms that indicate their rights as a standard practice. However, this is not done across the board. Occasionally, the federal government will provide additional funds to organizations to allow them to make an appropriate technology changes in a manner that will remain cost effective. However, in many cases, hospitals must make these alterations without the possibility of financial incentives.

Impact on Health Service Organizations

Health Care Managers must be made fully aware of this legislation and related implementation because they are fully responsible for ensuring that it is carried out properly. Five bullets of how this legislation impacts health services organizations operating in my state include:

• Requiring large health care organizations to implement electronic health record systems
• Providing for relevant training programs to help employees understand relevant legislation
• Keeping in communication with the government to gain an understanding of legal needs
• Keeping in communication with the government to gain an understanding of programmatic needs
• Hiring individuals if necessary to comply with new requirements

Resources

There are many online resources available to help Health Care Managers determine if new legislation is relevant to them. The most beneficial site for this purpose is the Department of Health and Human Services (HHS, n.d.). This site lists new legislation passed that is required to be implemented by all states. Furthermore, the Congress webpage and House of Representatives webpage can be utilized to help these individuals determine the information that helps them determine what kind of legislation is currently being discussed in these committees. Typically, each state has a state level requirement for the health department, House of Representatives, and Congress. These resources should also be referred to for Health Care Managers that wish to understand changes to state laws. Last, some Health Care Managers work in municipalities that require the same level of legislation and control. Thus, it is important for these individuals to determine whether this level of local law is in place for their city in addition to the websites that would report this information.

References

FDA. (n.d.). Medication Errors. Retrieved from http://www.fda.gov/drugs/drugsafety/medicationerrors/

Healthy People 2020. (n.d.). Adverse Event Reporting System. Retrieved from http://www.healthypeople.gov/2020/data-source/adverse-event-reporting-system

HHS. (n.d.). About. Retrieved from hhs.gov.

HIPAA. (n.d.). Retrieved from http://www.hhs.gov/ocr/privacy/

HITECH Act. (n.d.). Retrieved from http://www.hhs.gov/ocr/privacy/hipaa/administrative/enforcementrule/hitechenforcementifr.html

Sack, J. (2013). Law Enforcement In The Health Care Industry: What Do New Cases Against Novartis Tell Us? Retrieved from http://www.forbes.com/sites/insider/2013/05/09/law-enforcement-in-the-health-care-industry-what-do-new-cases-against-novartis-tell-us/