Tuesday, April 20, 2010

The Stimulus and Skilled Nursing/Long Term Care

I'm often asked questions about HITECH and its implications for specific organizations and groups. Last week, I was asked specifically about Skilled Nursing Facilities.

John Derr of Golden Living, LLC is a member of the HIT Standards Committee. I asked him for his view. Below is his answer, which I hope you find helpful.

"This email is in response to your email to Dr. Halamka and the HITECH program including Skilled Nursing Facilities (SNF). Even though SNFs and other long term & post acute care (LTPAC) providers were not yet included in the ARRA stimulus funds we have many programs underway to participate in the electronic health record (EHR) initiative. There are representatives of LTPAC providers on the HHS Federal Advisory Committee for both Policy and Standards. I am on the Standards Committee as well as the Quality and Implementation Committee Workgroups. I am also a Commissioner on the Commission for Certification of Health Information Technology (CCHIT) as we have a workgroup underway developing EHR Certification Standards for the SNF and other LTPAC provider applications. I also am on National Quality Forum (NQF) Committees working on the electronic quality measures. I mention this to let you know that after many years where SNF (LTPAC) was not at the table, we now have representation at the committee levels but have not yet received much attention from Congress that is why we are not in the ARRA.

In 2004 at the meeting where Secretary Thompson announced the Presidents Executive Order to develop the EHR the Secretary asked me to coordinate LTC HIT. I formed a collaborative called the LTPAC HIT Collaborative which is made up of all the LTPAC provider and vendor stakeholders. I assume Bethany Home Society of San Joaquin County is a member of AAHSA and CAST. they are both members of the Collaborative. I have attached a copy of the comments the Collaborative made on the ARRA Meaningful Use which provides the names of the organizations.

With that said, we are working very hard to have SNFs and Home Care be part of the incentive programs because many of the eligible hospital and physician "Meaningful Use" electronic quality measures will require interconnectivity and interoperability with SNFs and Home Care Agencies. At this point the HITECH program does require that providers with a large number of Medicaid patients be included in the HITECH program. In fact the states will have to write their plans to include all high census Medicaid providers in order to have their plans approved by CMS and ONC. The Collaborative is working with the states to develop a kit to help them include SNFs in their plans. We are also working with NQF on the "Meaningful Use" electronic quality measures so that a patient will have the same quality measures as they move from a hospital or physician practice to a SNF.

On June 7th and 8th there is an LTPAC HIT Summit in Baltimore where you can receive all the HIT activities concerning LTPAC. I would encourage you to attend this summit and to become involved at the state level. Much of the decisions will be at the state level and the more SNF informed CIOs that work with the state the better our chances of receiving incentive assistance.

Dr. Halamka's work and leadership is so very helpful to us all. Even though SNFs were left out of the ARRA legislation we are all working together to ensure that SNFs have not been left out of the future planning. If you attend the LTPAC HIT Summit you will receive the 2010 - 2012 updated LTPAC HIT Roadmap which can help you in the planning of your HIT system. Plus there is an interoperability showcase where there will be demonstrations of what others are doing to implement the EHR. I have attached a copy of the current draft program and a flyer.

Thank you for asking Dr. Halamka your question and for following his Blog. If you have any further questions please do not hesitate to ask.

Respectfully
John
John F. Derr, R.Ph.
Strategic Technology Consultant
Golden Living, LLC"

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