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With or without incentives, long-term and post-acute care needs EHR

For the past few years, long-term and post-acute care (LTPAC) organizations were forced to watch as other healthcare providers and hospitals receive billions of dollars in incentive payments as part of the Centers for Medicare & Medicaid Services (CMS) Electronic Health Record (EHR) Incentive Programs. But this has not stopped these organizations and collaborations from working to make EHRs, health information exchanges (HIEs), and other health information technology (IT) solutions significant features of their treatment of their unique patient population.
LTPAC is crucial to individuals, generally the elderly, who require assisted-living services or are recovering from a major health condition for which they received acute care. Considering the ever-expanding lifespan of the US population, the exclusion of LTPAC from meaningful use could be detrimental to ensuring that organizations specializing in this care are adequately prepared to meet the growing numbers and needs of their patients.
In order to avoid this scenario LTPAC Health IT Collaborative has been working to provide leadership and guidance through the publishing of its Health IT Road Map, which is now available in its fourth iteration. The 2012–2014 LTPAC Health IT Road Map demonstrates a commitment to make EHR and health IT a priority in LTPAC with or without the support of federal subsidies by keeping pace with innovations supported by the Health Information Technology for Economic and Clinical Health Act (HITECH) and other healthcare initiatives: “The LTPAC sector has a unique opportunity to use emerging cloud/social/local/mobile technologies to leverage and accelerate its unique person-centered competencies and mission to play an increasingly important role in our nation’s health and wellness.”
The roadmap identifies five areas that will be crucial to success over the next several years with EHR playing a major role in each:
1. Care coordination: Better communication between providers and hospitals will prevent errors from occurring, such as adverse reactions that result from medication errors, after patients are transferred. The collaborative recommends that LTPAC EHRs meet the standards, capabilities, and interoperability of other systems in other federal, state, and private programs. If providers of LTPAC choose EHR software that enables effective HIE, then they will be able to extend the continuum of care beyond organizations that are currently incentivized.
2. Quality and process improvement: Although LTPAC is currently not a part of the EHR Incentive Programs, this doesn’t preclude it from working to becoming eligible or participating in efforts to inform decision-making about electronic measures and standards put forth by the Office of the National Coordinator for Health Information Technology (ONC). LTPAC Health IT Collaborative suggests that “integrated, dynamic, longitudinal person-centric EHR” makes even ineligible meaningful use providers stakeholders in the process to avoid information silos and improve patient outcomes through quality measures.
3. Business imperative: The rise of accountable care organizations (ACOs) is just one sign of work to improve patient care and manage healthcare costs at the same time. Being able to partner with other groups to create ACOs or other strategic partnerships will not be feasible unless EHR systems can speak to each other, which involves LTPAC providers implement or upgrading certified and interoperable software.
4. Consumer-caregiver engagement: With LTPAC, the point of care depends on the needs of the patient. If patients and providers are unable to access health information and services outside the hospital, they won’t be able to manage their care effectively, which means being proactive in monitoring conditions. The roadmap identifies mobile health (mHealth) and patient communities as potential vehicles for extending care beyond hospital walls.
5. Workforce development: It’s not enough to have the technology; it’s necessary to have people trained in the skillful use of it. The collaborative advocates programs that focus more specifically on the health IT skills necessary for implementing and sustaining systems for meaningful use and more specifically LTPAC. Meaningful use as a general concept that requires specific applications suited to the needs of patients and their caregivers.
While the LTPAC Health IT Collaborative ultimately hopes to have LTPAC included in the EHR Incentive Programs, its efforts signal the need for ineligible healthcare providers and organizations to keep pace with their eligible counterparts not only to avoid penalties, which affect all providers, but also to provide their patients the best care possible. They owe it to themselves and to their patients. As life expectancy continues to increase, more and more patients will require care from more and more providers. If the latter cannot facilitate the smooth exchange of health information, then the former ultimately suffer.
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