U.S. GAO Calls for Improvement in HHS Plan for Post-Acute Care Electronic Health Information Exchange

The United States General Accounting Office (GAO) released a report on Feb. 27, 2017 evaluating the efforts of the United State Department of Health and Human Services (HHS) to promote electronic health information exchange (HIE) by post-acute care providers. The GAO noted that when patients are discharged from hospitals to post-acute care providers, electronic HIE can inform the receiving providers about patient needs and support coordination of care. Citing as one of its sources the LeadingAge NY study on electronic health record (EHR) adoption and HIE among its members, the GAO found low levels of HIE by post-acute care providers and identified five key factors affecting their use of EHRs and HIE:

1. the cost of EHRs;
2. concerns with the implementation of health data standards that facilitate HIE, including variability in the implementation of standards and the difficulty of finding relevant information when it is exchanged;
3. implementation of standards for EHRs and electronic health information exchange;
4. the impact of EHRs on workflow;
5. technological challenges such as lack of EHR capabilities; and
6. the need to train staff to use EHRs.

To improve efforts to promote EHR use and HIE in post-acute care settings, the GAO recommended that the HHS Secretary direct the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) to take the following two actions:

• Evaluate the effectiveness of HHS’s key efforts to determine whether they are contributing to HHS’s goal for increasing the use of EHRs and electronic exchange of health information in post-acute care settings.
• Comprehensively plan for how to achieve the Department’s goal related to the use of EHRs and electronic information exchange in post-acute care settings. This planning may include, for example, identifying specific actions related to post-acute care settings and identifying and considering external factors.

Unless HHS takes these steps to strengthen its comprehensive planning process, the GAO warns that HHS risks a failure to meet its goal of increasing the proportion of post-acute providers that send, receive, find, and use electronic health information by 2017.

Contact: Karen Lipson, klipson@leadingageny.org, 518-867-8383 ext. 124