Long-term care's role in the HIT revolution

In the push for electronic records and patient-centered care, long-term and post-acute care (LTPAC) providers have to be part of the loop. That means understanding their roles as well as the costs and benefits of healthcare technology, according to a paper published at Perspectives in Health Information Management.

The issues aren't just about technology and funding, but also legal and policy, technical and business operations, and, significantly, governance.

LTPAC facilities need to work with providers and hospitals in their efforts to attest to Meaningful Use to be in a position for possible shared savings or other benefits. They will be more involved in Stage 2, with broader focus on transitions of care. There they might offer secure messaging and/or query capability for discharge planning, the authors say.

New care-delivery and reimbursement models, such as the Medicaid Long-Term Services and Supports program coming in 2014, will require integration of multiple data sources. That will require HIT capacity and the work force to effectively use the knowledge gained.

To be successful in this new environment, the authors advise:

  • Participating in state health information exchanges.
  • Assuring internal HIT capacity to obtain, retain, and use continuity of care documents.
  • Ensuring the board and staff understand the business and clinical value in using health IT.
  • Expanding patients' access to their own information and using technology to better engagement them in their own health.

A number of business decisions also will have to be made, such as whether HIT will be used a management tool, performance-reporting tool, or both; who will have access to internal and external data; and the question of whether the technology be based "in the cloud" or on-premise. Compliance with HIPAA and other federal and state laws have to be part of the effort.

Many questions remain, such as what the costs will be and how those costs will be paid, but the changing environment requires LTPAC to move forward, the authors say.

A commission created by Congress to plan for long-term healthcare needs recently issued its findings without agreeing on how to pay for it. Among its recommendations were eliminating Medicare's required three-day stay to obtain nursing home coverage, the position of a recent editorial in the Journal of the American Medical Association.

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