The American Academy of Family Physicians is asking the CMS to push hospitals to more freely share patients' medical records. It says the current logjam of patient data is causing costly readmissions and putting patients at risk.
“Unfortunately, due to a lack of communication between hospitals and other healthcare facilities with primary-care physicians, the transmission or release of discharge information to the primary-care physician often does not occur at all,” the group said in a letter (PDF) to the CMS.
The trade group said without that hospital communication, providers are duplicating imaging and lab tests, and using drugs that may have already been unsuccessfully tried with the patient.
That lack of communication is also costing providers money, the letter continued. In the quest to reduce hospitals' rates of preventable readmissions, the CMS in 2013 launched its transitional care management (TCM) services (PDF) to make sure chronically ill and aging patients continued to be treated through community-based care after hospital discharge.
TCMs are meant to keep patients with complex medical needs away from the often-perpetual hospital turnstile.
To receive reimbursement for transitional care services, a provider must contact his or her patient two business days after discharge. The provider can also contact a medical colleague to set up a plan for that patient.
The AAFP is pushing the CMS to finalize a November 2015 proposed rule revising the requirements for discharge planning. The group feels the revised policy could better facilitate the flow of medical records between family physicians and hospitals.
The group said a 2014 informational booklet (PDF) should be updated to narrow the window that gives hospitals seven days to contact a patient's physician after they refer the patient for follow-up care to a long-term-care hospital or inpatient rehabilitation facility.
Those guidelines are not in sync with the two business-day requirement outlined in the TCM program, the AAFP noted.
Surprisingly, rural hospitals, which often are identified as having the biggest challenges with interoperability and health information-technology upgrades, might be the least affected.
In a rural community, the primary-care physician often is also the admitting physician, said Maggie Elehwany, vice president of government affairs at the National Rural Health Association. “Staff is small in rural hospitals, and information is more easily kept up with,” she said.
Others have said the CMS does not need to get involved.
“The most promising way to achieve communication is through interoperability among the multiple electronic health-record systems that can exist throughout the community,” said Jennifer Schleman, a spokeswoman for the American Hospital Association.
Schleman would like to see the federal government and the private sector fix the problem of interoperability and specifically focus on standards, certification and testing that ensure vendors have products that seamlessly work together.
A CMS spokesman acknowledged that it had received the AAFP letter but said the agency had no further comment.