Longitudinal care and the LTPAC world

In August, three important releases were published that will influence the role of long-term care/post-acute care (LTPAC) providers and vendors in the future months and years.

The first was the release of the Summary Report of Findings from the May 3 LTPAC Roundtable meeting sponsored by the Office of the National Coordinator (ONC). Anyone involved with LTPAC clinical healthcare information technology (HIT) should consider it mandatory reading.

Liz Palena Hall, our representative at ONC, provides an excellent overview of the Report. The members of the roundtable were very open in discussing the role of LTPAC in the HITECH Act. We did not hold back, and the report reflects how we can participate. We have laid the groundwork to provide volunteer quality measurements and standards that we will be introducing into Stage 3 of the HITECH Act, scheduled for implementation  in 2014.

Three major priorities emerged:

  1. Person-centric longitudinal care plans
  2. Transitions of care (TOC)
  3. Federally required patient assessments

The first priority is person-centric longitudinal care, including person-centric eQuality measurements that are harmonized across the individual’s spectrum of care. The S&I framework Longitudinal Care Committee is working on this, as is the National Quality Forum (NQF). NQF-HITAC just formed a new committee (Education subgroup and the eMeasure Learning Collaborative Planning Committee) that will meet on the September 21. I will be chairing the Medication Management section. This public meeting is available for attendance via the Web.

The second major release was the Final Rule on Meaningful Use Stage 2. Why is this 400-plus page report important to LTPAC? It provides guidelines as to the evolving Meaningful Use requirements from Stage 1 to Stage 2 and will be an indication as to Stage 3 Meaningful Use. The document contains the Meaningful Use criteria that your hospital and physicians will be striving to achieve to receive their incentives. Many of the Meaningful Use goals pertain to transitions of care, including when patients are transferred to and from LTPAC providers. As you will see, many of the criteria involve transitions of care to LTPAC providers. The HealthIT.gov website on Stage 2 provides guidance and resources for hospitals and physicians.

The third release was an Health Level Seven (HL7) September Ballot on standards. HL7 is a not-for-profit organization involved in the development of international healthcare informatics interoperability standards. The HL7 website (www.hl7.org) offers some templates on the Continuity of Care Document (CCD) and Clinical Document Architecture (CDA) composite. Although the templates are technology-oriented for HL7’s IT-based audience, they can give you an idea of how the requirements will affect the documentation of care.

This month we will start working on how we (HHS Federal Advisory Committees on HIT Policy and Standards) will include LTPAC, on a volunteer basis, in Stage 3 of Meaningful Use. We will be working with your associations to gather input.

Reading the roundtable report will provide an indication as to what role LTPAC will be playing in tomorrow’s clinical technology, person-centric, longitudinal world. Organizations should continue to plan and implement their HIT Clinical Strategic Plans. LTPAC facilities should be working to form transitions of care (TOC) partnerships with hospitals, HIEs, Beacon Communities and physician groups.

Remember that the hospital penalties for 30-day re-hospitalizations begin October 1. Hospitals will need LTPAC’s assistance to ensure that discharged patients do not need to be readmitted. Be sure to place obligations on the hospitals to provide you with more patient care and assessment information upon discharge so you can start the care plan immediately upon admission.

Topics: Technology & IT