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Black Book Research: Post-Acute Providers Sorely Lacking HIT Capabilities

November 14, 2017
by Rajiv Leventhal
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According to a recent survey, just 19 percent of inpatient post-acute providers have some technological capabilities of EHRs (electronic health records) operational, though that number has increased in the last year.

For the latest research, Black Book surveyed more than 2,000 providers of long-term and post-acute care (nursing homes, hospitals, short-term rehabilitation facilities, home health services, durable medical equipment/DME distributors, skilled nursing and sub-acute facilities, and hospices) to help industry stakeholders identify strategic responses to address the higher growth/demand for post-acute services in the challenging environment of lower fee-for-service reimbursements and impending valued-based payment models from all payers.

Related to EHR adoption, inpatient post-acute providers, overall, responded that 19 percent have some technological capabilities of EHRs operational in Q4 2017, as compared to 15 percent in 2016. Corporate chains and large nonprofit systems reported the highest adoption rates among network post-acute care facilities, nearing 34 percent as compared to 27 percent in 2016.

According to Black Book researchers, “The slow adoption rate and fragmented health IT environments are attributed to the different levels of technology investment and conflicting cultural priorities that prevent all providers from working together in a data-driven harmony.” To this point, 91 percent of post-acute administrators reported having no budgeted funds for technology acquisitions or improvements in this past calendar year of 2017.

“All healthcare organizations must find better ways to manage the patient transition into post-acute processes and keep hospital readmissions in check, and that may fall completely on hospital systems at risk in 2018,” said Doug Brown, managing partner of Black Book Research. “That answer will require the expansion of technology capabilities to connect physician practices, home health agencies, hospices, outpatient settings, skilled nursing facilities, rehabilitation centers, DME firms, and hospitals.”

What’s more, long-term care administrators reported that 86 percent of their facilities are not exchanging health information electronically with referring hospitals, physicians, or home health providers. The far majority (95 percent) of those sharing some records with acute care providers are networked in closed silo health systems EHRs with the long-term care center “The enormous disconnect between the post-acute world and the rest of the continuum is not correcting as hoped,” said Brown. “Finding ways to improve communications between disparate acute care EHRs and post-acute technology is a pressing problem for detached providers.”

Additionally, the Black Book study highlighted that effective post-acute management requires a multidimensional approach that incorporates connectivity between providers, data analytics and clearly defined care coordination responsibilities. However, only 3 percent of inpatient long-term care providers reported having the capabilities of data-driven analytics to lower cost of care, reduce unnecessary hospital readmissions and ensure facilities receive proper reimbursement for the care provided to the patient.

Meanwhile, in Q4 2017, 94 percent of care managers surveyed acknowledged that hospitals send their most complex patients with the highest morbidity to skilled nursing facilities with virtually no communication channels between the SNF and the acute provider.

“Long-term care facilities are still excluded from operating in a deeply connected care continuum due to limited resources and communication channels,” said Brown. “The lack of communication is an extremely expensive problem, especially as hospitals become responsible financially for long-term outcomes and preventable patient readmissions.”

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