WASHINGTON, DC — Long-term care has a deadline of 2030 for electronic interoperability — the process of exchanging healthcare information with other providers — but the goal still remains elusive for many facilities.
Experts — who are also impassioned advocates — discussed the sector’s health information technology (HIT) obstacles as well as efforts underway to improve the situation during a popular session at the LeadingAge Leadership Summit here earlier this week.
Most pivotal HIT legislation to this point has left out long-term care, explained Tara McMullen, co-chair of quality improvement and measurement for the Moving Forward Coalition, which comprises providers, staff, residents, policymakers, advocates and others. The coalition aims to advance a cohesive set of nursing home quality improvement initiatives in policy and practice.
“What the federal government will tell you is that nursing homes have just largely been left out of federal policies that support HIT adoption, that support incentives around it, all the facts that surround it,” McMullen said in an interview with McKnight’s following the presentation.
Legislative setbacks for LTC
McMullen cited the Health Information Technology for Economic and Clinical Health (HITECH) Act and the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) as examples of legislation that failed to include long-term post-acute care providers. (By contrast, the Improving Medicare Post-Acute Care Transformation Act of 2014 presented an opportunity to support data exchange and interoperability for long-term care and fill a legislative gap left by other laws, she noted.)
In part, thanks to legislative omissions, the HIT statistics for long-term care look grim, she and others pointed out. Only 84% of nursing homes have adopted HIT, and a whopping 60% lack the ability to share data with healthcare providers, recent reports reveal. The Centers for Medicare & Medicaid Services, however, has committed to transitioning to value-based arrangements by 2030. And this goal will require significant electronic health record data collection and interoperability, McMullen and others explained.
Moving Forward Coalition’s plans
The Moving Forward Coalition is determined to change the IT landscape for long-term care providers well before 2030, speakers said. It currently is creating action plans and will start engaging nursing home residents, staff, advocates and the public in July.
The key is educating nursing homes and helping them move to the next level, said Alice Bonner, chair of the coalition. The HIT committee is “scanning the literature, scanning the reports from major national organizations and state-based organizations to figure out what is already out there,” she told McKnight’s. “Are there health information exchanges that are doing some of this? Are there states that have put state money into this? So [the idea is] looking at the landscape, seeing what has been done and learning from those programs that have been successful, and then figuring out, if there’s a nursing home or state that’s not doing those things — how do they get from where they are now to the future state where they do have interoperability?”
Of particular importance to the coalition is incorporating residents’ desires into research. The group believes strongly in asking residents about their goals, priorities and preferences and using that data to create questions for residents upon admission.
“It could be a way of using technology in a really positive way,” Bonner noted. “That would help nursing homes to get the data, document the data, get it into the care plan and get it into the actual care delivery. So that’s a more specific approach that the committee is taking very seriously.”
