The CCHIT (Certification Commission for Health Information Technology) has recently certified the first batch of electronic medical records systems for use in long-term and post-acute-care facilities. The new certification program is designed to ensure quality among the long-term care software solutions used in skilled-nursing facilities, home health care, hospices, rehabilitation centers, and other LTPAC settings. Currently, even those software solutions earning certification cannot be used to claim meaningful use because LTPAC facilities are not eligible under the federal meaningful use incentive program. As a result of this exclusion from the incentive program, the rate of electronic health record adoption in LTPAC settings remains much lower than in hospitals, clinics, private medical practices, and other healthcare facilities. But CCHIT chairperson Dr. Karen Bell says that things may be about to change.

  According to Dr. Bell, there are impending changes in reimbursement that will promote better coordination between inpatient and post-acute care. Because of these changes, there has been a recent spike in interest in electronic health records specifically designed for the LTPAC market. In order to support the coordination between inpatient and post-acute care, the various EHR systems involved must be able to communicate with each other. The crucial step of integrating inpatient and LTPAC EHR standards has not yet occurred, largely because the leading information systems for acute-care hospitals are not made by the same vendors that provide the leading long term care software solutions.
A recent survey by the research firm KLAS suggests that 85 percent of home care agencies with electronic health records systems cannot exchange data with inpatient EHR systems. This number is shocking when you consider that over 60 percent of the home care agencies that participated in the study were owned by nearby hospitals with incompatible EHRs. In recognition of this problem, Certification Commission’s certification criteria include and focus on interoperability as a key element of EHR design. EHR vendors must show that their products can generate and exchange Continuity of Care Documents (which contain clinical summaries and care plans) in order to be certified for LTPAC use.  
 Dr. Bell said that “a lot of these vendors had not baked in the ability to transmit CCDs” and that some CCHIT members were therefore concerned about requiring this feature. Ultimately, the commission decided to “keep the bar high,” despite the fact that some vendors were unprepared. Bell said that including the requirement in the certification process would send “a strong signal that this type of interoperability was going to be critical going forward.”

 Other big players in the LTPAC industry have come on board with the CCHIT, including Cynthia Morton, executive vice president of the National Association for The Support of Long-Term Care. In a recent press release, Morton said that the CCHIT certification program “offers LTPAC providers greater assurance that their EHR systems will support their individual patient care and business needs,” and that the National Association for The Support of Long-Term Care “supports CCHIT’s efforts to raise the bar for EHRs used in these care settings.”

LTPAC facilities are not eligible under the federal meaningful use incentive program.

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