GAO criticizes HHS plans to improve interoperability across the continuum of care

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A new GAO report highlights deficiencies within HHS and ONC to improve interoperability among post-acute care providers.

The Department of Health and Human Services has failed to measure efforts to improve patient information sharing among post-acute care providers and has no suitable plan in place to improve those efforts going forward, according to a government watchdog agency.

In a new report (PDF), the Government Accountability Office (GAO) criticized HHS and the Office of the National Coordinator for Health IT (ONC) for failing to identify ways that post-acute care providers—including long-term care hospitals, skilled nursing facilities, home health agencies and inpatient rehabilitation facilities—can access information from other providers.

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In a letter to five senators included with the report, the GAO noted that the transfer of patient information from acute care providers to post-acute providers “can help coordinate care, avoid duplication of test and procedures, and prevent medication and other errors.” The report highlighted five areas of concern associated with information exchange between the two provider groups:

  • Cost: Post-acute care providers generally don’t have the capital to invest in EHRs.
  • Implementation of standards: Stakeholders told GAO that inconsistent implementation of health data standards limits interoperability.
  • Workflow disruptions: Post-acute providers are reluctant to implement EHRs because it alters existing workflows and because data from pharmacies and labs are housed in disparate locations.
  • Technological challenges: Inadequate internet access and limited capabilities within existing EHR systems prevent information exchange.
  • Staffing: High turnover rates force post-acute care providers to constantly train new staff members on EHR systems.

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The GAO reviewed several ongoing federal programs to improve EHR interoperability, including financial support and EHR certification from the ONC, as well as the agency’s Shared Nationwide Interoperability Roadmap that aims to increase the number of post-acute providers engaging in electronic information sharing. However, the GAO said the agency lacks a “comprehensive plan with specific action steps” and fails to consider “external factors that could significantly affect EHR use and the electronic exchange of health information for post-acute care settings.”