Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. 2.1. Research Questions

10/29/2013

The following research questions guided the work during the literature review, environmental scan, and interviews with key informants:

  1. What HIE interventions and activities are being implemented/advanced to support transitions in care and shared care involving persons who receive LTPAC/LTSS services?

  2. What is the evidence base for these HIE interventions?

  3. How does the use of health information technology (HIT) support these HIE interventions?

  4. What factors are enablers or create barriers for needed HIE on behalf of persons who receive LTPAC/LTSS services?

  5. What is a framework that can be used to synthesize and describe the HIE care models, interventions/activities, and barriers/enablers to support transitions in care and instances of shared care on behalf of person who receive LTPAC/LTSS services?

  6. Who are the LTPAC/LTSS providers engaged in HIE for transitions in care and shared care? What interventions are they implementing, and what are the key characteristics of these providers and the communities within which they are located?

  7. What information do LTPAC/LTSS providers have that other providers want for care planning, coordination, and transitioning? Functional status? Cognitive status? Medications? More medically-oriented information such as medications, diagnoses, allergies? Other information? (This question is agnostic as to whether HIT is used for HIE.)

  8. What is the state of electronic exchange for LTPAC/LTSS providers as it relates to assessments, care plans, and other documents to support transitions in care?

  9. How do the following impact the feasibility of adoption and type of HIE by LTPAC/LTSS providers?
    • Workforce preparation and support;
    • Payer mix;
    • Payer and other financial incentives;
    • Availability of HIT such as EHRs, interoperable standards-based information exchange, and/or summary of care records;
    • Type of information available to be exchanged; and
    • Exchange between non-affiliated exchange partners.
  10. What, if any, federal and state requirements create competing policies and/or priorities that may inhibit HIE?

  11. What public (e.g., Centers for Medicare and Medicaid Services [CMS]) payer incentives exist for HIE, and what, if any, other payer incentives support HIE in LTPAC/LTSS settings for projects identified in the conduct of this work?

  12. What is the payer mix related to each case study site and its impact on their HIE?

  13. How are LTPAC/LTSS being paid for and how does payment impact HIE including facilitators and barriers?

  14. What programs are developing and/or expanding that include an HIE component involving LTPAC/LTSS providers including Affordable Care Act and U.S. Department of Health and Human Services (HHS) initiatives (e.g., through CMS and the Office of the National Coordinator for Health Information Technology [ONC])?

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