To understand health information exchange (HIE) for long-term and post-acute care (LTPAC) providers, a site visit was conducted at Beechwood Homes (Beechwood). Beechwood is a non-profit long-term care community in the greater Buffalo, New York area. The community is comprised of independent living, assisted living and rehabilitative/skilled nursing services. The site visit conducted at Beechwood Continuing Care focused on Beechwood Homes, a 272-bed skilled nursing and rehabilitation facility with specialty units in early dementia, hospice, and rehabilitation. Its specialty rehabilitation unit, Wesley Rehabilitation Center, is designed specifically for residents with intensive, short-term rehabilitation or complex medical needs. Beechwood has embraced a patient-centered quality of life focus and is undergoing a transformation to a household environment rather than nursing units.
To deliver short-term and long-term care to its residents, Beechwood coordinates care and services with a number of health care professionals and community partners including physicians, local hospitals, ancillary services providers including pharmacies, labs and radiology, health plans and other LTPAC providers. Beechwood has begun participating in the Western New York regional HIE organization (HIEO), which is advancing electronic information exchange capabilities in the area.
Beechwood strives to be a leader/innovator in their area. Beechwood has embraced technology and looks for opportunities to expand its use of health information technology (HIT) to support their clinical and business operations, and identified regional HIE activities as important for their organization. They were selected as one of five LTPAC partners for the Western New York Beacon Community. As one of 17 Beacon Communities nationwide, Western New York is building and strengthening local HIT infrastructure and testing innovative approaches to make measurable improvements in health, care, and cost. Funded by the Office of the National Coordinator for Health Information Technology (ONC), the Western New York Beacon Community's efforts are focused on improving clinical outcomes and patient safety, through HIT and HIE.
The regional HIEO, HEALTHeLINK, is leading efforts to transform Western New York health care through the Beacon grant. Beechwood joins other community service providers (such as hospitals, physicians, labs, pharmacies, radiology centers, home health care, hospice, and payers) in participating in the regional HIE network. Beechwood is currently sending admission/discharge/ transfer (ADT) messages to the HIE and is working on receiving lab and radiology results through HEALTHeLINK.
Beechwood has the electronic health record (EHR) application Answers on Demand (AOD). They are using many modules in the system with ongoing plans to expand its use to support clinical and facility operations.
Health information is exchanged in many different ways (phone, fax, e-mail, mail, secure electronic exchange, portals, etc.) during key clinical and administrative processes. The flow of exchanged health information occurs in three categories: (1) hand-offs in care; (2) shared care; and (3) other administrative. Beechwood routinely exchanges information to complete preadmission assessments, at transfer and discharge, when assessing the patient in the development of their initial plan of care (POC), for ongoing maintenance of the patient's POC, and with status changes. Health information is also exchanged for administrative purposes to support billing and reporting.
A number of opportunities were identified over the course of the two-day site visit to expand HIE in support of clinical and/or business processes, or to address barriers. The opportunities and/or barriers include:
Opportunities to improve care delivery with better availability of information.
Need for clarified and/or implementable standards to support interoperability and HIE.
Ideas for expanding participation in HIE by LTPAC facilities by increasing the value proposition.
Beechwood with their community partners the Western New York Beacon Community and HEALTHeLINK, continue to explore new ways to improve care transition and coordination activities for their patients and the community they serve.
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