Performance Improvement 2007. How Can Barriers to Interoperable Health Information Technology in Post-Acute and Long-Term Care Be Reduced; Can Patient Data Be Made to Comply with Health Information Technology Standards?



This study provided recommendations regarding the use of health information technology content and messaging standards that could be applied to existing and emerging health assessment requirements (such as the assessments that nursing homes, home health agencies, and in-patient rehabilitation facilities are required to complete). Health information technology is expected to improve the quality of health care and patient safety, decrease costs, and increase efficiencies in health care delivery. To facilitate the effective and efficient use of health information technology generally, voluntary consensus standards are gradually being developed and adopted by a wide range of public and private individuals and organizations. To most efficiently support health information exchange and re-use, health information technology solutions must be "interoperable." Interoperability means the ability of different health information technology systems, software, and networks to exchange and reuse data accurately, effectively, securely, and consistently in various settings, including preserving the meaning of the data. Nursing homes, home health agencies, and in-patient rehabilitation providers face challenges in acquiring and implementing such interoperable health information technology solutions. Research has found that the health information technology products used by these providers are not interoperable with electronic health records systems used in other health delivery settings (for example, acute care hospitals and physician practices). Federal requirements for patient assessments are a significant barrier to interoperability. These assessments are not linked with health information technology standards that would support standardized exchange and reuse of assessment content. Federal law and Centers for Medicare and Medicaid Services' regulations require that Medicare and Medicaid certified nursing home providers complete, and electronically submit, patient-specific health and functional assessment information several times during each patient's stay. In nursing homes, the required assessment is the "Minimum Data Set" (MDS). Medicare, and sometimes Medicaid, uses this data to determine provider payments, report on various quality activities, and for other purposes.

The study , conducted in collaboration with the Centers for Medicare and Medicaid Services, examined how to apply health information technology standards to the Minimum Data Set. The study identified possible matches of standardized vocabulary terms and concepts with the Minimum Data Set concepts. The study also represented the Minimum Data Set in a format known as "Logical Observation Identifiers Names and Codes" (LOINC). The use of the LOINC format enables the standardized exchange using health information technology messaging standards of assessment results. The study constructed sample messages using data elements from the Minimum Data Set that had been represented in the LOINC format and linked standardized vocabulary content. The standards identified in this study were endorsed by the Consolidated Health Informatics (CHI) Initiative, one of the electronic government activities under the Office of Management and Budget and recommended for adoption and use by the National Committee for Vital and Health Statistics.

Report Title: Making the Minimum Data Set Compliant with Health Information Technology Standards
Agency Sponsor: ASPE, Office of the Assistant Secretary for Planning and Evaluation
Federal Contact: Harvell, Jennie, 202-690-6443
Performer: Apelon; Alameda, CA
PIC ID: 8338

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"PerformanceImprovement2007.pdf" (pdf, 717.63Kb)

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