As it has become increasingly common for patients to move from acute to post-acute settings for many types of treatment, Referral Sources and their providers have encountered what they sometimes call the “black hole phenomenon” – when their patient moves to out-of-hospital care, too often the provider loses visibility into that patient’s care and progression. Given the shift to value-based reimbursement models for those referral sources, the challenges providers face when systems aren’t interoperable are only becoming more painful. In fact, a recent survey found that 60% of providers said they would switch post-acute care providers if they could interoperate with them. This means that starting your journey to Interoperability could give you a competitive advantage with referral partners while also helping improve patient outcomes. Here are five recommendations to get started.

1: Get to a common definition of interoperability.

The main thing to remember is that interoperability is not just sending over a document. The HIMSS (Health Information Management Systems Society – the world’s largest health technology group) definition of interoperability includes the phrase “use the information,” which means you should be able to pull information out of structured clinical documents or discrete interfaces and automatically populate your EHR with it.

One question we hear often is, “Can I actually do this today?” The answer is yes. We have case studies of different groups who have implemented these systems, including agency concerns about how referral partners might react. Perhaps surprisingly, the agencies who were most worried turned out to be some of the highest adopters of the technology. We also found that once they start their journey to interoperability, they have been great partners in rolling up their sleeves to work with referral sources to generate even more value for both parties through interoperability.

2: Evaluate the sophistication of your inter-op capabilities.

Most healthcare organizations don’t have the size or expertise to build their own interfaces – and they shouldn’t need to. Assess EHR providers by looking at their capabilities to find out what they can do right now. Even five years ago, 80% of health systems were exchanging information outside of their walls, so there’s an ample network to plug in to if you’re partnering with the right EHR vendor.

If you find your EHR cannot support interoperability, put your clinicians in the driver’s seat and let them help guide your organization to a solution with a great point-of-care application and great interoperability with the rest of your healthcare ecosystem.

3: Evaluate the financial implications of your interoperability strategy.

This includes knowing what the financial impact will be if you don’t adopt an interoperability strategy. Understand how lack of interoperability can lead to high care delivery costs, or unnecessary readmits, poor profit margins due to lack of automation, or inefficiencies caused by staff having to chase information that already exists in other systems.

For home health providers, PDGM is a factor, too. If you want to be financially successful in a PDGM-based world, or if you’re a hospice thinking about expanding into palliative care, you have to get all patient information upfront, not only what the referral source knows. It’s financially beneficial for you to know everything about a patient so coding is accurate and can potentially lead to higher reimbursement. This is also where national organizations including CommonWell and Carequality can help provide a fuller patient history than the sometimes-limited care histories you can get from referral sources alone.

4: Leverage your interoperability strategy.

Remember that CommonWell and Carequality are bi-directional. This means you can allow information to flow back to your referral sources and other care providers who touch the patient. This can be a major differentiator for your organization with your referral partners. It’s a way to elevate your agency to become a trusted partner in care delivery by being easier to do business with and by providing visibility into the post-acute care being provided, rather than seeming like a black hole of care delivery.

5: Keep up with the organizations that are creating and enforcing interoperability standards.

Groups including the Office of the National Coordinator for Health Information Technology and CMS announced rules that will go into effect soon, mandating easier access to interoperability and more information exchanged in advanced formats to make data more usable. When you talk to your EHR partner, make sure they have a plan for how they’re going to support these changes. For example, MatrixCare is actively invested in the Home Care Technology Association of American, in the Private Duty Home Care Association, and in the National Association for Home Care and Hospice, as well as organizations like Direct Trust and the CommonWell Health Alliance so we make sure we understand where the industry is headed and can help guide our customers.

No matter what, your journey to interoperability all starts with a conversation. Talk to your referral sources, talk to your EHR partner, talk to MatrixCare. To stay competitive, it’s important to take the steps you need to get started.

Learn more about interoperability.

Disclaimer

The content in this presentation is for informational purposes only and is provided “as-is.” Information and views expressed herein, may change without notice. We encourage you to seek, as appropriate, regulatory, and legal advice on any of the matters covered in this presentation or materials.

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