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.
Interoperability, as it was envisioned, should be built on transparency and connectivity, allowing a patient’s critical health information to be easily accessible, regardless of where treatment is being administered. By creating an infrastructure that supports the sharing of patient data along the care continuum, hospitals, skilled nursing facilities (SNF) and long-term post-acute care (LTPAC) facilities can offer the best care possible. As a result, organizations that participate in interoperability best practices are positioned to become preferred providers.
Unfortunately, interoperability is still a work in progress for many organizations. While more than 95 percent of hospitals and 90 percent of office-based physicians are now utilizing electronic health record (EHR) platforms, many struggle with — or have reservations around — sharing information outside of their facility. As such, silos represent a great barrier to realizing a fully implemented state of interoperability.
The current data gap can drastically impact care. For example, a patient experiences a serious medical incident — such as a fall or stroke — and arrives at the hospital where staff may not have access to existing patient data which could inform the best delivery of care. Or perhaps they’re able to access that data, but not right away. Care is now delayed, which can be additionally concerning depending on the time-sensitivity of the patient’s condition.
Taking this example a step further, let’s explore what happens after care at the hospital has concluded. The patient requires rehabilitation, and a continuation of care document (CCD) is issued to a post-acute care facility. From there, the patient’s information is transferred by less-than-foolproof methods such as fax, for example. A glitch as simple as a jammed paper feed could prevent critical information from reaching the appropriate caregiver.
As value-based care and payment-care models are moving toward the forefront, blind handoffs of patient information are no longer viable, as they drastically increase the financial risks hospitals and payer groups are subject to — not to mention the clear detriment the system has on delivery of care.
Closing the gap
The larger question is how does the industry get from Point A to Point B? The easy answer is to liberate the data through a cloud-based infrastructure that supports an efficient, easy-to-access data exchange between all caregivers. An integrated solution would connect stakeholders across the care continuum, providing accurate insights when needed, eliminating data silos between care partners, and enabling more confident decision-making.
These systems would promote:
Optimized transitions: Data needs to travel with the patient — or before movement — discretely across all systems.
Patient visibility: Data should reflect the most current ADT information, identifying and sharing where a patient is and from where they’ve been discharged.
Central view of LTPAC patients: This facility-agnostic feature should offer automated updates of a patient’s functional progress.
Ongoing status and monitoring: Maintaining continued care is facilitated through alerts and notifications to caregivers regarding any change to their status or well-being and meaningful feedback on care pathway progress.
Facility performance: Beyond understanding a patient’s status, it’s also helpful to understand how facilities in and out of their PPN have performed.
The concept of interoperability, in some ways, seems contradictory to traditional best practices. Healthcare organizations are charged with protecting patient data at all costs, and the idea of sharing data in a way that opens access to a wider group of stakeholders could give pause. Regulatory infractions for data loss in the healthcare industry can be steep, and the number of well-publicized data breaches in recent years reinforces how valuable health records are to both the organizations who keep them and those who try to steal them.
So, it should go without saying that an EHR “superhighway” must be developed with security in its DNA, taking stringent regulatory requirements into account. The good news is that the newest breed of information exchange platforms is being built with security roles in mind, drastically reducing the possibility of data loss.