With or without clear definition, these words are out there and care providers have been told to take them seriously. Are they goals or strategies? Attainable or pipedreams? Reimbursable or pro-bono activities? Healthcare reform has generated new concepts and set lofty patient care targets. It has also introduced questions. Are these targets attainable? And, if so, what are our first steps to start coordinating care across the continuum?
While nearly every plenary and breakout panel at this week's Post Acute Link conference dealt with care coordination and preferred partnerships in narrow networks, one of them focused specifically on pre-acute care, the art of avoiding initial hospital admissions as well as re-admissions.
Lincoln Health brought together providers, payers, and vendors from across the post acute spectrum this week in Chicago to find ways to work together to improve patient care and control rising healthcare costs. SNF, ALF, CCRC, home health and hospice executives learned what problems they have in common and which ones are unique to each type of care.
A general consensus emerged: Data is at the core of every successful attempt to improve patient care. Sharing data is essential but fraught with obstacles. In some cases, the obstacles are technical. Patient data does not flow easily between EMR systems from different vendors. In other cases, obstacles emerge from a sense of branding, "This is OUR data. We are happy to receive yours but you cannot have ours." Or sometimes they are based on a legal argument, "Patient privacy laws forbid us from sharing our data."
"Consider the effect on patient health and safety," argues Addus Healthcare's Diane Kumarich. "We have non-medical home care aides in homes, doing grocery shopping and preparing meals, and the acute care hospital that discharges them will not tell us if they are diabetic." Legally sound, this argument, but dangerous to some recipients to in-home care.
Ray Darcey of Aurora at Home concurs. "There are definite advantages to being inside a healthcare system and using the same EMR," he asserted. "Everything is more difficult when you have to ask for data instead of being able to log on and get it." Aurora Health uses Epic.
Kumarich and Darcey participated in a panel discussion — with Shannon Abbott of Amedisys and Patty Upham from FirstHealth of the Carolinas — exploring pre-acute care. Though hailing from different home health environments in different parts of the country, the four panelists agreed on a set of guidances for any organization planning to offer pre-acute services to its acute partners.
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