HHS isn't doing enough to boost the use of electronic health records and digital information sharing in post-acute care, according to a new report from the U.S. Government Accountability Office.
In a report released Monday, the GAO determined HHS has failed to measure how effectively it has encouraged the use of EHRs in post-acute care, and it has no “comprehensive plan” for raising the number of post-acute care providers that digitally share health information.
The government watchdog recommended that the HHS secretary instruct the CMS and the Office of the National Coordinator for Health Information Technology, or ONC, to measure how effective the HHS is at getting more post-acute care providers to use EHRs to share information digitally. The GAO also recommended that HHS plan for how to further those efforts. HHS agreed with the suggestions, according to the GAO.
Although HHS encourages post-acute care providers to certify their health IT, including EHRs, GAO said it could better promote adoption by requiring providers to go through its certification process. So far, the ONC has not certified an EHR designed for post-acute care.
While the ONC has provided some financial awards for indirect promotion of EHR use in post-acute settings, as well as Medicaid matching funds, it has not gauged how effective these and other measures have been. “Without an evaluation plan for all of its four key efforts, HHS cannot determine whether or to what extent its efforts are contributing to the department's overall goals,” the GAO wrote.
As part of its investigation, the GAO interviewed 20 people whose work is related to EHRs in post-acute care, including vendors and providers. From the interviews, the office identified five barriers to greater adoption of EHRs and the digital transfer of health data in post-acute care settings: cost, the use of standards, interruptions to workflow, technology issues and staffing.
Unlike other providers, post-acute providers do not qualify for meaningful use payments through Medicare or Medicaid. Some interviewees said there is no business rationale for using EHR technology in post-acute care unless there are financial incentives or mandates.
Technology underscored other concerns, from how standards are implemented to internet connectivity. Though standards for electronic health data exist, they're sometimes put into place differently, which can make transferring information across systems difficult, according to the report.
One person said that writing something down on paper was more efficient than entering it electronically. The report did not note whether that was the same person who said it would be faster to print a health record than it would be to share it through an EHR.
Meanwhile, sometimes information transfer isn't even possible, such as when a patient has no internet access at home.
Technology issues also stem from lack of training: Some providers lack the dedicated IT staff to teach others the technology, and others are reticent to make changes to their work processes.
