Tech Tactics for the Long-Term
With growing emphasis on postacute care, leaders are looking for solutions that enhance information exchange and patient safety.
This article first appeared in the January/February 2016 issue of HealthLeaders magazine.
Technology is driving a new wave of care coordination into long-term postacute care and home settings to enable improved outcomes at lower cost.
In July 2015, the Centers for Medicare & Medicaid Services published a proposed rule that incorporates encouragement for LTPAC facilities to adopt electronic health records, even though the meaningful use incentive payment program provided zero dollars for purchasing EHRs.
Many LTPACs are still using paper records at this point.
Despite such industry challenges, Dallas-based Tenet Healthcare—a for-profit organization that operates 87 general acute care hospitals, 20 short-stay surgical hospitals, and more than 425 outpatient centers in the United States—is already leveraging technology to speed care coordination between its facilities and LTPACs. From February to October 2014, Tenet's health information service provider (HISP) connected 350 LTPAC providers with 75 Tenet hospitals in 23 states, says Carol George, Tenet director of clinical integration.
Specifically, each LTPAC became incorporated into an online directory available to Tenet care managers from within Tenet's EHR software.
Using the Direct secure messaging protocol required in meaningful use stage 2–certified software, Tenet case managers have since sent thousands of care coordination messages to LTPACs, George says.
Prior to this initiative, such LTPACs had to receive these messages via phone or fax. "They didn't have what I would call the catcher's mitt," says Liz Johnson, chief information officer for acute care hospitals and applied clinical informatics at Tenet. "They didn't have a way for us to send something to a secure box that was managed by someone who had had their ID proofed. We made a decision as a company that the best thing we could do, given that there was no incentive on their side, was to begin to orchestrate Direct mailboxes for those entities."
Using Direct secure messaging is "much easier than printing from a chart and faxing things over," George says. "And if you get a busy signal on a fax machine, you've got to wait. It seemed so normal in healthcare for years."
Johnson explains, "What we hope is, by getting more complete information to the place of care, that the patients would be able to move in a more orchestrated or orderly fashion, and therefore their care wouldn't [for instance] repeat meds," Johnson says.