During the American Health Information Management Association's (AHIMA) Long-Term and Post-Acute Care (LTPAC) Health Information Technology (HIT) Summit, held June 7-8 in Baltimore, MD, industry leaders and representatives from a variety of organizations met to discuss the future of HIT in LTPAC settings.
Eric Dishman, director of health innovation and policy at Intel Corporation and the keynote speaker, kicked off the summit with a presentation on the shift away from long-term care facilities to home and community-based care in the near future.
This model of care is very different from the current model of institutionalized long-term care and will transform how providers deliver services and brand their organizations. During his presentation, Dishman outlined the major building blocks of community-based care systems, which are as follows:
- Care coordination
- Telehealth/e-care capabilities
- Social network/online communities
- Virtual call center capability
- Remote fleet management
- Service aggregation
- Broadband to community
- Volunteer training/management
Dishman believes that to successfully build community-based care systems, long-term care facilities will have to partner with other organizations, such as local businesses, physicians, dentists, and technology companies. In addition to partnerships, the community-based care model will also rely heavily on the use of electronic health records (EHR) and the interoperability of HIT systems, which were main focuses of discussions throughout the summit.
Although LTPAC providers were not included in the EHR adoption incentive program of the Health Information Technology for Economic and Clinical Health (HITECH) Act, speakers at the AHIMA summit emphasized the importance of EHR use by these providers. One reason for LTPAC providers to begin EHR adoption efforts is that incentive programs may eventually be expanded to include these providers.
As outlined in the LTPAC HIT Roadmap for 2010-2012, which was unveiled at the summit, the LTPAC Collaborative will be "advocating for full participation, consideration, and benefits for LTPAC providers in national, state, and regional HIT incentives, investments, and initiatives." In addition, the HITECH Act requires the secretary to conduct a study on whether incentive payments for EHR adoption should be available to other providers.
According to Jennie Harvell, M.ed., senior policy analyst in the Office of the Assistant Secretary for Planning and Evaluation at the Department of Health and Human Services, this study should be completed in October and delivered to Congress in December. LTPAC organizations that begin EHR adoption and implementation efforts now will be in better positions if and when incentive programs are expanded to include other providers.
Implementing EHRs is a step in the right direction, but providers will reach a stand-still if their HIT and EHR systems are not interoperable, meaning information cannot be exchanged with other providers. Currently, a major barrier to interoperability between LTPAC providers is the inability to compare information collected using the different assessment tools—nursing homes use the MDS, home health agencies use the Outcome and Assessment Information Set (OASIS), and inpatient rehabilitation facilities (IRF) use the patient assessment instrument (PAI).
CMS is in the process of exploring one solution to this problem with the Post-Acute Care Payment Reform Demonstration (PAC-PRD), which makes use of the Continuity, Assessment, Record, and Evaluation (CARE) instrument.
The CARE instrument is an assessment tool that can be used by SNFs, home health agencies, and IRFs, instead of their respective assessment instruments. During the summit, Shannon Flood, technical project officer for PAC-PRD in CMS' Office of Research Development and Information, informed attendees that CMS is finished with the data collection phase of the demonstration and is currently doing analysis. "We plan to submit recommendations for payment reform next year, but will need congressional authority to then move forward," Flood said.
When asked if the CARE tool could be tied to payment bundling projects in the future, Flood responded, "Maybe. The long-term goal would be to combine the MDS, OASIS, and the PAI into one. But we really are at a pre-policy decision point."
Although a wide variety of technology-related topics were covered during AHIMA's LTPAC HIT Summit, the overall message was clear: healthcare is becoming more and more reliant on technology and LTPAC providers must adapt to the changing industry if they want to remain valuable players in the field.
MacKenzie Kimball is an associate editor in the long-term care market at HCPro. She writes PPS Alert for Long-term Care and manages MDSCentral.