The value of LTPAC providers adopting HIT and engaging in HIE is widely accepted yet challenges must be overcome. While the LTPAC provider is presently not eligible for CMS EHR incentive payments, it is arguably in the interests of eligible hospitals and eligible professionals to exchange information with LTPAC providers (in order to meet meaningful use requirements). Further, it is in the interests of LTPAC providers to participate in HIE activities to support quality and continuity of care, and engage in new service delivery models emerging through health care reform. The ONC and ASPE continue to direct resources to advance the participation in HIE activities by LTPAC providers, including supporting the dissemination and use of the free tools developed under this study. Work is needed to extend these tools and enable additional opportunities for the re-use of standardized assessment content to improve quality and continuity of care in LTPAC.
The goals of HITECH and ACA cannot be achieved without successfully engaging LTPAC providers in HIT and HIE policies and initiatives. Leveraging federally required PAIs and patient assessment summary documents provides a cost-effective entrance point for this sector to participate in interoperable HIE through the nationwide HIT infrastructure and build a pathway towards more sophisticated HIE and meaningful use of EHRs. There will be some costs of converting the non-interoperable assessments into interoperable assessment documents and/or re-using interoperable assessment content for various purposes, and at this time it is unclear who will bear these costs. These costs could be borne by the provider and/or organizational HIE entities (e.g., state HIT grantees, Beacon Community programs, etc.). The HIE entity may (or may not) charge a fee for the transformation and exchange of this content. Nonetheless, because this approach builds from currently available electronic health information the cost is expected to be relatively modest.
Implementation of the approach and interoperability tools provided in this report creates an opportunity and strong foundation for LTPAC providers to begin using modern technologies to take steps to improve the quality and coordination of care in today's fragmented health care environment and achieve the seamless information sharing envisioned with health care reform.
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