Technology reaches further into long-term and post-acute care policy

So far, 2013 has been an exciting year for long-term/post-acute care health information technology (LTPAC HIT), and I’d like to update you on the many federal and state HIT activities that will influence how you care for your residents. Like many issues in healthcare, these activities are works in progress.

I have been a member of the Federal Advisory Committee on HIT Standards and Office of the National Coordinator (ONC) since it was formed in 2009. I am also on three appointed workgroups: Implementation of Meaningful Use, Clinical Quality, and a new 2013 workgroup—Patient engagement. With the work of the S&I Framework Longitudinal Care Committee, we are making major advances in getting LTPAC involved in Meaningful Use Stage 3. We are building our case for including LTPAC on a volunteer basis in Stage 3 for a number of completed projects as well as one Federal Register Request for comments due April 22. In aggregate, the reports below on these projects will provide you with an up-to-date status of LTPAC with ONC:

• June 2012 The LTPAC HIT Collaborative published its third version of their roadmap—2012–2015 LTPAC HIT Roadmap: This roadmap will provide you with priority areas we are currently working on for 2012 and 2013. It is in harmony with the ONC Strategic Plan.
• July 20, 2012 Long-Term and Post-Acute Care (LTPAC Roundtable Summary Report of Findings):This report is a summary of an LTPAC Thought Leader meeting that was held in May 2012. The report establishes the strategic areas to be worked on in possibly meeting Meaningful Use Stage 3.
• March 15, 2013 Health IT in Long-Term and Post-Acute Care Issue Brief: This ONC brief highlights promising ways in which LTPAC providers are using health IT and information exchange to support care coordination, remote monitoring and quality improvement. It also gives a comprehensive overview of health IT-enabled care transformation opportunities for LTPAC providers under the Affordable Care Act. Finally, it offers some practical suggestions and resources for providers as they consider opportunities and adopt health IT and exchange information to improve care delivery and population health while reducing costs.
• March 21, 2013 Improving Transitions of Care in LTPAC: An Update from the Theme 2 Challenge Grant Awardees– ONC & Bill Russell, MD, of the LTPAC HIT Collaborative: In 2011 challenge grants were given to LTPAC organizations in Massachussetts, Maryland, Colorado and Oklahoma to work on transitions of care. These four programs will set the stage for more programs and products that will improve transitions of care between LTPAC and hospitals.
• March 27, 2013 Standards Committee meeting: Presentation on the S&I Longitudinal Care Committee: This presentation was a great success. It set the stage for follow-up meetings on the transitions of care and the development of the longitudinal care record, which is very important to LTPAC providers and IT vendors.

ONC has two programs where you can participate in forming policy and regulations on the HITECH Act:

• A Request For Comments (RFC) ONC Policy listed in the Federal Register March 7, 2013[comments due April 22, 2013]: HHS seeks input on a series of potential policy and programmatic changes to accelerate electronic health information exchange across providers, as well as new ideas that would be both effective and feasible to implement. To further accelerate and advance interoperability and health information exchange beyond what is currently being done through ONC programs and the EHR Incentive Program, HHS is considering a number of policy levers using existing authorities and programs. The LTPAC HIT Collaborative, Home Care Technology Association of America (HCTAA), NASL, NCPDP, LeadingAge, and AHCA are developing comments. Individuals can submit comments personally or through an association.
• ONC Update to its Strategic Plan: ONC desires public input to update the Federal Health IT Strategic Plan. This plan outlines goals and strategies for the nationwide shift to electronic health records and information exchange, and for the creation and spread of new health information technologies. On this site, you can learn about these issues and be part of the public discussion that will shape the new plan. In the current version of the ONC Strategic Plan the objective of working closer with LTPAC was suggested. We are hoping more definitive programs will be in the new edition.

ONC, within its authorized limitations, is working very hard to include LTPAC. ONC cannot directly do anything about reimbursement for upgrading our HIT infrastructure, but it can sponsor grants and programs. The March 15 Issue Brief and the RFC include requests for help in providing funds to LTPAC. This is very important in this world of new care and payment models.

Many other associations also met last quarter to discuss technology and LTPAC:

• National Quality Forum Health Information Technology Advisory Committee (HITAC) met in February. One of the big topics was the status of the Measure Applications Partnership (MAP) report. All should read this report because this group has a LTPAC section and is the beginning of the harmonizing of electronic quality measures across the spectrum of care.
• The strategic team of the National Association of Home and Hospice Care (NAHC) and the Home Care Technology Association of America (HCTAA) met on developing their strategic plan in providing care at home. HCTAA’s membership includes home and hospice IT vendors.
• The National Association in Support of LTC (NASL) held meetings for its IT vendor and therapy committees.
• The Health Information Management Systems Society (HIMSS) annual convention drew 35,000 members, primarily acute-care providers and information system vendors. It was again obvious that there is a lack of understanding by the acute healthcare sector of the role of LTPAC in health information exchanges and in the new care and payment models.

LTPAC is moving from the back burner of strategy to the front burner. This means that all involved in LTPAC have to become more aware of what is happening and to become more involved—not only involved in your own operations and care, but also in the programs and policies of the HITECH Act and where you will fit within your care demographics.

I also want to remind you of the 9th Annual LTPAC HIT Summit in Baltimore June 18-19, 2013. This looks to be the best summit yet and will provide the opportunity to see what is happening in our sector of care and to hear the top policy HIT influencers. Go to the LTPAC HIT Collaborative website to register.

John Derr

John Derr, RPh, currently serves as Health Information Technology Strategy consultant to Golden Living, where he previously served as CIO and CTO. He is currently on the HHS Federal Advisory Committee on Standards, a CCHIT Trustee, and serves on several other federal and state HIT advisory groups. His extensive career has included major executive positions with Squibb, Siemens, Tenet (NME) and AHCA/NCAL. With almost 50 years of experience in healthcare, Derr has also started four companies.