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Bringing Long Term Care Into HIEs Without An EMR

Posted on March 13, 2013 I Written By

Anne Zieger is a healthcare journalist who has written about the industry for 30 years. Her work has appeared in all of the leading healthcare industry publications, and she's served as editor in chief of several healthcare B2B sites.

HIEs will never achieve their full potential if all players in the healthcare process aren’t included in the network. But without an EMR to connect to the HIE, how can a provider participate?

A new software package developed by Geisinger Health System and the Keystone Beacon Community Program offers a new option allowing nursing homes, home health agencies and other long-term care facilities without EMRs to upload data to HIEs, reports EHR Intelligence.

The package, KeyHIE Transform, extracts data from the Minimum Data Set and Outcome and Assessment Information Set that nursing homes already submit to CMS. It turns that information into a Continuity of Care Document usable by any EMR which is HL7-compatible.

This approach provides a bridge to a wide range of data which currently gets left behind by most HIEs. And as EHR Intelligence rightly notes, with telehealth and remote monitoring becoming more popular ways of managing senior  health, as well as assisted living, it will be increasingly important for other providers to have access to all of the seniors’ data via the HIE.

Geisinger’s KeyHIE has already run several  pilot programs using t his technology in long-term care facilities and home health agencies. It expects to launch the technology to the market in April of this year.

As is often the case, Geisinger seems to be ahead of the market with a solution that makes great sense.  After all, finding a way to integrate new data into an HIE — especially one that draws on existing data — is likely to add significant value to that HIE.  I’m eager to see whether this technology actually works as simply as it sounds.

HIMSS Public Policy Forum Quick Hits

Posted on April 5, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Yes, I still have quite a bit of HIMSS content that I haven’t had a chance to post. Luckily most of the information is really timeless and so it doesn’t matter when it’s posted. One of those was some of the information I got at the public policy forum at HIMSS. Here’s some quick hits from it:

Dr. Rhonda Medows from Georgia said, “Could extend benefits to Long Term care based on capital improvement benefits.” I wonder if she’ll still do this if it’s true that there will be some money for long term care in the current healthcare reform. At least Georgia was looking at some creative ways to get some money for healthcare IT in under served areas.

State representative Rosenthall from NH-Representative said that 40-50 percent of doctors in NH have some access to EMR. She also said that 900 out of 4500 have ePrescribing (20 percent).

Probably the most interesting thing Representative Rosenthall said was in response to my question about how NH (a small state) would fund a state HIE. She quickly and frankly responded that their state must do a private partnership since the state won’t have the money in their small tax base to be able to fund the HIE. I’m guessing that many states will be in this same position.

Finally, I think it was one of the HIMSS public policy people (sorry I don’t remember which one) made an interesting comment about the government’s approach to funding the state HIE efforts. They described that the “seed funding” for HIE that’s been given to states is almost like a hope that they’ll figure out some sustainable creative revenue model and not just disappear the way RHIO have.

I remember the hype that surrounded even the term RHIO about 4 years ago and no one speaks of them anymore. It’s a really serious question to ask if HIE’s are going to find that “creative revenue model” that has alluded health information exchange in the past. I’d love to hear from people about what the most promising HIE revenue models are right now.

Long Term Care Missing Out on EMR Stimulus Money

Posted on September 22, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

A short while back I posted about my interest in the long term care EMR market. From that post I’ve started a number of really interesting discussions. It’s been quite enlightening and fun for me to learn about the long term care market since I was previously unfamiliar with the details.

One thing that kind of strikes me about the long term care EMR market is that it doesn’t seem to me that their going to be getting any help from the EMR stimulus money that everyone’s talking about. At least if my assumptions are correct. Since the EMR stimulus money is going to be paid out per provider, it seems like most long term care facilities are going to not be eligible since they’re nurse run and not provider (doctor) run. Someone please correct me if I’m wrong in this assumption.

Certainly, there is the possibility that ONC and HHS might make some of the other ARRA money they received available as grants to the long term care market for purchase of an EMR. However, that is still yet to be seen.

This is rather unfortunate for long term care facilities. I think we can safely say that healthcare’s use of technology is behind almost every other industry. Low EMR adoption rates are evidence of this fact. With that said, from what I’ve read and seen long term care facilities are even farther behind on their adoption of technology. Sadly, if long term care facilities aren’t getting any EMR stimulus money, then it’s possible they will lag behind even farther in adoption of healthcare IT.

Are there any other specialty areas or healthcare segments that are going to miss out on the EMR stimulus money as well?

UPDATE: One reader of my site sent the following additional information and questions: “Nursing Homes overall are considered as a provider. The Nursing Home is issued a Provider Number (not the administrator) and is used for billing purposes and reimbursement purposes. When the Feds say that providers are going to get stimulus money through grants does this mean that LTC facilities are excluded? Who knows at this time. What is the difference between an individual Provider and a Facility as a Provider? I can’t answer this. Only the Feds know at this time.”

I’ve talked to some other Long Term Care EMR companies and they have the same questions. Looks like the problem is that we just don’t know. Although, I’d argue that it’s likely that the Feds don’t know yet either.

Long Term Care EMR Market

Posted on September 7, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve been doing some research recently into the long term care EMR market. There’s a number of reasons why I’m interested in this area. One of which was that I met someone at a Las Vegas EMR event who was from a long term care center here in Las Vegas. We didn’t get a chance to talk much, but I was interested to learn more about how EMR software was being used in the long term care market.

I also find this interesting since our EMR has added some new functionality related to extended care as well. We don’t use it in my clinic, but it really is a different model when you might not discharge the patient for a couple years versus a couple hours or less.

I know there are a variety of long term care facilities even including such things as adult day care which kind of fits into that same category also. Does anyone know more about this niche? Anyone know of EMR companies that are trying to serve this niche? I’d like to learn more about what’s going on.

A whole other EMR niche to add to my list of EMR specialties.

CCHIT Task Force Process

Posted on July 2, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I was reading through a short article entitled “CCHIT TASK FORCE TO FOCUS ON STIMULUS PACKAGE REQUIREMENTS” which is actually a bit misplaced since the article really seems to talk about the CCHIT Task Force for Long Term and Post Acute Care, but I digress.

The thing that drew my attention was just reading through the process by which CCHIT puts together their criteria using task forces. I believe a number of people on my twitter feed are on or lead some of these CCHIT EHR task forces. I’d be interested to have a nice writeup from some of them on what it’s like to be on a CCHIT task force. How does it work? What’s the dynamic? If you’re willing to share, I’d love to hear more in the comments or drop me a note on my contact page.

I also was trying to think of other cases where a task force like approach worked for certifying software. I couldn’t really think of any. However, I couldn’t think of that many software certifications either. What I have seen work to a certain extent is large IT vendors that come together in some sort of organization to establish a standard for communicating. This is something that I wish would happen with a number of EHR vendors. It’s not something that will really help an EHR vendors bottom line, but it’s the right thing to do and that has its own benefits.

CCHIT Certification Thoughts

Posted on February 2, 2009 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I just came upon a blog post on the TempDev blog that talks about the expansion of CCHIT certification into a number of new specialty categories. It’s really interesting to look at the list of new categories:

  • Behavioral Health
  • Clinical Research
  • Dermatology
  • Oncology
  • Advanced Interoperability
  • Advanced Quality (in reference to Quality Measures)
  • Advanced Clinical Decision Support
  • Long Term Care
  • OB/GYN

As noted by Ben, these are in addition to the HIE and PHR categories added for 2009. Well, I never back away from a discussion about CCHIT. I just wonder why the Senate hasn’t called me up to a hearing to talk about CCHIT certification. Of course, my friend Al Borges would do much better than I, but I digress.

After reading through Ben’s post about the expansion of CCHIT I had to leave a few of my thoughts on the subject in the comments. I thought most of my readers would find it interesting and so here’s some off the cuff thoughts on CCHIT certification that I left in the comments:

You are dead on when you say that CCHIT is a powerful driver in the EHR marketplace. It’s a really tough decision for EMR companies to decide whether to spend money on CCHIT certification or not. Not because CCHIT certification will make their product any better. The biggest advantage CCHIT certification offers is in your ability to market/sale your EMR system. That fact can’t be argued. It’s just unfortunate that the public isn’t better informed about the meaning of CCHIT certification.

I do think that over time CCHIT certifications will be so old that EMR companies are going to have to avoid the discussion of with CCHIT certification year they have or something like that. This will lead to consumers being unhappy with the process and lead to more troubles in the future.

The problem is that CCHIT hasn’t create a sustainable certification model for most EHR companies. I even hear that CCHIT might not have a sustainable certification model themselves despite their incredibly high rates for certification. At least that was what I read when I heard that CCHIT was going back to the government for more funding.

I still think the biggest problem is that most people see certification as a strong indicator of whether the EMR is usable or not, but CCHIT doesn’t test that at all. I’m considering some options to measure that and even possibly pursuing a PhD in health informatics where I’d like to study the subject. We’ll see.

It will be interesting to see how many specialties actually certify in these categories. My guess is that it will be the same Jabba the Hut EMRs (my term) that did the original CCHIT certification.

I guess you know where I stand on this issue.

Watch for more discussion about CCHIT, because I think it’s important to share my views on the subject considering it could be a major part of what I call the Obama EMR stimulus package.