As skilled nursing anticipates an uptick in hospital referrals — and the possibility of more Medicare-covered stays — a new survey finds that those without robust information exchange capabilities could be driving away critical business.

Among acute-care providers, 78% said they would leave a current post-acute partner in favor of one with greater electronic data access. Just 14% said they were satisfied with their SNF providers’ current ability to receive electronic referrals.

The worse news for skilled care providers? Home care operators have ramped up their electronic information exchange capabilities over the last year and claim to have more of what health systems say they want.

Those findings come from a Porter Research survey released last week. The firm quizzed 100 health systems and 300 skilled nursing providers about their data-sharing needs and abilities. 

The survey found that only 12% of nursing home referrals are currently sent through electronic data feeds. But a whopping 94% of acute-care providers say that’s a top factor in where they send discharged patients.

“The pandemic has made it even more important to referring providers that their post-acute counterparts have advanced capabilities for exchanging patient demographic data, clinical information and documentation,” survey authors said. “A SNF’s ability to communicate with its referral sources seamlessly, bi-directionally, using machine-readable data, and in real-time, is making a significant difference in which SNFs get patient referrals.” 

Among 300 home-based care organizations also included in the survey, 85% said they can accept admission, discharge and transfer feeds — up from 34% last year. That increased capability is concurrent with home care’s gains in post-acute care referrals during the COVID-19 crisis.

“Home health providers have tapped into the opportunity created by COVID,” said Majd Alwan, Ph.D., senior vice president of technology and business strategy for LeadingAge, and executive director of its Center for Aging Services Technologies. “But ultimately, many of the capabilities are there (for skilled nursing), and we are making progress regardless of the setting.”

Alwan pointed out that home health has traditionally shown more willingness to adopt digital technology, possibly because of the remote nature of the work.

But other large studies show a higher proportion of partner data sharing among SNFs than the new, relatively small survey. In the 2020 LeadingAge Ziegeler LZ 200 report, 51% of participants reported an ability to electronically exchange data with partners. Those figures represent the nation’s 200 largest not-for-profit senior living organizations, which include some nursing home providers.

Competing priorities

Alwan acknowledged that referral capabilities within that group were probably lower. He also said that not all providers take advantage of the capabilities they have.

Many SNF respondents told Porter Research they still rely on electronic faxes (28%), phone calls (24%) or paper faxes (23%) for referrals.

“Post-acute providers are focused on patient care as their top priority; however, their reliance on manual processes ultimately takes focus away from those patients and … hinders their ability to effectively compete for referrals,” said Steve Pacicco, CEO and president of MatrixCare, which commissioned the survey.

While Pacicco said gaps in referral data-sharing can be filled with the right EHR solutions, Alwan added that one EHR may not fit all partners. Subscribing to a local Health Information Exchange network provides a “one-to-many” way to communicate and share data with multiple partners in a given region, he noted.

Alwan also mentioned the availability of interoperability frameworks, such as Carequality, that support health information exchange between and among multi-platform networks, providers and EHR and HIE vendors.

The federal government has been working for years on a Trusted Exchange Framework that will allow all providers to share information, regardless of software platform. So for now, providers must find a way to pay for whatever high-tech ways they share data.

“However, because of competing priorities, limited investment dollars and the uncertainty of the long-term effects of the pandemic, they face challenges in making significant headway toward reaching more mature states of interoperability,” the survey found.