What Does LTPAC Want – for Interoperability?

The Long-Term and Post-Acute Care (LTPAC) Health IT (HIT) Collaborative held its 10th Annual Summit in Baltimore at the end of June. HIT leaders, policy makers, providers, and vendors, convened to discuss industry initiatives and priorities from the Collaborative’s latest Roadmap for Health IT in LTPAC.

We participated in and attended several sessions on continuity of care and quality reporting.

Zabrina Gonzaga, Manager of Clinical Analysis & Policy, participated with a panel of CMS representatives to present the “IMPACT Act: A Strategic Approach for Enabling LTPAC HIT and Interoperability”. The Improving Medicare Post-Acute Care Transformation (IMPACT) Act legislates reporting of standardized data from the Federal PAC patient assessments for quality measurement and care coordination across settings. The session previewed CMS for a data element library that will link the assessment data elements to HIT standards.

Attendees shared their views on key pieces of information that care providers would like to have during care transitions, their frustrations with the current state of EHRs, the lack of full interoperability across settings, and challenges they’ve faced with achieving interoperability.

A separate session on the IMPACT Act, held the following day, posed 3 questions and asked participants for feedback.

  1. What one piece of information do you need to know to improve quality at transition of care?

Audience responses:

  • An accurate list of current medications
  • Changes in functional and cognitive status (current and against baseline)
  • Standardized terminology for Activity Daily Living (ADLs)
  • Advance directives
  • Patient’s home situation – physical and support environment/systems; safety of neighborhood
  • Allergies
  • All diagnoses – actual active diagnoses and past history (family history designated as such)
  • Hospital stay information – notification of home health patient in hospital, Length of Stay (LOS), etc.
  • Hospital discharge summary in real time (not 2-5 days later)

Participants also cited the need for a process to resolve conflicting information, for example based on the source, level of trust, provenance, etc.

  1. What one measure would demonstrate value from the care provided?

Audience responses:

  • Whether the goals of the plan of care were achieved
  • Assessment of the next care giver’s ability/training for the handoff in care (e.g., discharge to home)
  • Achievement or failure of shared decision-making
  • Appropriate length of stay based on PAC episode
  • Patient satisfaction
  • Level of patient access to his/her information from the PAC setting
  • Ability to live independently (or ratio of time a person is able to be independent)
  • Presence and adherence to patient’s advance directives
  1. What actions/preparation steps should be undertaken next?

Audience responses:

  • Change the reporting dates set in the IMPACT Act.
  • Publish lists of software vendors that are interoperable and those that are not.
  • Focus on important processes, including hospital readmission rates and communication.
  • Acknowledge the major culture shift to complete transparency including quality and cost.
  • Prepare providers for changes to assessment instruments.
  • Identify critical data in assessment instruments that would support decision support.

If you would like to learn more about the IMPACT Act and standards, you can attend the “IMPACT, Standards, and Interoperability: The Road Ahead” webinar Tuesday, August 25, 2015 at 12:00 PM EST. Lantana’s Lynn Perrine and Zabrina Gonzaga will present as part of the McKnight’s Super Tuesday webinar series focused on technology in LTPAC settings. Registration is open to everyone and Continuing Education credits are offered for the live event. Learn more and register at the McKnight’s Super Tuesday registration page HERE.