Implementing EHRs is a step in the right direction, but providers will reach a stand-still if their HIT and EHR systems are not interoperable, meaning information cannot be exchanged with other providers. Currently, a major barrier to interoperability between LTPAC providers is the inability to compare information collected using the different assessment tools—nursing homes use the MDS, home health agencies use the Outcome and Assessment Information Set (OASIS), and inpatient rehabilitation facilities (IRF) use the patient assessment instrument (PAI).
CMS is in the process of exploring one solution to this problem with the Post-Acute Care Payment Reform Demonstration (PAC-PRD), which makes use of the Continuity, Assessment, Record, and Evaluation (CARE) instrument.
The CARE instrument is an assessment tool that can be used by SNFs, home health agencies, and IRFs, instead of their respective assessment instruments. During the summit, Shannon Flood, technical project officer for PAC-PRD in CMS' Office of Research Development and Information, informed attendees that CMS is finished with the data collection phase of the demonstration and is currently doing analysis. "We plan to submit recommendations for payment reform next year, but will need congressional authority to then move forward," Flood said.
When asked if the CARE tool could be tied to payment bundling projects in the future, Flood responded, "Maybe. The long-term goal would be to combine the MDS, OASIS, and the PAI into one. But we really are at a pre-policy decision point."
Although a wide variety of technology-related topics were covered during AHIMA's LTPAC HIT Summit, the overall message was clear: healthcare is becoming more and more reliant on technology and LTPAC providers must adapt to the changing industry if they want to remain valuable players in the field.