The term “interoperability” is used a lot in the healthcare industry, but what does it really mean? In short, LTC interoperability refers to the ability of different elder care software, healthcare systems, and devices to work together (inter-operate) and share information. This term is particularly important in long-term care (LTC) because of the different technologies utilized when caring for residents.
So why is interoperability so important? Long-term care nurses must be able to track vital signs, administer medications, manage scheduling and documentation, and coordinate with other providers efficiently. Unfortunately, many software systems do not facilitate the ease of transferring the data related to these tasks, and this can lead to errors, inefficiencies, and frustration. When systems are able to talk to each other, information can be shared seamlessly, leading to better decision making, improved efficiency, enhanced resident care, and even safety.
How LTC interoperability works
LTC interoperability must be built into software systems from the ground up by the senior care software vendor. When done correctly, interoperability allows different devices and systems to share data and work together despite their different underlying technologies. That data sharing is essential for LTC staff who need access to information like vital signs, medication administration records, and care plans in order to do their jobs effectively.
There are a number of standards that must be met in order for interoperability to be possible. When these standards are collectively observed, MDS nurses will have quick and easy access to the information they need to provide the best possible care for their residents.
One such standard is the Health Level Seven (HL7) international standard, a set of international standards that allow different devices and systems to share data. Other important standards include the Fast Healthcare Interoperability Resources (FHIR) standard, which provides a means for representing and sharing information among clinicians and organizations in a standardized way, regardless of how different long-term care EHR software providers represent or store their data.
The CMS Interoperability Rule
The CMS interoperability rule is a set of guidelines that healthcare providers must follow to ensure that their systems can communicate with each other. This rule was put into place to improve the interoperability of healthcare systems—including long-term care software for LTC interoperability—and help reduce the number of errors that can occur when different technologies are unable to share information.
The CMS interoperability rule applies to all types of healthcare providers, including acute care hospitals, long-term care facilities, and physician practices. In order to comply with the rule, healthcare providers must use standards like HL7 and FHIR to ensure that their systems are able to exchange data.
On April 2018, the CMS announced that it was rebranding its familiar electronic health record (EHR) Incentive Programs from “meaningful use” to “promoting interoperability.” Among the proposed changes were welcome simplifications in reporting protocols, as well as new requirements surrounding EHR capabilities.
Specifically, these new requirements sought to improve pricing transparency, facilitate the sharing of patient information between providers, and further engage patients in managing their care. To complete this, all qualified providers had to show that they followed the 2015 Edition of CEHRT. There is however concern that in focusing on external interoperability, healthcare providers will ignore the value of internal interoperability.
In this context, external interoperability primarily refers to a hospital or health facility’s ability to communicate effectively and securely with other EHR systems outside of their organization, as well as its patients. This is something that can be greatly improved among healthcare providers.
According to Black Book Research, thirty-six percent of medical record administrators have trouble exchanging patient health records with other providers who aren’t on the same EHR platform. In addition, twenty-four percent say they cannot access useful patient information that is sent electronically from external sources. This is a problem for the crucial process of provider-to-provider communication, especially that which occurs during patient and resident transfers.
By sharing patient data across providers and EHRs, long term care providers ensure better care coordination with fewer redundancies in testing and treatment. These improvements to the patient experience play a large role in health outcomes. Similarly, patients with access to their health data will experience improved communications with providers, which can create more positive health outcomes. It is important to have external interoperability, but focusing solely on that will take the focus away from something EHRs still struggle with today: internal interoperability.
Most physicians utilize an EHR on a daily basis. This technology is designed to allow them to effectively manage their patients, and thus they want the EHR to work with their existing workflows. Additionally, physicians need to be able to quickly analyze the available patient data to make an educated decision concerning a patient’s healthcare.
It is for these reasons that one of the most important elements of a successful EHR is internal interoperability. What this simply means is that an EHR should allow easy access to the wealth of information available in the facility on a daily basis. This can be as granular as minimizing clicks throughout a workflow to as complicated as the integration of relevant external data into a record which may make a difference in the management of a patient or resident.
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5 Benefits of Promoting Interoperability in Long-Term Care
So why has the CMS been promoting interoperability? It is because of the wide range of benefits that LTC interoperability offers. As we mentioned, internal interoperability opportunities allow for less clicks in a nursing home software system and quicker analysis of patient and resident data for more effective care.
Other additional benefits of LTC interoperability include:
- Seamless exchange of data between state, local, and public health departments as well as care providers: The CMS interoperability rule applies to Long-Term and Post-Acute Care (LTPAC) providers. LTPAC providers can send and receive patient and resident data with other LTPAC, acute care hospitals, and primary care physicians using their senior care software. LTPAC providers can also query immunization registries and public health surveillance systems for longitudinal clinical information about their patients as well as send case reports to public health entities.
- Standardization of data elements: LTC providers will be able to use HL7’s Fast Healthcare Interoperability Resources (FHIR) standards to structure and exchange data. These standards define how information should be organized so different long-term care EHR systems can easily communicate with each other. The goal is for LTPAC providers to eventually exchange data with any organization that has adopted the FHIR standards regardless of the software they are using.
- Enhanced worker productivity across healthcare providers and public health systems: LTC providers will be able to securely access patient and resident information from other LTPAC settings as well as acute care hospitals, primary care physicians, and state and local public health departments—all through their LTC software. This will help LTPAC providers make more informed decisions about the care of their patients and residents, improving their care outcomes. Also, data exchange and transfer is quick and efficient, which means less time is spent querying and sorting data, thus improving productivity in nursing homes.
- Safeguarding of patient and resident data: The safeguarding of data is a major concern for all healthcare providers in America. By using FHIR’s security and privacy capabilities, which protect patient and resident data in transit, LTC providers can ensure that their data is secure. For more information on FHIR’s security and privacy capabilities, refer to the CMS Interoperability fact sheet, as it is a helpful resource.
- Enhanced care experience for patients and residents: The care experience for patients and residents is enhanced when LTC providers have access to their complete health information thanks to LTC interoperability. LTC providers can use this information to make more informed decisions about the care of their patients and residents. This means that patients and residents will receive better care and have a better overall experience while at a nursing home or assisted living facility.
The CMS has been promoting LTC interoperability due to the wide range of benefits it offers. Thus, LTC providers who adopt LTC interoperability solutions will be able to improve the care of their patients and residents as well as enhance the overall care experience.
Progress Made Toward LTC Interoperability
In a recent report from KLAS-CHIME, it was noted that the rate of LTC interoperability amongst senior care software providers has doubled since 2017. This is due in part to the increased LTC focus from EHR vendors. Federal and state regulations have also had a positive impact.
The increased demand for LTC interoperability can be attributed to the many benefits that it offers long-term care providers. LTC providers who adopt LTC interoperability solutions will be able to improve the care of their patients and residents as well as enhance the overall care experience. And with the global interoperability solutions market being $1.78 billion and expected to grow at a CAGR of 13.0%, we can only expect to see more and more strides being made in regards to LTC interoperability.
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