Despite Data Exchange Gains, Post-Acute Care Needs Interoperability

While post-acute care (PAC) providers and their EHR vendors improved data exchange capabilities from 2019 to 2020, they must continue to work towards true interoperability, according to a report from Porter Research on behalf of Matrixcare.

Interoperability has become more important as providers increasingly refer patients to PAC services such as home health, hospice, palliative care, and private duty homecare. However, PAC health IT has long trailed behind other provider technologies in terms of interoperability, making data exchange for care coordination tricky.

The 2020 interoperability survey collected insights from 300 home-based care providers and 100 referring physicians, care navigators, and discharge planners. Researchers compared these insights with the 2019 interoperability survey’s findings.

The survey revealed a growing demand for stronger interoperability. In 2019, 60 percent of referring physicians said they would change PAC partners to those that they believe can more effectively process electronic referrals. In 2020, 74 percent of physicians said they would change PAC partners due to interoperability issues.

Almost all referring physicians (99 percent) agreed that the ability to send and receive data with their PAC providers is important.

The good news is that PAC providers reported having a better understanding of the importance of interoperability for their referral sources; 95 percent of PAC providers reported that they believe interoperability is important to their referral sources, compared to 34 percent last year.

With a better grasp on the importance of interoperability, many PAC providers sought to improve their EHR systems in 2020. More than half (58 percent) of PAC providers reported that their EHR systems have made progress over the past year in terms of interoperability.

However, the research revealed that there is still a long way to go; 79 percent of PAC respondents said they are not fully satisfied with their EHR system’s ability to support interoperability efforts.

Additionally, the majority of referring physicians, care navigators, and discharge planners (85 percent) reported that they were not fully satisfied with PAC providers’ ability to receive electronic referrals.

The survey also found gaps in the understanding of true interoperability. Many PAC providers still use traditional means of sending and receiving referrals, such as phone and fax. In fact, only half of PAC providers can receive and use referral data sent electronically by providers.

The survey authors broke down three levels of interoperability maturity for PACs.

Basic maturity includes the ability to accept demographic and clinical documents. This level of maturity is expected by virtually all reference sources, the authors noted.

According to the survey results, 85 percent of PAC providers claim to be able to accept ADT (admission, discharge, transfer) information and 72 said they can accept clinical information in some format, be it documents or discrete data. Last year, just 34 percent of PACs could receive these two types of data.

However, the report authors noted that based on high levels of referring physician dissatisfaction, basic maturity is not adequate.

Moderate maturity includes the ability to receive and send additional data and documentation electronically such as signed physician orders, patient forms, visit notes, medication information, and even patient status updates.

According to the survey, only half of PAC providers said they can automatically send status reports and half reported that they can send discharge summary reports.

Referring physicians said that their main areas of frustration with PAC providers are poor response times, communication breakdowns, and not receiving information or confirmation.

“As lines of communication break down between referring physicians and those who handle the patient’s follow-up care, frustration and uncertainty creep into the relationship,” the report authors explained.

National networks like CommonWell Health Alliance and Carequality have stepped in to help advance interoperability across the care continuum. In these networks, care providers, EHR vendors, and data exchange vendors all leverage the same health information exchange (HIE) standards.

“These scalable networks provide the surrounding services that take interoperability from specifications to out-of-the-box usability and scalable functionality – such as connectivity, privacy, security, audit trails, brokered query and retrieval, and an exponentially growing set of endpoints with which patient-centric interoperability can be enabled,” the report authors explained.