U.S. Department of Health and Human Services
Health Information Exchange in Post-Acute and Long-Term Care: Project Summary
University of Colorado
November 2005
This project summary was prepared under contract # HHS-100-03-0028 between the U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Office of Disability, Aging and Long-Term Care Policy (DALTCP) and the University of Colorado. For additional information on this subject, you can visit the ASPE home page at http://aspe.hhs.gov or contact the ASPE Project Officer, Jennie Harvell, at HHS/ASPE/DALTCP, Room 424E, H.H. Humphrey Building, 200 Independence Avenue, S.W., Washington, D.C. 20201, Jennie.Harvell@hhs.gov.
Awareness and support for the need of interoperable, standardized electronic health records (EHRs) have greatly increased. To date, these efforts have largely focused on acute and ambulatory settings. Post-acute care (PAC) and long-term care (LTC) settings have unique needs for health information exchange (HIE). This project will examine how HIE is occurring between health delivery systems and unaffiliated PAC/LTC settings and the factors that promote or hinder this exchange. These research questions will be addressed:
- What HIT is being used to support the creation, storage, and exchange of: summaries of physician office visits and hospital stays, CPOE, and laboratory results reporting?
- What type of health information is needed for summary documents of hospital stays, physician office visits, medication orders, and laboratory tests?
- What clinical information is exchanged as part of the summaries of physician office visits and hospital stays, physician orders, and results reports?
- What health information is exchanged between health care providers and unaffiliated PAC/LTC settings and what are the mechanisms used to exchange information?
- What factors do PAC/LTC providers and representatives from the selected health care delivery systems identify as supporting or creating barriers to the timely exchange of physician and hospital summaries, physician orders, and results reporting?
Project activities will include a literature search and discussions with stakeholders involved in the development of EHR architecture and standards. Based on the information learned, a plan will be developed for conducting site visits, modifying previously developed tools to gather information. In the Summer of 2006, four site visits will be conducted. Progress presentations to the Assistant Secretary for Planning and Evaluation will be made in months 7 and 15 of the project. The information gathered through all the sources will be summarized and presented in the final report, which will identify policies that could promote information exchange and propose next steps on to how to support information exchange with PAC/LTC settings.