Post-acute care providers are facing an uphill battle when it comes to value-based care, and it is largely due to their IT infrastructure.
A recent survey from Black Book Market Research of over 2,000 long-term and post-acute care facilities revealed that one of the biggest issues facing these organizations is an inability to share healthcare information. Only 14 percent of long-term care administrators stated that their facilities exchange health information electronically with acute providers.
The research found a number of reasons for this including differing technology investment levels and conflicting cultural priorities. It is a trend that is unlikely to change soon since 91 percent of post-acute care administrators stated their organization did not allocate funds for technology adoption or improvements in 2017.
“Most post-acute providers don’t have the payment structure to support investing in IT or updating their existing infrastructure,” said Saqib Akhter, CEO of Post Acute Analytics, a company that helps health systems and providers monitor their patients in real time outside their four walls.
“They don’t have large IT teams. They certainly don’t have interface teams to put interfaces in place. And one of the reasons for that is post-acute reimbursement doesn’t enable the investment.”
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Yet the fact remains that post-acute providers play an invaluable role in the healthcare continuum. Still, these organizations are struggling with the necessities of value-based reimbursements, such as participating in accountable care.
Health systems, ACOs, managed care plans, and bundled payment participants whose patients are utilizing post-acute care still have the responsibility for ensuring compliance, communication, and performance analysis. Given the issues with many post-acute IT infrastructures, getting data from the organizations is not easy.
“In an ideal world, all post-acute electronic medical records (EMRs) would have interoperability standards, so they would work on a standard to exchange data with other systems. That standard being HL7 and one of the most common methodologies is ADT,” said Akhter.
“However, the truth of the matter is – that while many post-acute EMRs will, on paper, have HL7 and ADT capabilities – the number of post-acute providers that have it implemented, can afford it, and/or have the complexities of it worked out are less than 10 percent.”
This puts many organizations in a bind. The ideal solution is an automated patient monitoring and analytics tool, but many companies try to shoehorn in a solution that isn’t an ideal fit, which can actually lead to increased complexities, like manual data collection.
“While a lot of remote-monitoring and analytic companies claim that they can connect the continuum of care, they do that by requiring post-acute providers to send them HL7 and ADT. This leads to the majority of implementations not being successful because post-acute providers just can’t do it. So then a lot of technology companies tell post-acute providers to manually enter patient information, which is just a disaster. Manually typing in patient names is very labor intensive and, more importantly, prone to human error,” said Akhter.
Remote monitoring solutions that attempt to acquire data simply using HL7 and ADT capabilities will only be successful with the 10 percent or so of post-acute providers that can handle those requirements. In addition, simply expecting that the majority of these organizations are going to meet these expectations in the near future is unlikely.
What is required is a solution that is scalable across all post-acute providers, including large corporate chains and small, independent organizations, regardless of their existing IT capabilities.
The majority of post-acute providers are recording information electronically in EMRs and, those that are not using EMRs, are recording information electronically in instruments such as the MDS and OASIS. So, the industry needs the ability to extract data directly from the EMR, MDS, and OASIS without making additional requests or placing workload burdens, such as interfaces, on post-acute providers.
“That is exactly the integration that Post Acute Analytics has built,” said Akhter.
“We can integrate without HL7 and ADT because we have built direct integration with the majority of post-acute EMR systems. To be truly successful in a scalable way and pull information out of the vast variety of different systems, we need to be able to do it without making large IT requests of providers because they are already constrained with too many requirements.
“It’s not an easy technological feat because there are so many variables. Businesses have different EMRs, they can have different versions of EMRs, they can have the same EMRs but it is self-hosted or they can have it in the cloud. Different factors generate a bunch of different variables and to account for that is very difficult.
“But Post Acute Analytics understands this difficulty, and we know what has to be achieved in order to be successful in bringing real-time patient monitoring and data transparency to fruition.”