Is Your Agency Ready for Interoperability?

 

The New CMS ADT Mandate

There is a new mandate from the Centers for Medicare and Medicaid Services (CMS) on sharing admissions, discharge, and transfer (ADT) data among care providers, with the aim of improving care coordination and lowering readmissions.

As of May 1, the new regulation will require hospitals to notify all applicable post-acute care service providers and suppliers when patients are admitted to or discharged from the hospital, or transferred to another facility. Hospitals must share ADT information with primary care physicians (PCPs), physician groups, skilled nursing facilities (SNFs), home health, hospice agencies, and other providers in their care community.

This new CMS mandate promotes the significant role of interoperability in the healthcare industry. According to the Healthcare Information and Management Systems Society (HIMMS), interoperability is the ability of different information systems, devices, or applications to connect, in a coordinated manner, within and across organizational boundaries to access, exchange, and cooperatively use data amongst stakeholders, with the goal of optimizing the health of individuals and populations. Interoperability furthers the goals of optimizing healthcare by providing access to the right information needed to understand and address the health of individuals and populations.

 

Interoperability in Home Care
Value of Interoperability

One of the major takeaways from the 2021 Home Health Care News Outlook Survey and Report was about the potential of interoperability to encourage growth in home care. It showed that most respondents agreed that interoperability will have a high impact on their organization’s yearly growth.

Significantly, a recent survey about interoperability in post-acute care indicated that 74% of physician groups and other referral sources would send more referrals to post-acute care providers, including home-based care agencies, that offer greater electronic data access.

The results also showed that 95% of home-based care respondents and 71% of skilled nursing respondents acknowledged the importance of interoperability to their referral sources. These findings further underscore the growing value of interoperability.

Another contributing factor to the importance of interoperability is the need to process key patient information faster. This is due to increasing industry standards like shorter Request for Anticipated Payment (RAP) filing timelines and Patient-Driven Groupings Model’s (PDGM) compressed revenue cycle.

Minding the Gap

Despite this, many providers still only meet “basic maturity” interoperability standards. This refers to “the ability to receive patient demographic data and clinical information, such as diagnosis codes and allergies, electronically.” In order to reach high-performing mature interoperability, providers need to be able to receive physician orders, patient forms and visit notes, medication information, and patient status updates.

As referral sources grow more demanding, providers that don’t prioritize meeting these standards could be left behind and lose business. This is an opportunity for home-based care providers to strategically address their interoperability shortcomings as soon as possible to stay competitive.

 

Preparing your agency for interoperability

To effectively position your organization as the partner of choice, you must first evaluate your agency’s interoperability capabilities and then identify key areas of improvement.

Have a conversation with your EMR provider to make sure their capabilities match the expectations of your referral partners. Interoperability goes beyond documentation, so it is essential to work with an EMR that already has the framework to allow businesses to collaborate with a wider healthcare network. The same collaborative approach should also be applied with your third-party contractors and outsourcing partners.

Choose an outsourcing provider that can support your interoperability goals. The right outsourcing partner has the vision to leverage technology and data-driven processes, which can lay the groundwork for interoperability. This is an essential part of embracing patient-centric solutions, which will have a positive impact on all fronts. It will improve referral relationships, increase your organization’s credibility within the home healthcare network, and empower clinicians with key information useful for delivering higher quality patient care.

 


Resources:
CMS Interoperability and Patient Access Final Rule >
HHCN: 74% of Referral Sources Prefer Home-Based Care Providers That Meet Interoperability Standards >