Guest Columns

I was a HIMSS Virgin (#HIMSSnewbie)

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Steven Littlehale
Steven Littlehale

Yes, this was my first time. I was nervous and did not know what to expect. Let me start with a confession: Five years ago, I didn't even know what HIMSS (Healthcare Information and Management Systems Society) was.

As a clinician with a deep understanding of post-acute care, data and analytics, this organization seemed more about information technology (IT) and less about my passions. WRONG! And that's really the point here. Read on!

According to its website, “HIMSS is a global, cause-based, not-for-profit organization focused on better health through information technology (IT). HIMSS leads efforts to optimize health engagements and care outcomes using information technology.”

Yet long-term post-acute care (LTPAC) is just now emerging as a presence at the annual HIMSS conference. This year, sessions were added to exclusively address the challenges and opportunities faced by LTPAC providers. Much like I was new to HIMSS, the society itself is new-ish to LTPAC.

The Health Information Technology for Economic and Clinical Health Act (HITECH Act — February 2009) was designed to improve the US health care delivery system through the adoption and use of health information technology. The federal government allotted $19.2 billion to promote the adoption and meaningful use of interoperable health information technology and electronic health records (EHRs), but excluded LTPAC from these incentives.

One year and one month later, the Affordable Care Act (ACA) brought attention to LTPAC and the importance of interoperability to reduce rehospitalization and costs. The very next year, LTPAC had a seat at the table. Now some would say we weren't at the table, we were the dinner. But I say that we now have a seat, and we were just brought in via the back door.

Some impressions from my first time at HIMSS: LTPAC has a meaningful presence at HIMSS; we were small but mighty! There were opportunities to connect with LTPAC colleagues and learn how folks are making Hosp/PAC relationships work in ways that reduce cost, improve quality and lead to happier patients.

I presented two sessions on how we developed several acute/post-acute collaboratives that improve outcomes, while leveraging the abundance of standard and reliable LTPAC data. One of these presentations was with Idriz Limaj, the COO for post-acute services at Levindale Hebrew Geriatric Center, a LifeBridge Health holding. He envisioned a better performing LTPAC network; together LifeBridge and PointRight achieved that through the use of common, standard and operational metrics.

The value of available standard and reliable LTPAC clinical data is significant, and something that differentiates LTPAC providers their acute-care counterparts. The primacy of MDS and OASIS data is indisputable; your acute-care partners are largely unaware that it exists and instead use unreliable and very dated claims information.

There were lots of new and amazing bits of technology, some with amazing value to patient care, and others with little to none But it was exciting, and at times intimidating, to see the possibilities of technology.

However, payment and regulatory policies are barriers to adoption and must catch up and stay current in order to leverage the benefits of these new technologies. The adoption has been much slower than anticipated due to Medicare keeping a tight lid on what it reimburses, however there is change afoot!

Other challenges we face were validated in the HIMSS annual Workforce and Leadership Survey, which reported that the biggest impediment to the future was that LTPAC providers don't really have a true IT role / or defined “healthcare IT executives” on staff.

In fact, almost one-third of LTPAC providers reported that they didn't have an IT executive and 13% reported not employing full time IT staff.

For LTPAC providers to secure a place at the table (and be brought in via the back door), we must support the development of our IT professionals, including the development of clinical informatics within our organizations.

Last insight: Virgin or not, 40,000-ish people and miles and miles of walking leave you hoarse and with sore feet!

Steven Littlehale is a gerontological clinical nurse specialist, and executive vice president and chief clinical officer at PointRight Inc.

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