By Bill Chartnetski, EVP health system solutions and government affairs, PointClickCare.
For too long, long-term and post-acute care (LTPAC) facilities have not benefited from the same health IT investments or incentives as other care sectors.
Since the U.S. government introduced the meaningful use program as part of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009, LTPAC organizations – notably nursing homes – and the vulnerable patients they serve have been left behind. As a result, these provider types sit outside of current interoperability and health information exchange efforts, and have been slow to adopt electronic health records (EHRs) due to a lack of government incentive programs. In fact, recent data show that only 18% of skilled nursing facilities (SNFs) integrate patient health information electronically.
The lack of investment impairs the necessary exchange of health information, exacerbates care fragmentation and disables the ability to transmit a patient’s critical health and demographic data across the trajectory of care. Patients of LTPAC providers are more likely to have chronic health conditions or behavioral health needs.
The complex nature of their health history and requirements makes care coordination more difficult as they transition between settings. So, why are we depriving the providers that care for them of critical infrastructure investments, especially as other sectors have received similar investments and adoption incentives in recent years?
Long-term care facilities are suffering from long-existing shortcomings exacerbated by COVID-19. On a daily basis, they contend with staffing challenges, infection control, oversight and regulation. Yet they are resilient and unwavering in their commitment to care.
Technology presents enormous opportunities to alleviate these issues, namely staffing challenges and the burden of administrative tasks that often take them away from caring for patients. One study, for example, found that six months after implementation of an EHR, nurses were spending significantly more time engaging patients in their rooms with purposeful interactions and less time at a nurse station. Using health information technology to capture resident health information in real time can also substantially reduce staff fatigue, burnout and the burden of relying on short-term memory, while also improving patient safety by enhancing the accuracy of the patient information.
By B.J. Boyle, vice president and general manager of post-acute insights, PointClickCare.
B.J. Boyle
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.
