Why LTC providers need electronic health records

There are no financial incentives in the American Recovery and Reinvestment Act for providers of long-term and post-acute care (LTPAC) to adopt and implement a certified electronic health record (EHR) and meet the meaningful use criteria of the Department of Health and Human Services. Without these incentives, why should the LTPAC community commit its resources to adopt or upgrade an EHR system?

Adopting an EHR system can make healthcare more efficient for providers while improving the quality of care for patients. Information that is critical to patient care—from medical histories and care plans, to test results and prescribed medications—can be accessed much more quickly and has the potential to reduce the number of unnecessary interventions and hospital readmissions, and avoid medical error. At the same time, the rapid exchange of information can improve diagnosis and treatment decisions by providers and streamline transactions with payers.

The basic capabilities to assess in choosing an EHR system are functionality, interoperability and security. While each is important, interoperability among different systems is the key to preparing LTPAC providers for the evolution under way in healthcare.

Traditionally, healthcare was delivered through a system in which various needs were met in individual and isolated “silos.” We are moving away from this fragmented, uncoordinated approach. Today, the goal is an integrated seamless health delivery system that improves the quality of care, avoids duplicative tests and other interventions and enables physicians, hospitals and LTPAC providers to communicate with each other to coordinate patient care.

This will be particularly important to the growth and sustainability of long-term care providers moving forward. Upwards of 40 percent of all Medicare recipients require post-acute services, whether they be skilled nursing, home health, hospice or rehabilitation—and the number of patients requiring these services will grow as the population ages. If LTPAC providers expect to participate fully in the new healthcare paradigm, they need the capability to share patient information through interoperable EHRs to facilitate activities such as partnerships and programs with hospitals, accountable care organizations and health information exchanges.

There also is a strong incentive to adopt a certified EHR to ensure that it meets national standards for interoperability and security that will be compatible with other systems. Recently, the Certification Commission for Health Information Technology (CCHIT) developed the first EHR certification program tailored specifically to the LTPAC market. This CCHIT Certified program was created by a volunteer work group co-chaired at by the president of the National Association for the Support of Long-Term Care. The group represented a broad range of expertise, including representatives of the LTPAC community and other providers, clinicians, and HIT developers as well as other industry stakeholders and consumers.

The CCHIT LTPAC testing includes a rigorous inspection of integrated EHR functionality, interoperability and security. As part of the process, successful use is verified at live sites. It is designed to support the unique patient and business needs of long-term care organizations and exceeds the federal requirements for Office of the National Coordinator for Health Information Technology authorized certification. CCHIT’s LTPAC certification consists of a core certification applicable to all LTPAC systems with optional add-on certifications available for skilled nursing facilities and home health. The first group of certified LTPAC EHRs was recently announced.

While there are many EHRs on the market from which to choose, it’s important to be certain that we choose wisely by assessing the level of functionality, interoperability and security provided and that the systems we invest in are tested and certified against industry standards that will support the needs of our patients, both now and in the future.

Cynthia Morton is Executive Vice President of the National Association for the Support of Long-Term Care (NASL). Prior to joining NASL in 2010, Cynthia served as the Vice President for Political Affairs for the American Health Care Association/National Center for Assisted Living.

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