Post-acute care (PAC) leaders have raised concerns about the lack of interoperability between healthcare providers in the PAC setting. At a HIMSS23 listening session on long-term and post-acute care, leaders highlighted that patient information is not being shared electronically in many cases, despite the technology being available. While there is no statutory authority to mandate interoperability, efforts such as the Post-Acute Care Interoperability Project (PACIO) aim to advance interoperable health data exchange between PAC, other providers, and patients.
Interoperability is a critical issue in the post-acute care (PAC) setting. During a HIMSS23 listening session on long-term and post-acute care, a group of PAC leaders expressed their concerns to the Centers for Medicare and Medicaid Services. According to these leaders, sharing patient information from a hospital to a post-acute setting is not done electronically in many cases. The technology exists to allow systems to talk to each other, but implementation is not widespread due to cultural and technical reasons, as well as cost.
Susan Adams of LifeCare Services highlighted the disparity between the cost of some EHR systems and the cost of a phone call. Although the information is passed on in other ways, getting more in-depth patient assessments from the hospital would be beneficial to understand the individual’s health level and goals. However, the systems aren’t communicating with each other, according to Adams.
John Byer, the CEO of Cumulus, stated that patient assessments are included in the referral. This assessment may include information such as needed nutrition assistance. However, when home care comes in and does an in-depth assessment, more information is discovered that never made it into the referral. Byer suggests that there needs to be a more robust method of exchanging patient information to ensure all relevant data is available in the PAC setting.
While there is no statutory authority to mandate interoperability, a Post-Acute Care Interoperability Project (PACIO) is a collaborative effort to advance interoperable health data exchange between PAC and other providers and patients. The project aims to develop a standard set of interoperability requirements and protocols for PAC providers to follow.
Lorraine Wickiser, a nurse consultant for the Centers for Medicare and Medicaid Services, stated that about half of patients discharged from a hospital are discharged to post-acute care. This includes hospices, home health care, skilled nursing facilities, rehabs, and long-term hospitals. During the HIMSS23 listening session, it became apparent that no one is still using faxes to transfer patient information. Instead, a few are using paper and phone calls.
Robert Anthony, director of certification and testing at the Office of the National Coordinator for Health Information Technology, stated that people are using faxes less than they were ten years ago. However, interoperability is not where the ONC would like to see it. The ONC is working towards greater interoperability in the healthcare industry, including in the PAC setting.
Interoperability between healthcare providers is vital to ensuring that patients receive the best possible care. With half of the patients discharged from a hospital being discharged to PAC settings, there needs to be a standard set of interoperability requirements and protocols for PAC providers to follow. While technological solutions exist, cultural and technical reasons and costs are preventing their widespread implementation. The healthcare industry must work together to overcome these barriers and ensure that patient information is readily available to PAC providers.
