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Post-Acute Care EHR Adoption, Health Data Exchange Lags Behind

Black Book found that most post-acute care facilities lag far behind other care settings in EHR adoption and health data exchange.

EHR Adoption

Source: Thinkstock

By Kate Monica

- Inpatient post-acute care organizations lag significantly behind other healthcare settings in EHR adoption and health data exchange, according to a recent Black Book survey of long-term and post-acute care (LTPAC) providers.

Black Book surveyed 2,068 LTPAC providers from nursing homes, hospitals, short-term rehab facilities, skilled nursing facilities, and other care settings to gain insight into the state of EHR adoption, use, and data exchange in these environments. Respondents included CEOs, CIOs, executive directors, chief operating officers (COOs), and other leadership members of LTPAC facilities.

Only 19 percent of responding inpatient post-acute care providers reported having some EHR system technological capabilities operational in Q4 of 2017 — a 4-percent increase from 2016.

Post-acute care facilities part of corporate chains and large nonprofit systems reported a higher EHR adoption rate of nearly 34 percent, up from 27 percent last year.

Researchers attributed the slow, fragmented EHR adoption rates of different LTPAC providers to disparities in how much certain healthcare organizations intend to invest in technology. Many LTPAC providers plan to invest very little.

For example, survey findings indicated 91 percent of post-acute administrators had no budgeted funds for technology acquisitions or improvements in the 2017 calendar year. Inconsistencies in investments bar providers from joining together to work toward a data-driven healthcare system.

“All healthcare organizations must find better ways to manage the patient transition into post-acute processes and keep hospital readmissions in check, and that may fall completely on hospital systems at risk in 2018,” said Black Book Research Managing Partner Doug Brown. “That answer will require the expansion of technology capabilities to connect physician practices, home health agencies, hospices, outpatient settings, skilled nursing facilities, rehabilitation centers, DME firms, and hospitals.”

Rates of health data exchange in LTPAC facilities are similarly low. Eighty-six percent of responding long-term care administrators reported their facilities are not exchanging health data electronically with referring hospitals, physicians, or home health providers.

Furthermore, 72 percent of all post-acute care providers anticipate that the lack of health data exchange capabilities and interoperability among LTPAC facilities will persist as one of the most significant challenges for post-acute providers in the coming year.

“The enormous disconnect between the post-acute world and the rest of the continuum is not correcting as hoped,” said Brown. “Finding ways to improve communications between disparate acute care EHRs and post-acute technology is a pressing problem for detached providers.”

Survey findings also found the vast majority of long-term care facilities suffer from a lack of communication. In Q4 of 2017, 94 percent of care managers stated hospitals send their most complex patients with high morbidity rates to skilled nursing facilities (SNFs) without initiating any communication between the acute care provider and the receiving SNF.

This lack of communication could have a detrimental effect on care coordination. Fifty-five percent of surveyed SNF and long-term rehab care providers expect that problems with care coordination will become one of the most pressing issues facing post-acute care providers in 2018.

“Long term care facilities are still excluded from operating in a deeply connected care continuum due to limited resources and communication channels,” Brown stated. “The lack of communication is an extremely expensive problem, especially as hospitals become responsible financially for long term outcomes and preventable patient readmissions.”

Researchers expect that remote monitoring and video visits between patients and providers could temporarily allow hospitals to track patients after discharge until connectivity improves among post-acute care facilities.

Black Book also surveyed respondents about the top LTPAC health IT companies to gauge user satisfaction using 18 key performance indicators. Netsmart outperformed all competing health IT companies in 10 areas. NextGen, PointClickCare, Cerner Caretracker, AOD Software, and Matrixcare also scored well for user satisfaction.

While few LTPAC administrators budgeted for EHR system acquisitions or improvements in 2017, slightly more intend to budget for health IT purchases in the future. Twenty-two percent of all post-acute care providers reported intentions to allocate funding toward health IT acquisitions in 2018.

Despite the mostly low rate of health IT adoption in LTPAC facilities, 87 percent of large and corporate chain post-acute providers plan to prioritize technology investments next year.

LTPAC providers may have a long way to go before catching up to other care settings in health IT adoption and health data exchange, but most facilities are making slow progress. 

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