Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. 1. Introduction

10/29/2013

Long-Term and Post-Acute Care (LTPAC) providers play an important role in the United States health care system providing care for elderly, frail, and disabled individuals, including persons who require ongoing treatment after an acute health episode. Over a third of all Medicare patients discharged from acute hospitals receive subsequent LTPAC services such as skilled nursing or home health services.1 Health information exchange (HIE) involving LTPAC providers is expected to play a significant role in improving and achieving health policy goals, such as those in the Patient Protection and Affordable Care Act (Affordable Care Act), related to care coordination and reducing avoidable hospital readmissions.2 Currently, there is limited information on the use of HIE interventions/activities to support care coordination by LTPAC providers.

To fill this information gap, the Office of the Assistant Secretary for Planning and Evaluation (ASPE) contracted with Westat to conduct a literature review, environmental scan, interviews with key informants, and in-depth, on-site case studies with three providers engaged in HIE to support care coordination for persons receiving LTPAC/Long-Term Services and Supports (LTSS). This report summarizes the findings with a focus on:

  • Synthesizing evidence-based practices regarding HIE interventions and activities to support transitions in care and shared care by multiple members of the care team.

  • Describing these HIE interventions and activities including electronic HIE.

  • Characterizing the HIE interventions, activities, LTPAC/LTSS providers and external entities that are engaged in HIE to support care coordination and transitions of care, guided by a framework developed for this study.

  • Identifying factors that enable HIE or create barriers to implementing these HIE interventions/activities.

  • Describing the availability of process, outcome, and cost measures and metrics to assess the impact of the HIE interventions identified.

This report provides information to help advance the use of HIE for policymakers charged with improving quality and efficiencies across the health care continuum and LTPAC providers who seek to improve the quality and continuity of care, and participate in the changing delivery system.


1. Accountable Care Organizations (ACOs). See http://www.acofp.org/Practice_Management/ACO/Medical_Home/, accessed March 2013.

2. Encyclopedia of Nursing and Allied Health, ©2002 Gale Cengage.All Rights Reserved. Full copyright.

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