I’ve been reading and writing so much about the long-term healthcare industry lately that I may have forgotten I write for Healthcare Informatics and not our sister publication, Long-Term Living.
But perhaps my inclination to write about the long-term care market—and its growing need for health IT—is because others have ignored the industry. According to a January 2014 report from the California Healthcare Foundation and Bluepath Health, a Calif.-based consulting firm, “HITECH [the Health Information Technology for Economic and Clinical Health Act] ignored most critical skilled nursing and interim care facilities, resulting in an enormous disconnect between the acute site and rehabilitative care. This disconnect may prove to be a significant barrier in achieving new payment models that rely on providing seamless care transitions.”
HITECH, of course, focused on the hospital and physician practice side—as such, EHR adoption has been boosted to approximately 80 percent of doctors in the U.S. Comparatively speaking, according to a National Center for Health Statistics data brief released in September 2013 that relied on the 2010 National Survey of Residential Care Facilities, just 17 percent of the nation's assisted-living and other residential care communities use electronic health records (EHRs).
If you have read my two recent articles on the long-term care market—one on how the industry has begun to embrace technology, and the other on how health IT has specifically helped one assisted living facility—you probably have seen these statistics in one form or another. To me, they’re pretty telling numbers, especially when you consider the rising acuity in these communities.
It seems fairly apparent at this point that the need for new technology in this market is there. But can the supply meet the demand? The Ontario, Canada-based PointClickCare, a cloud-based software provider for long-term care, is one vendor that has been recognized by KLAS as the top-rated software vendor for meeting the fundamental needs of senior care providers. PointClickCare is the EHR of choice at American Baptist Homes of the West (ABHOW), a Pleasanton, Ca.-based provider of senior housing and care, where the EHR platform streamlines workflow and improves documentation, leading to improved care, according to the organization.
PointClickCare is one example of a relatively new but good and aggressive IT company that seems to be putting some of the “legacy” long-term care IT vendors to shame. According to a 2013 report from the LeadingAge Center for Aging Services Technologies (CAST), “The market is highly volatile: vendors come and go, merge and get acquired, and fail to respond to surveys or regulatory changes. Many claim that they have an EHR when by most definitions they do not.” Of course, vendors come and go and merge in ambulatory and inpatient settings as well, but with less backing from the government, vendor/caregiver relationships in the long-term care market are probably murkier.
To that end, on the policy side, federal policymakers, including the Office of the National Coordinator for Health IT (ONC), are beginning to understand the important role that long term post-acute care settings can play in care transitions. ONC recently published an issue brief about health IT in this environment, in addition to awarding challenge grants to help four states promote long term post-acute care health information exchange (HIE) initiatives for transitions of care. However, despite this, providers in this industry are not eligible for meaningful use dollars.
Additionally, Majd Alwan, Ph.D., senior vice president of technology at LeadingAge, a Washington, D.C.-based nonprofit organization for institutions that serve the aging population, said in an interview last year that LeadingAge hopes Congress expands the meaningful use program to include long-term and post-acute care facilities.
Although it is just my opinion that the long-term care market has been neglected for the most part when it comes to IT, it is a fact that assisted living communities are caring for residents with more complex healthcare needs than just a few years ago—most adults aged more than 65 years (80 percent) have one chronic condition, and 50 percent have two or more, notes the Centers for Disease Control and Prevention. Again, more evidence of the need to move away from paper-based processes.