GAO Report: HHS Needs Better Planning on Increasing Information Exchange in Post-Acute Care Settings

This week the Government Accountability Office (GAO) publicly released a report entitled “HHS Needs to Improve Planning and Evaluation of Its Efforts to Increase Information Exchange in Post-Acute Care Settings.” The report recommends that the Department of Health and Human Services (HHS) evaluate the effectiveness of its key efforts to increase the use of electronic health records (EHRs) and electronic information exchange, as well as comprehensively plan for how to achieve the department's goal regarding the use of EHRs and electronic information exchange in post-acute care settings.

The GAO conducted stakeholder interviews, including an interview with the Society’s leaders about EHR and quality, and found five key factors that affect the use of EHRs in the post-acute care settings. Those factors include:

• Cost: Stakeholders stated that facilities often have limited financial resources to cover the initial cost of an EHR and noted that additional costs may be incurred for exchanging information and for EHR maintenance.
• Implementation of standards: Stakeholders expressed concerns with the variability in implementation of health data standards and the difficulty of finding health information relevant to post-acute care providers when this information is exchanged.
• Workflow disruptions: Stakeholders stated that implementation of EHRs requires post-acute facilities to change their daily work activities or processes, which can be disruptive.
• Technological challenges: Stakeholders stated that they face technological challenges, such as having EHRs that are not capable of electronically exchanging health information.
• Staffing: Stakeholders noted that a lack of staff with expertise to manage EHRs and high staff turnover result in a constant need to train staff to use the technology.

The report also mentioned that the Office of the National Coordinator for Health Information Technology (ONC) is planning to survey providers in post-acute settings to gather baseline data on the rates of EHR adoption and activities that demonstrate ways to electronically exchange health information. However, these surveys are not intended to assess the effectiveness of HHS's efforts to promote EHR use.

GAO noted that “although HHS's goal depends in part on actions by post-acute care providers and EHR vendors, HHS lacks a comprehensive plan with specific action steps to achieve this goal. HHS's planning also does not address how to overcome key external factors that may adversely affect its key efforts. Without a comprehensive plan to address these issues, HHS risks not achieving its goal of increasing EHR use and the electronic exchange of health information in post-acute care settings.”

The Society continues to work with the LTPAC HIT Collaborative to advance the goals of interoperability for clinical practices working in these settings. The Collaborative holds an annual summit that brings together clinicians, EHR vendors, and LTPAC facility providers that help advocate for and advance the goals for information exchange in this sector. The Society is a strategic partner for the summit and encourages its members to participate in these discussions.