GAO: More planning needed to increase info exchange

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HHS lacks a vision for EHRs in post-acute care, a report says.
HHS lacks a vision for EHRs in post-acute care, a report says.

When patients leave the hospital and move to post-acute care settings such as skilled nursing facilities, electronic health records and the electronic exchange of patient health information can help better coordinate patient care and reduce costs.

Yet many post-acute care providers view EHR systems as too complicated and costly, which has led to slower EHR adoption in these settings, according to the Government Accountability Office.

The watchdog agency interviewed 20 stakeholders on the adoption of EHRs in post-acute care settings and found that cost was the top factor inhibiting use, along with a facility's ability to exchange EHR information. Facilities' financial resources often are limited to covering initial implementation costs. Stakeholders also noted that post-acute care settings did not receive federal incentives for meaningful use of EHRs aimed at acute-care hospitals and other providers, and without that, or a mandate to adopt EHR technology, “there is no business case for post-acute care providers to adopt EHR technology,” stakeholders told the GAO.

Varying implementation standards, workflow disruptions, technological challenges and difficulty in finding post-acute relevant health information among exchanged data were also listed as barriers to EHR use. A lack of staff expertise, coupled with high staff turnover, leads to a “constant need” to train staff, according to acute-care providers.

In its February report, the GAO also highlighted efforts by the Department of Health and Human Services to encourage EHR use in the post-acute sector. However, it points out that HHS has not measured the effectiveness of those efforts, and “lacks a comprehensive plan” to meet its goal of increasing EHR use and the electronic exchange of health information in post-acute care settings by 2017. The GAO recommended improved evaluation of these efforts and greater planning moving forward.