Cynthia Morton

The urgency and devastation around the COVID-19 pandemic have supplanted the very real concerns about the coming “Silver Tsunami’s” impact on our nation’s healthcare and long-term care industries. 

With today’s headlines now including phrases like the “new normal” and “learning to live with COVID,” we hope to refocus on the tsunami that’s nearing our shores.

The year 2030 marks the proverbial “run-up” of the silver tsunami, with an important demographic turning point in U.S. history, according to the U.S. Census Bureau. In less than seven years, baby boomers will be older than age 65. In less than a decade, ALL baby boomers will be older than age 65 and for the first time in U.S. history, seniors will outnumber children.

An aging population means our overburdened healthcare sector will see the most significant volume of elderly patients. If ignored, this impending natural and human-induced disaster will devastate healthcare — people will die if we don’t implement a “disaster recovery” ahead of the silver tsunami.

This situation requires a set of policies, tools and procedures which enable the recovery or continuation of vital technology that enables the communication necessary so that the level of care provided is not compromised.  

Is the healthcare industry prepared for an increased elderly population?

The vision for nationwide interoperability is one that improves care for all through effective data sharing. But so many healthcare providers are left out of that vision because the industry has made it prohibitively difficult to understand and to afford the path forward. 

We are constantly reading messages on how the next Star Wars-level precision medicine is right around the corner to save us all. In a perfect world, these innovations can take us to a new future of thriving healthcare for all. However, providers and other stakeholders in the healthcare community have not bought into it. Many post-acute providers are simply trying to keep the doors open and the lights on. 

Therasa Bell
Therasa Bell

We tend to focus on semantic and advanced interoperability, albeit critically important, but meanwhile we have 70% of transactions appearing on a paper fax machine. Somewhere in the middle, we’ve got something missing.

Post-acute providers will be much better prepared to meet the needs of the Silver Tsunami if they embrace interoperability. Financial incentives will likely not come for post-acute care even though the pandemic has shown us that our sector probably has the greatest need for interoperability.  

Therefore, we need to provide a strong business justification for providers to want to transition to a digitally enabled healthcare organization now. Because of the government’s role as the payor for the majority of post-acute care, our government partners should be in the trenches with us.  

Interoperability addresses the business needs of post-acute providers

Providers today operate such thin margins, and their house may feel like it is on fire. Responding to regulatory pressures, changes in reimbursement, increasing patient loads and pandemic challenges all while they are in the midst of a staffing shortage can feel like drinking from a firehose. 

We cannot ask providers to pay attention to some eight-syllable word (interoperability) that is still not widely understood and expect them to execute on it. Stakeholders need to educate the healthcare community in ways they understand and illuminate the business benefits that will help them care for rising patient loads. 

If I walked into the average provider’s office and said becoming more interoperable addresses all of their business issues and more, their ears would perk up. 

If your facility becomes digitally enabled and embraces electronic data sharing, you will be able to:

  • Do more with less staff because data can now be quickly reviewed and added to the patient record
  • Implement patient matching to automate the filing of patient information to their chart
  • Have visibility into the data and analytics needed to participate with ACOs, thus providing the opportunity for higher reimbursement
  • Eliminate the expense of paper and toner, as well as the time spent performing manual processes when sorting, scanning, attaching and shredding patient information
  • Improve performance ratings for your organization because you are now equipped with the knowledge about a patient upon arrival, rather than documents getting reconciled days after
  • Attract talent by using technology that fits today’s generational shift towards a millennial and Gen Z workforce that isn’t interested in fax, and more importantly, doesn’t even know how to use it 

Connectivity is the governor to interoperability

According to a recent KLAS survey, post-acute care interoperability is far behind the modest success of acute care and ambulatory settings. Therefore, is it safe to assume providers don’t care about the latest interoperability innovation when they are spewing over nine billion fax pages each year? I’m not so sure. In that same survey, post-acute providers make a simple request: “Help me connect.” 

Electronic communication is already ubiquitous, yet many don’t realize they have these capabilities already embedded into their electronic health record (EHR) system. We use a language of acronyms and tech talk that is foreign to some providers or rename the capabilities inside of their EHR, developing yet another barrier to communication outside their own four walls. 

We need to meet them where they are. People don’t care how they communicate; they just want it to happen. Let’s use the mobile phone as an example. Many don’t care how it works, what network they’re using, where it goes, or what wireless protocols are used. They just want to make sure they have it, it sticks and stays, and they can communicate. 

Surf the wave: Implement electronic data sharing with these simple steps

Providers need a simple, pragmatic way to share data that can help them keep the doors open for business and take care of our ever-increasing aging population. To close this gap in interoperability, here are five simple steps post-acute care providers can take now: 

  1. Find out what you have: Contact your EHR to understand what electronic communication capabilities are available. More specifically, find out if you have Direct Secure Messaging, an encrypted “email-like” message with attachments.
  2. Get a Direct address: You will not be able to receive messages until you have an address. Allow the information to show up in an inbox rather than your fax machine.
  3. Learn how to use Direct: Have your EHR account rep point you to a knowledge-based article or video on how to use Direct messaging. Ensure all personnel receive training and are clear about your goal to transition off of fax over to Direct.
  4. Publish your address: Be sure others can find your organization in the National Provider Directory by making sure your Direct address(es) are published. 
  5. Notify others in your community: Call or email the providers you exchange with the most to notify them that you’d like to transition away from fax to Direct Secure Messaging. Provide your Direct address and see if they know theirs.

Providers don’t need to take an all-or-nothing approach. Start with the largest concentration or highest volume. Fifty percent of a provider’s volume in post-acute may be with organizations who use a specific EHR, or 40% of their referrals may come from a single entity. Transitioning off of fax, over time, will bring tremendous relief to providers right now.

Cynthia Morton is a national expert on Medicaid, Medicare, and other public policy affecting the long-term and post-acute care sector. She serves as the Executive Vice President for the National Association for the Support of Long Term Care (NASL), where she advocates for her members’ interests in Congress and with the Administration. 

Therasa Bell is the Co-founder, President, and Chief Technology Officer at Kno2 (Boise). Combining her passion for healthcare and extensive technical expertise, Ms. Bell created Kno2 as market forces began to drive more effective, lighter-weight healthcare solutions.

The opinions expressed in McKnight’s Long-Term Care News guest submissions are the author’s and are not necessarily those of McKnight’s Long-Term Care News or its editors.