The future of post-acute care: Unveiling the power of interoperability

With providers and patients demanding seamless data exchange, interoperability is vital for patient referrals and quality care in the evolving post-acute care landscape.

The healthcare industry is at a crossroads with post-acute care.  Consumer expectations among patient populations are being shaped by online retail experiences with companies like Amazon and Google.

Even so, post-acute care (PAC) has lagged behind in the use of modern technology typically employed in acute and ambulatory care. PAC must now address the growing need for interoperability among all care settings. 

Healthcare providers must be able to exchange data electronically to support their own operations, and more importantly, their patients. Patients and providers now expect instantaneous, personalized experiences that have become streamlined and commonplace in most other settings.

The Interoperability and Engagement Research Report, commissioned by Brightree and MatrixCare, conducted by in90Group, revealed that 99 percent of hospitals and physicians are more likely to refer patients to PAC providers that offer interoperability. That percentage, up from 74 percent in 2021 and 60 percent in 2019, reinforces the potential for increased referrals when healthcare organizations are equipped with the right tools.

However, most PAC providers are not prepared to meet referral source and patient expectations for the interoperable exchange of data. The major voids include effective transitions of care, providing visibility into the patient’s post-acute care journey, and coordinating with other providers as the patient’s care needs evolve.

Interoperable technologies are necessary to coordinate care between referring providers and post-acute care providers during transitions of care. In addition, they provide a 360-degree view of their patients, offering providers rapid access to a patient’s complete medical records. With accurate care histories, SDOH data and analytical insights, providers can make more informed decisions to ensure the most appropriate and timely care for their patients.

By leveraging interoperable technology platforms, PAC providers can ensure they remain competitive and provide high-quality patient care. The survey results show that PAC providers are being increasingly judged based on their interoperability capabilities. Those that invest in these solutions will benefit from increased referrals and better relationships with their referral sources.

Why interoperability matters

Recently, the role of PAC providers has been in the spotlight as value-based care becomes popular across the healthcare industry and as more consumers choose to receive care in their homes.

Traditional post-acute care is now often referred to as “out of hospital care,” as many believe these settings prevent unnecessary acute encounters. The survey findings reinforce the need for PAC segments (home health and hospice, home medical equipment, pharmacy, home infusion and skilled nursing facilities) to adopt interoperable software and engagement solutions, which physician and hospital referral sources now expect. Seamless data exchange between disparate systems has become a fundamental requirement of successful value-based care models.  Without accurate, complete and timely data, the risk of failure in value-based care models dramatically increases.

This year’s survey confirms interoperability is not a bonus feature, but a prerequisite capability for PAC providers to keep up with referral sources’ expectations and remain competitive in the out-of-hospital market. With full interoperability, PAC providers can improve communication and collaboration across the healthcare continuum, ensure the efficient use of resources and improve patient outcomes.

Current findings

This year’s Interoperability & Engagement Research spanned multiple post-acute segments.

Some 65 percent of referring entities surveyed reported greater than 25 percent of their revenue is now tied to value-based care arrangements. With another measure, 51 percent expect that percentage to grow over the next 12 to 18 months.

 “Help prevent costly complications” is the No. 1 capability referring entities expect from their post-acute care providers. This is followed closely by “proactively keep me updated on patient status after the referral is made” and “contribute positively to my patient satisfaction scores.” None of this is possible without modern, open technology systems that can exchange data seamlessly with other systems, care providers, and patients/family/caregivers.

When choosing where to send patients, hospitals and physicians focus on the post-acute care network’s ability to seamlessly exchange data. In fact, nearly all of the hospital and physician entities surveyed said they are more likely to refer patients to post-acute care providers who support interoperability workflows such as electronic referrals for patient intake and providing patient status updates.

Many post-acute care providers acknowledge the importance of interoperability, but few have advanced their interoperability strategies over the past 12 months. Progress has been made among electronic health record (EHR) vendors, but many post-acute care providers are not satisfied with their current vendors’ interoperability capabilities. In fact, 72 percent reported that they would be willing to switch vendors with a system that met their most important interoperability requirements.

Strategies for interoperability

With comprehensive, interoperable technology in place, healthcare providers can focus on patient-quality care rather than processes and workflows. Data exchange processes must ensure that information is easily understood by both patients and providers and healthcare providers need to pay attention to how they use it.

As electronic referrals become the norm, healthcare providers must ensure that referral processes take advantage of automated technologies such as electronic referral forms, appointment scheduling tools, and automated communication systems. These tools ensure quick and accurate referrals, with enhanced communication and timely care for patients.

Referral processes must serve customer needs with automated reminders to help patients keep track of appointments and systems for patients and family caregivers to communicate with a broad and complex care team.

Providers must monitor the patient experience regarding data exchange. The Centers for Medicare & Medicaid Services now require provider organizations to post their CAHPS survey reviews online. This may affect referrals, reiterate the importance of understanding how patients perceive the data exchange process, and highlight the steps required to ensure a positive experience.

The modernization of the healthcare continuum is an ongoing process. Feedback from surveys like this and annual CAHPS surveys offer providers a checklist to ensure they stay competitive. Interoperability is not a short-term trend but is vital to the progression of post-acute care and patient success. An organization’s PAC strategy should be an important part of its operation, with attention paid to connecting with those care settings.

Nick Knowlton is vice president of strategic initiatives for ResMed.

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