Since 2005, a group of associations known as the Long Term and Post Acute Care (LTPAC) Health Information Technology Collaborative (the Collaborative) have hosted the annual LTPAC Health IT Summit to discuss and advance health IT issues for long LTPAC providers. Following the Summit, the Collaborative publishes a Road Map that identifies the progress made in the past years and formalizes the priorities for the next 24 months. The recently published Road Map details the areas LTPAC providers should focus their IT efforts for 2012 through 2014.
A unifying theme of the 2012-2014 Road Map is for LTPAC providers to take a proactive approach to their IT development. Providers must no longer remain reactive to changes in technology, only implementing systems in response to changes in government reimbursement and compliance regulations. Instead, providers must experiment with various business and service models and partnerships that allow growth as revenues are disrupted.
The Collaborative has identified five priority areas for action in this Road Map: 1) Care Coordination; 2) Quality; 3) Business Imperative; 4) Consumer Centered; and 5) Workforce Acceleration.
Current LTPAC IT systems have very limited, if any, coordination between the facility and other providers, such as physicians or hospitals. Care coordination involves activities to promote, improve, and assess integration and consistency of care across all levels of providers throughout an episode of care and during transitions. Care coordination is enhanced through the expedited flow of patient information, which reduces duplication and omissions of care services. Additionally, care coordination can reduce errors and lead to cost savings. According to the Joint Commission, almost half of all hospital-related medication errors, and 20% of all adverse drug reactions, are attributable to poor care coordination during transitions of care.
The Collaborative highlighted three key care coordination priorities for LTPAC providers:
- Leverage health IT to improve care coordination within and across all provider settings.
- Promote the inclusion of LTPAC in national and regional care coordination related health information exchanges (HIE), standards, and certification initiatives.
- Educate the LTPAC community about best practices for HIE and health IT enabled care coordination.
Quality and Process Improvement
LTPAC providers must leverage technology to support transparent, acceptable delivery, measurement, and improvement of quality of care, services, and outcomes as experienced by consumers within and across care settings. Providers must have a goal to improve the quality of care and quality of life for people receiving LTPAC services by fostering person and caregiver centered, harmonized quality measurement, and improvement throughout the spectrum of care.
The Collaborative argues that to activate the ultimate national objective of an integrated electronic health record (EHR), all providers must be included in health IT initiatives. Emerging models such as accountable care organizations (ACOs) and bundled payments will require comprehensive longitudinal care processes.
The Collaborative identified key priorities for providers, vendors, and associations:
- Include LTPAC providers and vendors in developing electronic measures suitable for accountable care, meaningful use, and reducing hospitalizations.
- Focus on longitudinal person-centric quality outcome processes and measurement in chronic and co-morbidity care.
- Assist eligible hospitals and physicians with meeting meaningful use in care involving PTPAC settings, particularly during transitions of care.
- Develop and include Quality of Life electronic measures.
- Harmonize quality measures across the spectrum, leveraging existing processes to reduce administrative burdens.
Health IT can be a key enabler to providing LTPAC services efficiently, cost-effectively, and in coordination with other providers. This makes health IT a business imperative for care providers and aligns with national goals to improve care, population health, and reduce health care costs through the use of health IT.
The Collaborative found the following key priorities to encourage LTPAC providers to adopt health IT and demonstrate it can:
- Streamline processes, increase efficiencies, and reduce operating costs.
- Enable new business models, including integrated/coordinated care models.
- Exchange electronic health information across care settings to support care coordination during shared care and transitions of care.
- Achieve transparent quality outcomes and reduce readmission rates and costs to payers and strategic partners.
LTPAC settings have been rapidly evolving their care delivery to take greater account of person-centered services, and to support consumer engagement and choice through culture change movements. LTPAC providers must accelerate person-centered culture change across any beyond LTPAC settings and services to empower and support consumer and care-giver well-being, engagement, and choice. Emerging technologies, including personal health and wellness records, tele-health and tele-monitoring, smart-home, and customer relationship management (CRM) technologies are allowing LTPAC providers to craft new services built around consumer preference and need.
Increasingly, LTPAC providers may be able to exercise leadership by coordinating consumer engagement with person and wellness centered solutions across the health care spectrum.
The Collaborative identified the following key priorities for consumer and caregiver engagement:
- Identify and disseminate case studies that demonstrate LTPAC culture change and wellness initiatives empowered and accelerated by technology.
- Explore business and service models and strategies to scale LTPAC-led longitudinal coordinated care models, such as the Program of All-Inclusive Care for the Elderly (PACE).
- Develop practices for integrating care (EHR) and hospitality (CRM) systems, while preserving privacy and security, to support person-centered services.
- Promote adoption and support of consumer access to health and wellness information and service portals by LTPAC providers.
- Promote consumer and caregiver activation and engagement in use of health, wellness, and compliance monitoring technologies for improved self-management.
A substantial barrier to IT adoption in LTPAC settings is workforce education. The development of a workforce possessing the skills necessary to implement and effectively use health IT and other technologies is the foundation to advancing technology adoption. Research has demonstrated that, even in fully implemented systems, typically only 30% of the systems’ capabilities are utilized due to lack of workforce training. As the LTPAC industry adopts newer technologies, it is imperative for providers to have leadership and trained staff with advanced technological skills to fully implement and use systems effectively.
The Collaborative identified the following key priorities for workplace acceleration:
- Promote provider awareness of the need for and engagement/employment of trained health IT professionals.
- Promote LTPAC specific technology training.
- Identify and evaluate the costs and benefits of LTPAC certification or credentials that recognize health IT expertise.
- Advocate for the incorporation of LTPAC in broader health IT training and curriculum development initiatives.