Efforts to bolster the exchange of information between skilled nursing facilities and hospitals are producing feeble results.
That’s according to a new study by University of Minnesota researchers, published Monday in the American Journal of Managed Care. Analyzing hospitalization records from nearly 5,500 patients, they noted that SNFs used such health information exchange only about 46% of the time when it was available. Only 29% of patients had their records accessed by SNFs in the three days following hospital discharge.
Part of the problem for hospitals is that there hasn’t been a lot of research done on what successful info exchange looks like between the two sides of the equation, said author Dori Cross, Ph.D., assistant professor in the school of public health. Sharing records is one thing she said, but there needs to be more follow-through on whether it’s useful to the post-acute partners.
“There hasn’t really been any guidance given to define and disseminate what useable, value-generating information exchange looks like in that context,” she told McKnight’s. “Health systems are trying, but they’re in some ways kind of throwing spaghetti at the wall.”
Cross and colleagues’ study looks to get more to the bottom of why providers might not be capitalizing on this data, through follow up interviews at the hospital and HIE-enabled SNFs. Hang-ups varied, according to the study, including lack of workflow integration, and staffing limitations on nights and weekends, when administrators and senior SNF staffers, the only ones with portal access rights, were not on duty. HIE access was also less likely for more complex patients, as measured by those with longer lengths of stay or a greater number of conditions.
To remedy some of those barriers and facilitate greater information sharing, Cross and colleagues urged for changes to HIE system design and information accessibility, alongside rearranging workflows in skilled nursing facilities.
“This could be facilitated by community-based hospital-SNF collaboration mechanisms and active policy efforts to promote care transition processes that more explicitly incorporate data elements specific to the needs of SNF providers,” authors concluded.
Cross also noted the exclusion of skilled nursing in meaningful use incentive programs as another wrinkle. Holly Harmon, associate VP of quality and clinical affairs, American Health Care Association, said skilled nursing providers are working hard to get on the same page as their hospital partners, despite this disparity.
“Sharing HIE is a challenge across all healthcare settings, not just between hospitals and SNFs,” she told McKnight’s Tuesday. “Nursing centers did not receive funding for electronic health records and, as a result, are often on a completely different system than a hospital. Despite being left out of government funding for this, centers have been working diligently to improve this challenge.”
Meanwhile, two new government rules, aimed at addressing information-sharing challenges between providers, have been delayed by the government shutdown, Bloomberg reported Tuesday. One would create incentives for electronic health records systems to communicate with one another, while the other would make it more difficult for hospitals to block requests for patient information.