Electronic Health Reporter

By B.J. Boyle, vice president and general manager of post-acute insights, PointClickCare.

In my last post, I discussed how our healthcare system is approaching a critical time in which the looming “silver tsunami” will drive baby boomers into hospitals and post acute care facilities in record numbers. Similarly, we will see dramatically increased patient transfers between care facilities, as an aging population moves between hospitals, skilled nursing facilities and senior living facilities in unprecedented numbers. At the same time, a seamless and accurate patient data transfer process is critical, given our current and predicted future nursing shortage, and the time-consuming and error-ridden nature of manual data transfers.

In order to determine if our system is optimized to deliver what is needed, PointClickCare recently conducted a Patient Transition Study in partnership with Definitive Healthcare, which found that alarmingly, many facilities haven’t yet fully embraced all of the possibilities of integrated electronic health record (EHR) platforms and are, instead, still relying on manual-based processes to handle patient transfers.

Respondents to the survey, which included c-suite executives from acute and post-acute care facilities, explained their current data sharing policies, interoperability issues, as well as other care delivery and coordination concerns in this important blinded voice-of-customer quantitative study. The data shows that while EHRs are nearly ubiquitous in hospitals and skilled nursing facilities, many healthcare professionals still struggle with — or have reservations about — sharing critical patient information with their care partners.

Instead of relying on secure, simple, HIPAA-certified technology to streamline patient transitions, providers have been utilizing manual processes like phone calls and faxes — systems that require a human touch and are prone to inefficiencies, mismatched details, and omissions.

The Over-Reliance on Manual Processes = Inefficiency 

As patients move from acute-care facilities to LTPACs, the sharing of critical patient information and associated data safely and securely is extremely important for coordinating care. But despite best efforts and intentions, many providers still aren’t sharing all patient data and information.

The most startling findings from the survey dive into the number of acute care and LTPAC facilities that still use manual-only strategies to coordinate patient care. In fact, thirty-six percent of acute care providers use manual-only strategies to coordinate patient transitions with the LTPAC community, compared with only 7 percent of LTPACs with acute care providers. Although a majority (84 percent) of LTPACs use a mix of digital and manual strategies to manage processes, only 56 percent of acute care providers do.

One respondent to the survey, a CEO of an LTPAC facility, explained that their local hospital “uses faxes to accommodate HIPAA and [to] be confidential.” He (or she) found this particularly frustrating as it creates more work and slows down care delivery: “Almost everything we touch is obtuse. You have to search it out, figure it out, and confirm it by phone,” adding that the absence of standardized forms and data-entry fields makes faxes especially inefficient.

“Sending a patient to a facility that doesn’t have a good intake process is a reflection on us,” said one hospital CIO.

In cases in which patients are readmitted to a hospital, the manual information transfer is done in reverse, forcing staff to redo work that could easily have been shared by the LTPAC electronically. In other words, emergency department personnel are again forced to rely on paper, phones, or faxes instead of complete information about care provided at the post-acute care facility and the reasons for the transfer.

One respondent admitted care coordination and follow-up are “done manually and by phone with copies of the patient chart.” And another, the CMO of one hospital, admitted that “the routine is (patients) leave with an envelope full of their chart, and we don’t have shared EHRs.”

In an age when advanced EHR technology makes information sharing effortless, patient outcomes are being needlessly impacted by these manual processes that can slow down or even halt care delivery altogether.

Lack of Information Between Facilities is Negatively Affecting Patient Care  

Not only is the over-reliance on manual process to coordinate patient care and share data inefficient for clinical staff, it’s leading to a dearth of important information that can negatively impact patients and providers.

Acute-care providers share “very little” (7%) or “some” (35%) patient data with their post-acute care partners, and only 16% of acute-care providers report sharing “all” patient data, according to the survey.

Most acute-care providers share only the most critical data points: 98% share only medication information while 89% share demographic and diagnostic data.

Many important elements that can be critical to providing the highest level of care are still missing, such as measurements and observations, advanced care planning information, and location and patient status information. This lack of patient information brings mistakes that can greatly affect care. One survey respondent recalled that a patient’s transfer out of the hospital was held up until the next day because the post-acute care transfer team sent the wrong type of wheelchair multiple times. Even after the correct transfer equipment arrived, the receiving facility had none of the patient’s information and had to subject the patient to the entire registration process again from scratch.

Not only does this lack of information negatively impact patient care and morale, it affects providers, too. Hours of valuable time are all-too-often spent on manual processes, chasing down missing information and redoing paperwork.

How Can Technology Help?

Introducing interoperable solutions is vital to many of the issues outlined in the study, but an astonishingly small number of facilities have adopted them effectively. According to the survey, only two percent of acute care and LTPAC providers are using IT-only strategies to coordinate patient care and transfer data.

We know that technology can streamline processes, expedite patient transfers, and cut costs — and respondents agree. One noted that introducing an interoperable EHR solution would help the bottom line: “All of a sudden, you have a financial implication. Transfer of data would certainly help in streamlining the referral to the discharge facility. No question,” they said.

Not only could it help improve operating costs, but would also positively affect patient care and boost morale as staff enjoy more confidence in providing optimal care on a consistent basis with trackable results.

“With better communication between the facilities, we would cut back on readmission and sending patients back to the ER and any sort of miscommunication,” said one hospital executive.

The path forward is clear indeed: it’s time to embrace digital means of transferring patient data in both directions for the benefit of patients, providers, staff, and families alike.