A proposed federal rule setting Medicare FY 2016 payment rates for skilled nursing facilities sets no requirements nor offers substantial help for these critical partners in care coordination to adopt electronic health records and health information exchange technologies.

The rule, from the Centers for Medicare and Medicaid Services, follows a bill awaiting President Obama’s signature changing how physicians are paid under Medicare that also declares interoperable electronic health records across the nation by 2019 to be a national objective. It also follows a draft national Interoperability Roadmap from the Office of the National Coordinator for Health IT, accelerated work by Health Level Seven to complete its FHIR initiative creating an open healthcare data standard using the latest web standards, and ramped up operations by industry-backed interoperable organizations CommonWell and Healtheway.

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Another recently proposed rule from ONC strongly encourages providers not covered under the EHR meaningful use program—including skilled nursing facilities—to adopt certified EHRs. Further, the new proposed rule for skilled nursing came out as CMS and ONC officials spent several days at the HIMSS15 conference touting the need to accelerate interoperability.

In the 150-page rule, CMS spends two pages encouraging skilled nursing facilities to adopt electronic health records and health information exchange technologies. “HHS believes that all individuals, their families, their healthcare and social service providers, and payers should have consistent and timely access to health information in a standardized format that can be securely exchanged between the patient, providers and others involved in the individual’s care,” the rule states.

But aside from the listing of available reports and guidance documents, such as a list of “best available standards and implementation specifications to enable priority health information exchange functions,” skilled nursing facilities along with other ancillary providers critical to care coordination are left on their own to enter the Information Age. CMS did not respond to a request for comment on the lack of substantial assistance being made available. The proposed rule is available here.

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