Survey of State Health Information Exchanges Regarding Inclusion of Continuity of Care Documents for Long-Term Post-Acute Care (LTPAC) Patient Assessment
October 28, 2014
Objectives: This study aimed to measure awareness and interest among state health information exchanges (HIEs) in a tool that translates long-term post-acute care (LTPAC) patient assessment information to a Continuity of Care Document (CCD) format for sharing; whether any state HIEs currently integrate patient information from LTPAC providers; and the anticipated benefits and barriers to using such a tool. Materials and Methods: The study consisted of an online survey of state HIEs. Results: Responses were received from representatives of 29 of the 51 HIEs (57 percent). Eleven of the 29 respondents (38 percent) were aware of the LTPAC-to-CCD translation tool, and 24 (83 percent of respondents) were interested in it or felt LTPAC providers in their state would be interested. Twenty-one of the 24 interested respondents (88 percent) indicated a desire for more information about this technology. Discussion: Skilled nursing facilities and home health agencies receive no incentives for adoption of electronic health record systems and are not commonly included in HIEs. These organizations do, however collect extensive structured data about their patients (Minimum Data Set for nursing facilities, Outcome and Assessment Information Set for home health agencies) and transmit the data electronically to the Centers for Medicare and Medicaid Services (CMS). A tool is now available that will intercept the transmissions to CMS, transform content extracted from patient assessments into CCDs, and send the CCDs to a designated HIE. Conclusion: Responding HIEs reported almost no experience exchanging patient assessment information from LTPAC providers. Anticipated benefits include safer care transitions; anticipated barriers include information technology constraints in LTPAC settings.