Integration Challenges in the Post-Acute Care Environment

Integration Challenges in the Post-Acute Care Environment

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Getting with IT

Technology Challenges in the Long-term and Post-Acute Care Industries:
While larger health organizations and physician practices continue to integrate healthcare information technology into their operations, the long-term post-acute care (LTPAC) industry has been slow to adopt for many reasons. With the increased need for LTPAC services due to the aging population and prevalence of acute conditions such as diabetes, cancer and other chronic illnesses, these providers must begin actively engaging in the health information exchange to continue to deliver seamless, quality patient care.

Addressing the Need:
Due to the complexity of their condition, patients with an acute condition or chronic illness often travel back and forth between a LTPAC facility and an institution. Without electronic data to guide decision-making at the point-of-care, both the institution and the LTPAC provider don’t have the accurate information they need to treat and diagnose these often life-threatening illnesses. LTPAC facilities today currently face:

  • Manual, Paper-based process: Most LTPAC facilities have same fundamental processes, and still rely on typing, faxing and other inefficient, paper-based methods to input records and information.
  • Outdated paperwork: Today’s LTPAC providers have overly depended on (often outdated) paperwork to guide decision-making, and may be reluctant to change.
  • Data in multiple locations: Patient data exists at multiple institutional locations and regions, making it hard to find up-to-date records for accurate patient diagnosis and care.
  • Digital divide: LTPAC facilities currently have little means to exchange standardized clinical information with care partners such as primary care physicians, labs, pharmacies and hospitals to enhance the quality and outcome of care.
  • Prescription delays: Because most LTPAC providers don’t have an in-house pharmacy, they must currently order based on patient needs, rather than on site, which results in delays to the patient for much-needed prescriptions.
  • Increased hospital readmissions and complications: Without access to at-risk patient health information, LTPAC providers are missing valuable data that can help with clinical decision-making. This leads to increased ER visits, hospital readmission, and complications, further increasing overall healthcare and operational costs.

Why the Slow Adoption Rate?
Despite the opportunities to change, and the potential improvements and efficiencies, LTPAC providers have been slow to integrate electronic health systems. Some of the reasons behind this include:

  • Lower rates of technology use: Historically, LTPAC facilities have been slow to adopt electronic systems, and prefer to remain on the tried-and true, paper-based system.
  • Operate on lower budget: With most TTPAC providers reimbursed by Medicare/Medicaid for services, most of them have little funding for IT initiatives.
  • Multiple IT solution options: With providers are offering a wealth of attractive IT solutions for the LTPAC facility, including privately and publicly funded programs, but facilities struggle deciding how to choose the one that is the right long-term fit.
  • New systems aren’t compatible: Even with new solutions aimed at moving LTPAC facilities to electronic data, formats aren’t compatible with the hospital system’s formatting, so often the information doesn’t exchange well even when implemented.
  • Little incentive: LTPAC facilities often don’t want to spend the time to make electronic data work because there is no current financial incentive to change. These facilities currently do not currently qualify for Medicare and Medicaid EHR Incentive programs. However, this is changing with federal programs offering new payment policies and readmission penalties.
  • Training and turnover: With a high turnover rate in the LTPAC industry, facilities often have trouble keeping leaders and staff trained and updated on all of the latest software and systems upon adoption.

A System for Success:
While LTPAC providers are far from full-scale integration of health IT and interoperability, they can begin to incorporate it in stages, whether implementing a custom solution from scratch or integrating a new solution into an existing application. Working with an IT solution provider, LTPAC facilities can begin with an overall assessment, workflow analysis and documentation of current systems. This will help them to discover a solution that best fits the workflow needs of their facility, in order to enhance and improve existing systems.

Help is on the Way:
With reform on the way and larger organizations leading the efforts, technology integration within the LTPAC setting can help improve transitions and improve care management. With a complete, electronic account of the patient’s history, LTPAC providers will be able to understand the full picture of their patient’s health and coordinate care appropriately. While we may be years away from this achievement, with increased training and funding, LTPAC providers will show greater health IT adoption and eventual interoperability with the rest of the healthcare industry.