As hospitals adapt to the concurrent needs of converting to digital health records and systemic changes driven by the Patient Protection and Affordable Care Act
, experts are beginning to recognize that the integration of senior care and rehab settings into their networks will be crucial to achieving better outcomes and fewer readmissions
For too long, America's frail elderly have moved between acute and long-term environments with a regularity that hinders caregivers, confuses patients, worries families and disrupts the continuity of care. With the knowledge that tackling readmissions is a prime goal of healthcare reform, it is now clear the decision not to include IT subsidies for long-term care
settings in the HITECH Act, or to address them in the ACA, was extremely shortsighted.
Because long-term care providers lag behind hospitals and doctors in adoption of EHRs
, the crucial exchange of information between acute and long-term care providers that supports more integrated care is lacking. Senior-care providers, already stretched by chronically low reimbursements, are struggling to determine how to invest in IT.
This is further exacerbated because the Office of the National Coordinator for Health Information Technology
has not certified or made clear the expectations for long-term care EHRs. Yet for senior-care facilities to integrate with local acute-care providers and to deliver better outcomes for residents, there is no other choice: an EHR is a must-have.
Because the information we document in long-term care settings is different from what hospitals capture, utilizing platforms that navigate and perform similarly will facilitate collection of data important to both settings and allow us to stay focused on the patient. It is imperative that hospitals be able to access and be familiar with the records of the patients who come to them from senior-care organizations. Likewise, long-term care providers must be able to read the hospital's records and understand the prescribed care plans. To achieve interoperability we need guidance from the feds. Given the premium placed on reducing readmissions among Medicare beneficiaries, we need it soon.
As a system specializing in continuing care, we serve seniors who live independently as well as those who need intensive rehab and skilled-nursing care. We've moved ahead with EHRs in the absence of clear direction from policymakers, because we recognize these systems have the potential to improve seniors' care. We just wish policymakers would recognize it too.Chip Burns is CIO of Asbury Communities, a not-for-profit operator of continuing-care retirement communities based in Gaithersburg, Md.