EHR Adoption in LTPAC Trails Other Health Settings

CAST | December 20, 2017 | by Donna Childress

Use of electronic health records (EHRs) and health data exchange is 19%, with some LeadingAge members leading adoption.

Adoption of electronic health records (EHRs) and health data exchange among inpatient post-acute providers is tracking far behind other health care settings: Only 19% exchanged data in the fourth quarter of 2017, according to a recent Black Book survey of long-term and post-acute care (LTPAC) providers.
 
The survey found that adoption rates among corporate chains and large nonprofit systems were the highest among network post-acute care facilities and climbing, from 27% to 34% in the past year. EHR adoption among inpatient post-acute care providers increased only slightly (4%) during the same time.
 
EHR Intelligence reported the findings, which represent 2,068 providers of long-term and post-acute care—nursing homes, hospitals, short-term rehabilitation facilities, home health services, durable medical equipment/DME distributors, skilled nursing and sub-acute facilities, and hospices.

Study Echoes CAST Findings

The findings align with a survey conducted earlier this year, when LeadingAge CAST and LeadingAge Gold Partner with CAST Focus Ziegler asked members of the LeadingAge Ziegler 150, the largest nonprofit senior living systems in the United States, to classify the sophistication of members’ current EHRs using CAST’s 7-Stage EHR Adoption Model. Those survey findings revealed that larger LTPAC nonprofit organizations are leading their smaller peers in EHR adoption and EHR sophistication, advanced functionalities, and health information exchange capabilities.
 
Other recent studies by outside parties found that a majority (64%) of skilled nursing facilities (SNFs) used an EHR in 2016 and that critical-access hospitals are falling behind other hospitals in their use of advanced EHR functions.

Technology Investment Varies

The patchwork of adoption rates reflects differences in technology investment and conflicting cultural priorities, according to the study. For example, 91% of post-acute administrators said they had no budget for technology acquisitions or improvements in 2017. The differing investment levels prevent providers from working together on data-driven health care. Several findings lead to this conclusion.
 
Analytics: Only 3% of inpatient long-term care providers had data-driven analytics to lower the cost of care, reduce unnecessary hospital readmissions, and ensure facilities are properly reimbursed.
 
Interoperability: Among long-term care facilities, 86% are not exchanging health information electronically with referring hospitals, physicians, or home health providers. Of those who share some records with acute care providers, 95% are networked in closed silo health system EHRs.
 
Care Coordination: Among long-term care organizations, 82% are struggling to account for care, receive proper reimbursement, manage eligibility, prove medical necessity, and institute strong reimbursement. In addition, 94% of care managers reported that hospitals send their most complex patients with the highest morbidity to SNFs with virtually no communication channels between the SNF and the acute provider.
 
“The lack of communication is an extremely expensive problem, especially as hospitals become responsible financially for long-term outcomes and preventable patient readmissions,” said Doug Brown, Managing Partner of Black Book Research.
 
Black Book predicts that remote monitoring and video visits will be used temporarily to allow hospitals to track patients after discharge, until post-acute care facilities can afford the needed technology.

Top Performing Post-Acute Care Technology Vendors

The report highlighted several LeadingAge members that are leading EHR and health data exchange adoption. LeadingAge CAST Supporter Netsmart outperformed competitor EHRs in 10 of 18 key performance indicators in the user satisfaction survey.
 
Scoring among the next tier of highly rated vendors were LeadingAge Gold Partner with CAST Focus PointClickCare and LeadingAge Silver Partner with CAST Focus MatrixCare.