I never imagined the way my care team — the doctors, the hospital,
my rehab center, the home care agency — how they all communicate with each
other so they can give me better care. All this technology made the impossible
possible.
Recent studies have shown that good communication
among members of a care team can improve care coordination and ease transitions
of care for older adults.
That certainly was the case for Alma
Jones.
Alma is a fictional 83-year-old great-grandmother and the
central character in CAST’s High-Tech Aging
video. The video shows how Alma stays healthy and independent after a stroke by
staying connected with her health care providers from the comfort of her own
home.
Alma’s care team begins providing her with coordinated care
from the moment she collapses suddenly in the kitchen of her apartment. By the
time she arrives at the hospital, Alma’s doctors and nurses already have access
to her entire electronic medical record.
That information — about
Alma’s medical conditions, medications and allergies — help caregivers pinpoint
the right treatment for her stroke. According to her hospitalist, this exchange
of health information “probably saved her life.”
I’ll be exploring
health information exchange in this 9th installment of our 12-part series on the
technologies that appear in the High-Tech Aging video.
What is
Health Information Exchange?
Think of health information technology as a
network that stores and manages patient data. Authorized users can access this
information at any time while caring for an older adult. In the best scenario,
this information is shared across organizational and provider boundaries.
Sharing a person’s health information among multiple providers can be
challenging, according to a recent Report to
Congress on aging services technologies written by CAST and NORC at the
University of Chicago. This is especially true in the case of older adults who
typically:
- Have a large number of providers.
- Make frequent
use of the health care system. - Are prone to changes in their health
care status. - Often move from one care setting to another.
Consider the typical path of older adults with congestive heart failure. They
may see a hospitalist during an acute-health episode. Their care shifts to a
home health agency after hospital discharge. A primary care physician may take
over the case after their condition stabilizes.
That’s 3 sets of care
providers in 3 different locations who all need access to the same set of
personal health information. Providing that access results in what we call
“health information exchange.”
Electronic Health Records: The Backbone
of Health Information Exchange
The exchange of Alma’s health information
doesn’t happen automatically.
First, Alma’s caregivers must all have
robust HIT systems that include electronic health records (EHR).
Most important, those systems must be interoperable. This means that the
technology implemented by team members in different settings must be able to
“speak the same language.”
If EHRs are interoperable, the
information they contain can be shared directly with other care providers in a
“point-to-point” approach. That information can also be shared through a
regional or state-level health information exchange organization.
These
organizations allow health data collected at doctors’ offices and other
locations to be transferred seamlessly among various technologies and care
settings, including long-term and post-acute care settings.
Searching
for Interoperability
Interoperability makes it possible for 2 disparate
EHR systems to exchange data. Unfortunately, not every EHR product you buy will
work seamlessly with another provider’s product.
Fortunately, there
are ways to make sure that your EHR product gives you the features you need and
also provides the highest level of interoperability currently available in the
marketplace.
The newly updated CAST
whitepaper on EHR planning and vendor selection offers a host of tips for
achieving these goals.
In addition, the CAST
EHR Selection Matrix and the online CAST EHR
Selection Tool will help you select an EHR that meets interoperability
standards and supports desired health information exchange modalities.
These resources also will help you determine if the product you’re
considering is certified for interoperability by one of the bodies that certify
EHR products.
Finally, CAST’s 2013
EHR case studies highlight examples of the impacts experienced by providers
who implemented interoperable EHRs and exchanged health information with other
providers.