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Written by: Bob Habasevich, PT on Tuesday, December 18, 2012 Posted in: Inpatient Rehab

Long-term care and post-acute care facilities are not officially eligible to take part in the Meaningful Use EHR Incentive Program.  However, many facilities are still closely watching the quality measures and health IT standards called for in the program. The proposed meaningful use requirements for Stage 3 will focus upon care coordination and sharing of information across the care continuum. That means everyone who cares for and treats Medicare patients who have been in the hospital and continues caring for them post discharge. Care planning, coordination, delivery and communication in post-acute care has received the attention of the Office of the National Coordinator for Health Information Technology (ONC) to expand its efforts to adopt health information technology across the delivery continuum.

The Standards and Interoperability (S&I) Framework was launched on January 7. ONC is looking for participants to collaborate on interoperability challenges critical to meeting meaningful use objectives for 2011. The S&I Framework is a collaborative community of participants from the public and private sectors who are focused on providing the tools, services and guidance to facilitate the functional exchange of health information. In order to qualify for Medicare and Medicaid HIT incentive payments, eligible professionals and hospitals must use electronic health records (EHRs) that are certified as meeting the Secretaryu2019s standards for technology, including security and interoperability standards. To support the certification program, the S&I Framework will work with NIST and other stakeholders to develop a robust certification program that will include:

  1. Developing a process for certifying EHR technology;
  2. Establishing technical requirements and testing infrastructure;
  3. Maintaining the master list of all certified EHR technology products and making this list available for providers and purchasers of EHR technology products to meet, in part, meaningful use requirements.

Over the past year, the Standards & Interoperability (S&I) Longitudinal Care Coordination (LCC) Workgroup (WG) to the Office of Standards & Interoperability (OS&I) has been working to define and identify the requirements for care transitions and care plans for medically complex and/or functionally impaired persons. The recommendations of this workgroup have been published in the Aug. 14, 2012 report,  the white paper has been posted under the LCC reference materials site, a copy of the report is available here

Recommendations outlined to the ONC include a Consolidated Clinical Document Architecture (CDA) to permit the standardized exchange of functional status, cognitive status and pressure ulcer content. Also, recommendations for ONC to support the development of requirements (i.e., standards and implementation guide) for care plans to support longitudinal coordination care for medically-complex and/or functionally impaired individuals.

Although early in development, the implications for how rehabilitation providers will communicate and report their care interventions between providers is now being proposed. The activities and resources of the Longitudinal Care Plan Workgroup can be followed on the website.