Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. 3.4. State of Health Information Exchange to Support Care Coordination

10/29/2013

The previous section discussed many drivers of HIE to support care coordination for persons receiving LTPAC services. This section describes factors, facilitators, and barriers that impact the ability of LTPAC/LTSS providers to engage in HIE, and discusses the state of electronic HIE for LTPAC/LTSS providers as it relates to assessments, care plans, and other documents to support transitions in care. While there are many drivers to HIE to support care coordination, there are also important barriers to HIE that will be discussed in this section. These barriers impede care coordination and effective transitions of care; retard improvements in the delivery of quality health care; contribute to higher costs for payers and patients, and poor outcomes; and may eventually stymie EPs', EHs', and CAHs' ability to qualify for incentives for the MU of EHRs.1 Key barriers include continued high costs for technology acquisition, lack of awareness and use of emerging technology solutions, inadequate workforce preparation for IT use, ongoing privacy and security concerns related to HIE, and lack of stakeholder awareness of and use of HIE data standards.

Currently, CMS only requires certain LTPAC providers to complete and electronically transmit assessment information for their residents/patients to state databases for billing under the prospective payment system and QI initiatives.71 Historically, LTPAC providers have focused on technologies that support compliance with federal assessment requirements and billing. These federal requirements do not support interoperable use and exchange of this assessment information.

However, some LTPAC providers are realizing the benefits of moving beyond collecting data solely for billing purposes, and adopting technologies such as EHRs/electronic medical records (EMRs) that support patient care. LTPAC providers are slowly transitioning to software programs that not only support caregiving and their administrative data collection needs for Medicare and Medicaid programs, but also can accept information from and share information with other providers.778


1. Dougherty M, Harvell J. Opportunities for engaging long-term and post-acute care providers in health information exchange activities: Exchanging interoperable patient assessment information. Washington, DC: 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; 2011. Available

athttp://aspe.hhs.gov/daltcp/reports/2011/StratEng.htm.

7. LTPAC Health IT Collaborative. A roadmap for health IT in long term and post-acute care, 2010-2012. Available athttp://library.ahima.org/xpedio/groups/public/documents/ahima/bok1_047579.pdf. Accessed July 25, 2013.

71. LTPAC Collaborative, State HIE Toolkit Module: Vulnerable populations and HIE. 2010.

78. LeadingAge Center for Aging Services Technology. EHR for LTPAC: A primer on planning and vendor section. Washington, DC: LeadingAge Center for Aging Services Technology; 2013.

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