Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. 4.5. Use of Health Information Technology Standards to Support Interoperability and Exchange

10/29/2013

Basic HIT and interoperability standards are sometimes used to support electronic HIE at the sites (e.g., use of HL7 version 2 messaging). One of the three sites (Rush) has an EHR vendor that is certified for Stage 2 of the EHR Incentive Programs, but demonstration of HIE with LTPAC providers outside of their network was not observed. None of the sites have implemented standards identified for Stage 2r to support more robust HIE at times of transitions in care and for instances of shared care on behalf of persons receiving LTPAC/LTSS (because Stage 2 HIE requirements were not in effect at the time of the site visits). In addition, the focus has been on the application of these standards to providers eligible for the EHR Incentive Programs and there is a lack of awareness about the extensibility and applicability of these standards by and to LTPAC/LTSS providers.

Generally, HIE using the LTPAC EHR systems does not leverage HIT standards included in either Stage 1 or Stage 2 EHR Incentive Programs. For example, standards used to exchange information from LTPAC EHR systems used HL7 message standards (e.g., HL7 version 2.x) rather than document standards such as the CCD or CCDA. While many of the standards required by the EHR Incentive Programs could be used to support HIE with and by LTPAC providers, integration and use of these standards into LTPAC EHR products often requires additional investment of time, financial resources, and organizational awareness of the availability and applicability to support HIE. Further, some standards are still early in their maturity level requiring a significant level of effort to implement.

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