3 health IT challenges facing home health agencies

1. EHR interoperability challenges

While home health agencies (HHAs) are increasingly implementing EHR platforms, adoption lags behind other healthcare providers. According to a 2023 HHS report, over 85% of ambulatory practices and 95% of hospitals use EHRs, compared to 80% of HHAs.

The report authors indicated that this divide is largely due to HHAs not receiving the federal EHR adoption incentives that drove widespread implementation across ambulatory practices and hospitals.

Paper-based documentation within HHA can present challenges for providers. A survey-based study of HHA nurses and staff revealed that organizations lacking EHR systems experienced inefficient and time-consuming paper charting processes.

HHA nurses and staff without EHR platforms also mentioned challenges regarding care coordination and timely communication with other providers.

Still, EHR implementation is not the golden ticket to interoperability.

For instance, a 2019 survey of individuals from 56 home healthcare agencies in Colorado found that 90% of organizations used EHRs. However, less than half of the nurses and staff surveyed reported having access to EHR data from referring hospitals or clinics.

Further, even when respondents had access to EHR data from referring providers, they often reported insufficient information across several domains, including recommended tests and pending studies.

HHA nurses and staff indicated that connecting to a regional health information exchange (HIE) was a valuable way to access additional clinical information from hospitals.

Federal interoperability efforts such as TEFCA could streamline data exchange for home health agencies (HHAs), enabling them to access data from multiple health information networks through a single connection.

2. Mobile device management

Mobile devices enable greater flexibility in providing healthcare to patients and are the only logical way for home health workers to access EHR data in the field. However, reliable internet connectivity is not guaranteed when traveling to patients' homes, especially in rural areas.

According to a report by the Federal Communications Commission, about 96% of the United States population had access to broadband at the FCC's minimum speed benchmark in 2019, compared to 73.6% of rural Americans.

Providing staff with devices with strong connectivity, such as 4G LTE or 5G, can help ensure that home health workers can access data and document patient information at the point of care.

However, with increased mobile connectivity comes heightened security risks. As providers implement mobile solutions to enhance care delivery, they must ensure HIPAA compliance to protect the security of protected health information (PHI).

According to HHS, healthcare providers, other covered entities, and business associates may use mobile devices to access electronic PHI in a cloud "as long as appropriate physical, administrative, and technical safeguards are in place to protect the confidentiality, integrity, and availability of the ePHI on the mobile device and in the cloud."

HHAs looking to ensure HIPAA compliance can leverage mobile device management (MDM) tools as part of their larger cybersecurity strategy. According to the National Institute of Standards and Technology (NIST), these solutions allow organizations to secure mobile devices used to access organizational resources.

Home health organizations can enroll employees' personal or company-owned mobile devices into an MDM solution to apply enterprise configurations, manage enterprise applications and enforce compliance with organizational policies.

3. Telehealth connectivity challenges

Historically, home healthcare required providers to travel to patients' homes to deliver care. However, the care model increasingly includes elements of telehealth, reducing the need for in-person appointments and allowing providers to monitor patients' health from afar.

While a 2019 study found that only 16% of HHAs used telehealth, the use of virtual care is likely to have increased across HHAs since the COVID-19 pandemic.

However, the swift adoption of telehealth during this period brought forth several challenges for home healthcare, including the absence of internet or device accessibility in patients' homes, technical glitches and cognitive and sensory impairments hindering patient engagement in virtual care.

Additionally, wearable devices that monitor physical activity, heart rate, and other vital signs offer valuable data to inform home healthcare. However, integrating this data into the EHR and clinical workflow remains a significant challenge across the care continuum due to the lack of interoperability between different devices and EHR systems.

Device and EHR vendors use proprietary and closed communication methods, making it difficult for them to communicate and transfer data. To address this barrier, researchers are looking to create "plug-and-play" interoperability standards like those seen in consumer electronics to support device compatibility between different vendors.

Overcoming health IT challenges in home healthcare will require collaboration between policymakers, vendors and healthcare providers. By prioritizing interoperability, patient data security and connectivity, HHAs can deliver high-quality care with the aid of health IT.

Hannah Nelson has been covering news related to health information technology and health data interoperability since 2020.