HITPC: Workgroup explores certification program for LTPAC and behavioral health entities

Long-term post-acute care (LTPAC) and behavioral health (BH) entities remain ineligible for Meaningful Use incentives, yet one-third of patients discharged from hospitals end up in these facilities.

Health IT Policy Committee (HITPC) Certification and Adoption Workgroup co-chairs Larry Wolf, CIO of Kindred Healthcare, and Marc Probst, Intermountain Healthcare CIO, examined how to encourage these entities to adopt EHR capabilities without incentives through a new voluntary ONC certification program at the HITPC meeting on March 11.

“There is definitely desire in the industry to have some type of requirements because there is so much unmet need,” said Probst.

Wolf presented a five factor framework to identify and prioritize certification criteria for health IT for providers outside of the MU program. These are:

• Tie the ONC certification program to a national priority or legislative mandate
• Align program with existing federal and state programs. “The theme, is that in some ways, less is more, and fewer programs better aligned to move forward technology and move forward improvement in healthcare are what we all are looking for,” Wolf said.
• Utilize the existing technology pipeline.
• Build on existing stakeholder support. “It’s about engaging stakeholders and understanding what they’re trying to accomplish,” Wolf said.
• Appropriately balance the costs and benefits of a certification program.

The workgroup conducted hearings with both LTPAC and behavioral health (BH) organizations and drilled down on several recommendations on areas for inclusion in the criteria.

For all providers outside of the MU program, they recommended focus on criteria dealing with transitions of care; privacy and security; and enhancements of privacy and security. Specific priorities for LTPAC settings would include patient assessments and survey and certification and BH-specific areas include patient assessments and consent management. Wolf said the workgroup is asking for help from the privacy and security tiger team with enhancements of privacy and security.

“These are the things that all surfaced above the imaginary line of being important, but I would say there was some degree of contention in the workgroup on all of these,” Wolf said.

In her comments, National Coordinator for Health IT Karen DeSalvo, MD, MPH, MSc, thanked the committee for its work and said the question must be thought through on how to enable and support adoption for these entities without programs like MU. She said market-based solutions that interoperate and are modular and affordable should be explored.

“This is such an important part of the continuum of care,” she said. “It’s becoming increasingly obvious if you want to lower costs, lower readmissions and unnecessary care, we have to be able to see the rest of the continuum."

The workgroup agreed to return to formally recommend which criteria to prioritize in future meetings, with all criteria approved by July.