WHA Post-Acute Work Group Tackles EHR Interoperability and Other Issues

September 01, 2017

Hospitals and post-acute care providers need to talk to each other to provide smooth care transitions for patients who are discharged to post-acute settings after an inpatient hospital stay. Communication can be challenging for a number of reasons, including incompatible electronic health record (EHR) systems. The patient’s medication status, progress report and care plan must be shared promptly and accurately in order to avert potential problems that might result in a poor experience for the patient and potentially lead to a hospital readmission. WHA’s Post-Acute Work Group has been studying best practices for communicating patient information during these care transitions.

Wisconsin Statewide Health Information Network (WISHIN) CEO Joe Kachelski updated the Post-Acute Work Group on the status of WISHIN participation and services. He noted that WISHIN, which was co-founded by WHA in 2010, is maturing as an organization, pointing out that the WISHIN Pulse Community Health Record now contains clinical information on more than 4.9 million unique patients from every county in the state.

Kachelski told the group he expects post-acute-care facilities will be included in the next wave of WISHIN adoption, particularly since they will soon be subject to financial penalties related to preventable readmissions. He emphasized the real-time nature of the data shared via WISHIN Pulse and the fact that the sharing happens automatically and prospectively, ensuring clinical information is available to support effective transitions of care, both into and out of the post-acute-care setting.

Matthew Stanford, WHA general counsel, explained WHA’s Team-Based Care Regulatory Reform initiative and sought the Work Group’s feedback. The goal of this initiative is to leverage all licensed clinicians’ training and experience within a team-based model of care. Work Group members have discussed how certain statutes and regulations can impede team-based care by preventing some health care providers from practicing at the top of their license. To the extent that these barriers can be eliminated, health care providers’ abilities may be optimized, including in post-acute care settings.

In addition to promoting best practices for care transitions, the Work Group has identified several policy priorities that it will develop in more detail in upcoming meetings. A top priority is creating incentives for developing specialized post-acute care facilities and services that can meet the needs of patients with multiple, complex conditions. Patient discharges from hospitals may be delayed due to the lack of services that meet the needs of these complex patients, both pediatric and adult, who no longer need hospitalization but require a level of care not readily available in many areas of the state. Many patients require transportation to post-acute settings, and in some areas of the state it is not readily available, which can delay hospital discharge.

An adequate supply of health care providers is a severe area of need in post-acute care, as it is in many other health care settings. The Work Group is examining ways to increase availability of nurse aide training and testing programs to address the acute shortage of these providers. Other workforce priorities identified include increasing the supply of home health workers and private duty nurses. Low reimbursement for these providers may make it extremely difficult to find post-acute care in a home setting for both pediatric and adult patients.

The Post-Acute Work Group will meet again in the fall to discuss these priorities in more detail, with a goal of completing its recommendations by the end of the year.

This story originally appeared in the September 01, 2017 edition of WHA Newsletter