HIT and risk management considerations for LTPAC providers

So far this year we have discussed the definition of long-term and post-acute care (LTPAC), how the stars are aligned for LTPAC health information technology and how we can all participate in the development of LTPAC HIT.

But one of the areas we have not discussed is also one of the most immediate: risk management. (This topic is fresh on my mind as I recently gave a webinar to SNF risk managers for the ECRI Institute in Philadelphia.)

The availability of a person-centric dynamic integrated electronic health record (EHR) that provides clinical trending brings into play new payor models, such as pay-for-performance and payment bundling. These new pay models also require payors to look closer at risk management. Traditional risk management analyzes the risk of taking a risk. We now have to also analyze the risk of not taking a risk.

This comes into play when we do not: expend funds to upgrade our internal HIT infrastructure, develop a facility electronic medical record, work with other LTPAC providers to develop EHRs for interconnectivity, or join either a health information exchange or a Beacon Community if one is in our geographical area.

And there are definite financial risks with a lack of referred patients when another LTPAC provider does have the HIT infrastructure to facilitate electronic interconnectivity with hospitals and physicians.

What can you do today to prepare for sharing risk with other providers?

1. The obvious is upgrading your facility HIT infrastructure—both clinical and financial applications.

2. Gain an understanding of the programs that the hospitals and physicians are participating in, especially the 30-day re-hospitalization program.

3. Meet with the hospitals and physicians that are referring patients to your facility and discuss with them how you can help them to meet their program obligations.

4. Form partnerships.

5. If there is a health information exchange, a Beacon Community or an accountable care organization in your geographical area, make an appointment to discuss their needs and how you can help. Today you might only be able to discuss a paper process, but you’ll be showing you are involved.

Remember, the business of providing care tomorrow will not be the same as today. This is not a revolution but an evolution, so you have time. Develop a clinical technology strategic plan and begin your implementation.

Keep an eye out for…

Here’s an update on what’s happening nationally: The Office of the National Coordinator for Health Information Technology is holding a roundtable of LTPAC thought leaders on May 3 to begin the work on the LTPAC white paper for presentation to the HHS Federal Advisory Committee on Policy and Standards. Larry Wolf of Kindred, who is on the Policy Committee, will be giving a presentation, and I will also give a presentation to the standards committee to educate the members.

Also, remember to register for the 8^th LTPAC HIT Summit, June 17-19. We’ve added a pre-meeting on the 17th that will provide attendees with an overview of the national scene. Find out more here.

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.