On April 6, I was impatiently awaiting the release of an important new report from the National Academies of Science, Engineering, and Medicine (NASEM) on improving nursing home quality, The National Imperative to Improve Nursing Home Quality: Honoring Our Commitment to Residents, Families, and Staff (2022). I was eager to see what recommendations the Committee that led the study had to say. After all, it is the first comprehensive study of the challenges facing nursing homes in the United States in 35 years!

“This report is a piercing wake-up call for policymakers,” said LeadingAge CEO Katie Smith Sloan in a recent press statement. “Decades of underfunding have left America’s nursing home system in desperate need of an overhaul. As our nation grows rapidly older, millions of older Americans will need safe, high-quality care. It’s time to act to ensure they can access and afford the vital care nursing homes provide.”

As you know, the Biden Administration has recently announced a focus on overhauling the country’s nursing home system, and LeadingAge is meeting with federal leaders to share members’ experience. LeadingAge is calling for a three-pronged, all-of-government approach to nursing home improvement that

• addresses the urgent staffing crisis,
• funds quality care, and
• applies evidence-based quality improvement and measurement.

I know for sure that with appropriate technology, funding, and support, health information technology can significantly help in all of these areas, and I was thrilled to see “Adopt health information technology in all nursing homes” is one of the goals outlined by the report.

The report’s recommendations focused on electronic health records (EHR) interoperability, certification criteria, adoption incentives, workforce training, and evaluation studies.

Report’s Health IT Recommendations

To support Goal 7, “adopt health information technology in all nursing homes,” the report presents the following recommendations:

Recommendation 7A: The Office of the National Coordinator (ONC) and CMS should identify a pathway to provide financial incentives to nursing homes for [interoperability] certified EHR adoption that supports health information exchanges to enhance person-centered longitudinal care. These incentives should be modeled on the HITECH incentives provided to eligible hospitals and professionals.

• ONC should ensure that the nursing home program complements the Promoting Interoperability Program; and
• ONC should develop appropriate nursing home EHR certification criteria that promote adoption of health information exchange of important clinical data (e.g., admission, discharge, and transfer data).

For Short-Term Implementation

Recommendation 7B: In order to measure and report on HIT adoption and interoperability in nursing homes, HHS should:

• Develop measures for HIT adoption and interoperability, consistent with other health care organizations;
• Measure levels of HIT adoption and interoperability on an annual basis and report results in Care Compare; and
• Measure and report nursing home staff, resident, and family perceptions of HIT usability

For Short-Term Implementation (Initiation of Research and Grants) and Long-Term Implementation

Recommendation 7C: CMS and HRSA should provide financial support for the development and ongoing implementation of workforce training, emphasizing core HIT competencies for nursing home leadership and staff, such as clinical decision support, telehealth, integration of clinical processes, interoperability, and knowledge management in patient care.

For Short-Term Implementation (Initiation of Research and Grants)

Recommendation 7D: ONC and AHRQ should fund rigorous evaluation studies to explore:

• the use of HIT to improve nursing home resident outcomes;
• disparities in HIT adoption and use across nursing homes;
• innovative HIT applications for resident care; and
• the assessment of clinician, resident, and family perceptions of HIT usability

For Short-Term Implementation (Initiation of Research and Grants)

Be sure to read the full report for detailed information.

Sounds Familiar?

Surely these recommendations do sound familiar, right? In fact, LeadingAge and CAST have advocated for improving the state of Health IT in Nursing Homes and beyond for a very long time (you can see it in CAST’s Technology Policy Priorities and the Technology Focus of LeadingAge’s 2022 Policy Platform).

However, I must stress that the lack of interoperability and the negative consequences it has on care quality, and the needs for interoperability verification/ certification, training the workforce on health IT, and financial incentives are not limited to nursing homes! It reverberates throughout the whole long-term and post-acute care (LTPAC) sector. In fact, a recent survey I have conducted with Program of All-Inclusive Care for the Elderly (PACE) providers recently revealed that EHR interoperability is a major concern for PACE providers.

Just last month, I led a session at our Leadership Summit to inform our members about our latest advocacy efforts on the health IT incentives front, and to appeal for them to join our campaign to bring interoperability and health information exchange to LTPAC.  Our advocacy effort not only aligns nicely with this report’s health IT recommendations, but also includes our suggestions to avoid pitfalls of the HITECH Act.

If you’re interested in hearing more about the NASEM report and its health IT recommendations, I would encourage you to attend the upcoming Virtual Collaborative Care Tech Summit, June 7-8, 2022, to hear from Gregory Alexander, PhD, RN, FAAN, FACMI, FIAHSI, Helen Young CUPHSONAA Professor, Columbia University, School of Nursing, one of the report’s authors and a member of the LTPAC Health IT Collaborative.

The session, to be held Tuesday, June 7, 2:15 – 3:00 p.m., will discuss Efficiencies Gained from Using Health IT Correctly!

Attendees will:

• Hear about the role of correctly implemented health IT solutions in reducing clinicians’ burdens, burn-out, and time spent on documentation.
• Explore case studies showing how providers are using health IT to reduce staff’s burdens, drive efficiencies, and improve outcomes.
• Discuss a myriad of the key success factors for maximizing the efficiencies of health IT.

Be sure to join us—register today!

I firmly believe that this issue is well-overdue, and that the time to fix it is now! I hope you can join us in supporting turning these recommendations into action for not only nursing homes, but all LTPAC providers that provide health care services to older adults, who deserve better care, better outcomes, and better access to their health information.

As always, if you can help, have any suggestions, or if I can be of assistance in any way, please do not hesitate to contact me.