Opportunities for Engaging Long-Term and Post-Acute Care Providers in Health Information Exchange Activities: Exchanging Interoperable Patient Assessment Information. Electronic Information System Capabilities in Nursing Homes and Home Health Agencies

12/01/2011

Federal assessment requirements have resulted in LTPAC providers having the information technology capacity to support the maintenance and transmission of required assessments. This section describes what is known about electronic systems capabilities in nursing home and home health agencies. Little research is available regarding the HIT capabilities for IRFs.

FIGURE 4. Nursing Home Electronic Information System Capability in the United States by Percentage of Adoption (2004)
Bar Chart: Any EIS (99.4), MDS (96.4), Billing (95.4), Admission (79.6), Personnel (58.7), Dietary (51.2), Medication Orders (51.1), Physician Orders (48.5), Medical Records (42.8), Laboratory (41.4), Medication (38.1), Staff/Scheduling (37.2), Daily Care (17.6).
SOURCE: Resnick, H.E., Manard, B.B., Stone, R.I., Alwan, M. "Use of Electronic Information Systems in Nursing Homes: United States, 2004." Journal of the American Medical Informatics Association (JAMIA), 2009, 16: 179-186. Abstract available online at: http://jamia.bmj.com/content/16/2/179.abstract

Nursing homes and home health providers currently use electronic information systems to support some administrative and clinical processes. Figure 4 and Figure 5 illustrate the most common HIT capabilities and adoption percentages. An analysis shows that nursing homes and home health agencies use electronic information systems to support a variety of internal processes. However, findings also show a significant underuse of the clinical capabilities in EHRs once acquired16 thus widespread use of full functioning EHRs is not yet prevalent in this sector.

FIGURE 5. Home Health Electronic Information System Capability in Home Health and Hospice by Percentage of Adoption (2007)
Bar Chart: OASIS -- All (79), Home Health Only (93.3), Mixed (98.2). Email with Staff -- All (73.7), Home Health Only (71.9), Hospice Only (88.9), Mixed (65). Scheduling appointments -- All (72), Home Health Only (75.6), Hospice Only (62.8), Mixed (69.9). CPOE -- All (63.2), Home Health Only (67.7), Hospice Only (48.9), Mixed (64.2). CDSS -- All (63), Home Health Only (70.3), Hospice Only (53.2), Mixed (51). Test results -- All (25), Home Health Only (21.1), Hospice Only (25.7), Mixed (35.2). Test reminders -- All (23.9), Hospice Only (21.9), Mixed (31.9).
SOURCE: Resnick, H.E., Alwan, M. "Use of Health Information Technology in Home Health and Hospice Agencies: United States, 2007." Journal of the American Medical Informatics Association (JAMIA), 2010, 17: 389-395. Abstract available online at: http://jamia.bmj.com/content/17/4/389.abstract.

* Estimate should be interpreted with caution.

There is growing awareness of the importance of fully interoperable HIT capabilities.17 LTPAC leaders are conscious of the need for the sector to participate in the growing nationwide HIT infrastructure. Since 2005, a group of LTPAC associations and leaders (known as the LTPAC Health IT Collaborative) has been working together to set priorities, advance HIT, and align the LTPAC sector with national policy priorities. The collaborative publishes recommendations for action for LTPAC providers, policymakers and other stakeholders every two years. The 2010-2012 priorities are as follows:18

  • Leverage existing programs and policies to engage LTPAC providers.

  • Certify EHR vendor solutions for LTPAC providers to promote interoperability.

  • Advance adoption and use of HIT and EHRs.

  • Foster HIE that includes LTPAC.

  • Prioritize technology that supports ToC and electronic prescribing to promote care coordination and continuity of care.

  • Focus on person-centered health and health care.

  • Showcase valuable and effective use of HIT to the LTPAC sector.

  • Promote and disseminate research and best practices.

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