Health Information and Technology

Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. Appendix L. Standards Available to SUPPORT Health Information Exchange of Long-term and Post-acute CARE Data

TABLE L-1. Standards Available to Support HIE of LTPAC Data

Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. Appendix K. Summary of Information Routinely Exchanged by the Three Sites Visited, by CARE Coordination Function

TABLE K-1. HIE Activities for Transitions of Care

Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. Attachment J-1. Eastern Maine Health System Pioneer Accountable Care Organization Quality Measures

Description of ACO Measures: Excerpts and Table from CMS "Accountable Care Organization 2013 Program Analysis--Quality Performance Standards Narrative Measure Specifications" Report

Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. Conclusion

EMHS is an innovative organization providing industry leadership on how LTPAC providers and technology can be integrated into new care delivery and payment models. Their patient-centered approach to care coordination embraces the spectrum of providers and integration of community services. Technology plays an important role in coordination of care

Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. For Eligible Beneficiaries Who are Enrolled in Part a and Part B, Part a Finances Post-institutional Home Health Services Furnished During a Home Health Spell of Illness for up to 100 Visits During a Spell of Illness. Part a Finances up to 100 Visits Furn

Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. Barriers

Barriers to Expansion of Telehealth . The use of telehealth has shown promise for improving patient care management, outcomes and cost, but EMHC identified challenges with the reimbursement structure coupled with high cost of the equipment create challenges for expanding the technologies use across a broader population with a large, rural geog

Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. Barriers and Opportunities for Improved Health Information Exchange Practices

Over the course of the two-day site visit, a number of issues were identified related to information exchange in support of care transitions and ongoing shared care. EMHC and EMHS staff interviewed offered the following insights on both barriers and opportunities for improvement in using HIE to improve communicating and coordinating care.

Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. Health Information Exchange Related Measures

TABLE J-7. HIE by Care Coordination Function and Partners, Eastern Maine HomeCare EMHC does not report or identify any specific HIE measures. They report the 33 required quality measures as a Pioneer ACO. These measures are detailed in Attac hment J-1.

Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. Health Information Exchange Information Flow

Table J-7 , Tabl e J-8 , and Table J-9 describe the information exchange activities for EMHC in three categories: (1) hand-offs in care; (2) shared care; and (3) other administrative exchange.

Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. Home Health Care Processes

EMHC staff described the clinical workflow processes for care and how information is used and exchanged. Table J-6 describes the process, information collected and/or exchanged and observations by staff. TABLE J-6. Home Health Care Workflow Processes

Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. Health Information Exchange at Eastern Maine HomeCare

The availability, use and exchange of information is crucial for an EMHC to begin care and coordinate care with other service providers. Information exchange occurs through multiple different methods -- via phone, photocopies, fax and e-mail as well as through access to the hospital EHR, customized portals and the HIE. This section describes HIE i

Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. HealthInfoNet Population Analytics

HIN is moving toward population health management including support for the Northern New England ACO Collaborative (multi-state and multi-provider) and their need for analytics at a broader community/population level. HIN is focusing on data analytics to drive changes in care. For examples, HIN is analyzing data in such areas as: Services uti

Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. Home Health Gold

EMHC division utilizes a tool called Home Health Gold, which is a data scrubber, and analytics tool that is interfaced with the home health EHR. The Home Care Quality Assurance/Performance Assurance director uses the information to regularly assess clinical, operational and financial data. Figure J-6 shows the Home Health Gold Dashboard. The to

Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. Data Analytics

EMHS utilizes a number of data analytics approaches to leverage their information in support of decision-making. Interviews with various staff and stakeholders illustrated how data analytics tools and query/report processes were used to pinpoint patients that required additional attention, identify risk, or measure improvement.

Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. Eastern Maine HomeCare's Work List for Electronic Health Record, Telehealth and Health Information Exchange

The EMHS's IS department in collaboration with EMHC have identified three priority projects currently under development. The following projects, once complete, will improve EMHC's interoperability and HIE capabilities:

Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. Electronic Health Record Systems

Moving toward one EHR vendor has been a significant project for EMHC. As hospitals and home care agencies merged, each agency had their own EHR application. The Beacon Community Grant provided the financial resources to invest in a single EHR infrastructure across all home care and hospice sites. This allowed the organization to build interfaces t

Eastern Maine HomeCare Technology Infrastructure

Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. Eastern Maine HomeCare Technology Infrastructure

TABLE J-5. EMHC Software Applications

Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. Overview of Technology at Eastern Maine HomeCare

The Information Services (IS) department supports many of the strategic priorities and centralizes the management of the technical infrastructure for of the EMHS. The IS strategic plan is a piece of the overall EMHS strategic plan. Prior to 2005 the organizations that comprised the health system maintained their own technical infrastructure and ap

Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. U.S. Department of Agriculture (USDA) Grant to Expand Telehealth

Hancock County HomeCare and Hospice received $50,000 in federal grant funds (USDA's Rural Utilities Service) to expand its telehealth program and with matching funds. The agency was able to purchase an additional 28 units.

Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. Transitional Care Project (No Longer Funded)

The Beacon grant helped in supporting a transitional care project providing telehealth for patients who were not homebound and did not qualify for home care. Currently there is no funding to sustain the transitional program for patients who do not qualify for home care. When patients do meet home health qualification (i.e., homebound, skilled nee

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