While long-term care and post-acute care facilities are not officially eligible to take part in the “meaningful use” EHR Incentive Program, many facilities are still closely watching the quality measures and health IT standards called for in the program. Others are actually working on implementing certified health IT systems and voluntarily meeting the meaningful use measures as a way to be more patient-centric as well as prepare for future government incentive programs, according to John Derr, R.Ph, a strategic clinical technology consultant with Golden Living, LLC. Derr is also a member of the Office of the National Coordinator for Health IT’s (ONC) Consumer/Patient Engagement Power Team, a subgroup that works to ensure the health IT certification standards are created with healthcare patients—and long term care facilities—in mind.
In order for healthcare to be truly patient-centric, as called for in the Centers for Medicare and Medicaid Services’(CMS) EHR Incentive Program, all aspects of healthcare, including long term care and post acute care (LTPAC), need to implement certified health IT and follow measures that give patients the ability to manage their health information, Derr said.
“The HITECH Act, the basic legislation, said we have to have a patient-centric, integrated electronic health record based on the certification standards,” Derr said. “Most of our talk in the three years (of meaningful use program development) has been on episodic care and not on longitudinal care, which is really what patient-centric medicine should be.”
In order to be truly longitudinal and patient-centric, health IT development needs to extend beyond the physician office and hospital and into LTPAC facilities, Derr contends.
ONC has taken notice, and in July released a report recognizing the LTPAC community’s health IT concerns and needs. The LTPAC Roundtable Report, based off a roundtable discussion between ONC leaders, software vendors, and LTPAC executives, highlighted areas of the meaningful use program that the LTPAC community felt discouraged their voluntary participation.
Current federal law doesn’t authorize CMS to extend EHR incentives to LTPAC providers, and it would take an act of Congress to change the American Recovery and Reinvestment Act of 2009 that created the program. However, the ONC discussion was meant to ensure future meaningful use measures and standards didn’t discourage LTPAC from participating, and in the least keeps their interests in mind so they can help transform healthcare.
For example, stage 2 meaningful use criteria requires hospitals and eligible professionals to send care summaries along with patients during a transition of care—such as moving from a hospital to a long-term care facility. But the roundtable participants said the information included in those care summaries is not sufficient for LTPAC facilities to develop adequate care plans. For stage 3 of the meaningful use program, currently under development, the report recommended that a broad range of data elements used by LTPAC facilities be required in the care summaries.
Some LTPAC facilities are adhering to the meaningful use program as a way to get their systems ready for future initiatives they can take part in—such for pay-for-performance initiatives that would require the reporting of clinical quality measures.
During the roundtable, participants said the development of a patient-centered and longitudinal care plan should be an immediate priority for ONC and the meaningful use program.
“If you don’t include (LTPAC) you can’t really be patient-centric,” Derr said. “We need more interconnectivity throughout the whole spectrum of care. Continue down the line with the end focus a person-centric, electronic longitudinal health record.”