Most PACE providers, 89%, are using an electronic health records (EHR) system, according to a recent LeadingAge CAST survey. More than half of respondents said they like their EHR’s functionality that is relevant to PACE operations, but more than 80% are challenged by interoperability issues, with 71% still missing PACE-specific functionalities.

These findings will help LeadingAge CAST understand how EHRs can best address PACE providers’ needs and expectations. Results of the PACE EHR Requirements Survey will help to improve EHRs and the way PACE providers document and coordinate care and services.

Results

Of the 38 respondents, 74% said they are in management. Most responding organizations are affiliated with a long-term care facility (34%), yet 32% are not affiliated with a sponsoring agency. Nearly 11% of responding organizations are affiliated with a hospital.

EHR adoption is high, with 89% of respondents using an EHR, and 9% saying they are not but that their organization is planning or considering implementing an EHR. Only 3% are not using one.

When asked what EHR system(s) their sponsoring agency is using, the top three responses were Epic, PointClickCare, and Netsmart. PointClickCare is a LeadingAge Gold Partner with CAST Focus, and Netsmart is a LeadingAge Bronze Partner with CAST Focus.

However, respondents said they are using a wide variety of PACE EHRs. TruChart/Mediture captured 38% of responses, 29% picked PACE Care Online, and 14% chose Epic. Additional write-in responses included NextGen, Cognify, PointClickCare, American Health Tech, MatrixCare, Netsmart, Eirene, and Greenway-Prime Suite.

When asked if they are generally satisfied with their EHR, respondents said they are neutral.

When presented with five answer options, respondents said they like these elements about their EHR:

• Available Functionality(ties) Relevant to any Aspect of PACE Operations (clinical, care/case management, support services, financial, etc.) – 57% of respondents
• Interoperability/ Integration with other Software/ Information Exchange Capabilities – 42%
• Built-In Alerts and Decision Support Tools – 24%
• Available Reporting/ Dashboards/ Data Analytics – 24%
• Ease of Use/ Usability/ User Interface – 14%

Write-in responses included liking one of the PACE EHR’s “flow of information upon admission/discharge such as immunizations and medication history, and appointments with specialists.” Another PACE EHR was liked because of “functionalities relevant to PACE’s multi-disciplinary teams, including social supportive services.”

Respondents disliked the following elements of their EHRs:

• Lack of Interoperability/ Integration with other Software/ Information Exchange Capabilities – 81%
• Missing Functionality(ties) Relevant to any Aspect of PACE Operations (clinical, care/case management, support services, financial, etc.) – 71%
• Ease of Use/ Usability/ User Interface – 62%
• Reporting/ Dashboards/ Data Analytics – 57%Missing R– 43%
• Built-In Alerts and Decision Support Tools-43%

Write-in responses included “having to document in two areas or two software systems or having view-only access” on interoperability; “lacking functionalities relevant to PACE’s social supportive services” on functionality; lacking, poor, or non-intuitive alerts; requiring a lot of customization and building custom forms, when it comes to user-friendliness; poor reporting capabilities, producing errors, and generating erroneous data.

Respondents personally use the EHR for reporting, data pulls, data analysis/review, financial, charting, and admissions.

If the EHR vendor community were to design a new PACE EHR system, these are PACE providers’ top must-have requirements:

• Reporting/ Dashboards/ Data Analytics (89% responded): Easy-to-use reporting capabilities for internal use and regulatory information reporting, the ability to create ad-hoc reports, automated reports that can be emailed from the EHR, and the ability to pull HPMS/CMS/DataPACE 2 and population health reports.

   

• Interoperability/ Integration with other Software/ Information Exchange Capabilities (84% responded): An information flow between clinical, in-home services, and financial; seamless integration or open API to integrate with different software systems; and the ability to share HPMS/CMS/DataPACE 2.

   

• Functionalities Relevant to any Aspect of PACE Operations (clinical, care/case management, support services, financial, etc.) (84% responded): A specific suite of templates to document assessments for each discipline, including activities and scheduling functionalities, service utilization, process monitoring; support for team-based care planning; and templates for Service Determination Requests (SDRs) and falls tracking.

   

• Ease of Use/ Usability/ User Interface (68% responded): Is easy to navigate and search for information and documents; supports collaborative team documentation; single entry of data that moves to other reports and assessments, care plan libraries; has the ability to format notes for including in required documentation; and is designed for clinicians, not IT specialists, with good understanding of their workflows.

   

• Built-In Alerts & Decision Support (68% responded): Shows task list by team member; has decision-support tools and alerts and due dates for each discipline, including default alerts for labs, vaccinations, and treatments; has a user-friendly template for tracking participant and care partner contact information; integrates easily with changing regulations; sends smart alerts triggered by other criteria in the chart (end-of-life program, fall risk, etc.); creates ad-hoc reports; and includes predictive modeling and alerting capabilities.