The Golden Years: Interoperable We Stand, Disconnected We Fall

By Therasa Bell and Cynthia Morton

Similar to the recent Covid 19 pandemic, which has had tragic consequences globally, an approaching concern for the future of our elderly population in the healthcare sector is looming.

As the year 2030 draws closer, the realization that our generation of baby boomers will be over 65 becomes abundantly clear. According to the U.S. Census Bureau, this will be a demographic turning point in US history…the senior population will outnumber children. 

Is the Healthcare Industry Prepared for Changes in American Demographics?

Currently, interoperability appears to be a foreign concept to many post-acute providers who are still using old-fashioned data sharing methods due to a lack of understanding and affordability. Although new innovations in interoperability are always on the horizon, 66% of patient information is still being shared via paper fax machines in the post-acute sector. While many would agree that interoperability needs to become front and center for the future of healthcare, how do we garner their attention when dealing with staffing issues and reimbursement concerns? 

We need to relate it to their business and the pain points they are experiencing right now. If we shift the conversation from technology, protocols, and acronyms to the outcomes their staff and their patients will experience, perhaps this will invoke a paradigm shift in how patient information is shared or accessed. Therefore, we need to provide a strong business case to justify the transition to a digitally capable healthcare organization to drive the need for this transition. 

Government incentive dollars to implement interoperable systems will likely not come, yet the government plays a role as the payor for most senior healthcare services; they must be on board and help us proactively pursue this as a universal solution to this impending problem.

Interoperability and Business Needs are Aligned 

With rising healthcare costs, everchanging reimbursement schedules, drastic rises in patient loads, and staff shortages, the healthcare system is in a downward spiral, amplified by the Covid19 pandemic. Provider profit margins are so thin nowadays that the thought of such a task is overwhelming. They may be too close to the trees they are chewing on bark and focused on the risk of change instead of some immediate rewards. 

So how can we overcome this? 

Education is key! We have not done an excellent job of explaining that interoperability can relieve the pressures they are feeling today and ultimately enable administrative efficiencies and cost-effectively improve patient care. By embracing interoperability, post-acute care providers will become prepared for the rising caseload of senior citizens.

The distinct advantages to becoming a digital organization capable of electronic data sharing include:

• Do more with less staff because data can now be quickly reviewed and added to the patient record
• Implement patient matching to automate the filing of patient information to their chart
• Have visibility into the data and analytics needed to participate with ACOs, thus providing the opportunity for higher reimbursement
• Eliminate the expense of paper and toner, as well as the time spent performing manual processes when sorting, scanning, attaching, and shredding patient information
• Improve performance ratings for your organization because you are now equipped with the knowledge about a patient upon arrival, rather than documents getting reconciled days after
• Attract talent by using technology that fits today’s generational shift towards a millennial and gen z workforce that isn’t interested in fax and, more importantly, doesn’t even know how to use it 

Interoperability Starts with Connectivity 

According to a recent KLAS survey, the success rate of interoperability in acute care and subacute settings far outweighs post-acute care. But does it mean that they are complacent with doing things the old-fashioned way? One may think so, but that is not necessarily true. The survey also concluded that when propositioned with the idea of interoperability, they requested help to get them connected.

Many electronic health record (EHR) systems already have electronic data sharing capabilities, yet providers simply don’t realize they are connected and just need to flip a switch to communicate electronically. It doesn’t help that each EHR renames the functionality, using a language specific to their product and unfamiliar to others, creating a barrier to the universal use of data sharing outside of their particular institution.

We need to create a clear path to interoperability, regardless of each provider’s level of technology adoption, and bridge the gap between where they currently are and where they need to be successful. We need to leave the tech talk behind and provide simple steps so they can begin their interoperability journey, whether they need to start with the basics or improve and enhance what they already have in place.

5 Simple Steps to Get Connected

To survive challenging times today AND prepare for the uptick in the senior population, providers need us to cut through the noise and provide simple instructions to get connected and begin to exchange and access patient information electronically. Here are five helpful steps post-acute providers can take right now: 

1. Find out what you have: Contact your EHR to understand what electronic communication capabilities are available. More specifically, find out if you have Direct Secure Messaging, an encrypted “email-like” message with attachments.
2. Get a Direct address: You will not be able to receive messages until you have an address. Allow the information to show up in an inbox rather than your fax machine.
3. Learn how to use Direct: Have your EHR account rep point you to a knowledge-based article or video on how to use Direct messaging. Ensure all personnel receive training and are clear about your goal to transition off of fax over to Direct.
4. Publish your address: Be sure others can find your organization in the National Provider Directory by making sure your Direct address(es) are published. 
5. Notify others in your community: Call or email the providers you exchange with the most to notify them that you’d like to transition away from fax to Direct Secure Messaging. Provide your Direct address and see if they know theirs.

Getting connected is as simple as taking the first step. Start with the largest concentration or highest volume. Fifty percent of a provider’s volume in post-acute may be with organizations who use a specific EHR, or 40% of their referrals may come from a single entity. Embracing interoperability and transitioning off of fax, over time, will bring tremendous relief to providers right now. 

Therasa Bell. Co-founder, President, and Chief Technology Officer at Kno2 (Boise). Combining her passion for healthcare and extensive technical expertise, Ms. Bell created Kno2 as market forces began to drive more effective, lighter-weight healthcare solutions. She is known for three things: her focus on driving interoperability, her ability to simplify the complexities of patient document exchange and clinical workflows, and her commitment to serve that infuses her interactions with everyone and powers the company’s purpose to democratize healthcare communication for all, enabling the secure, effortless, and maximized exchange of patient information. A true inventor at heart, Ms. Bell is responsible for Kno2’s innovation, vision, and engineering, and holds six patents for patient information exchange.

Cynthia Morton, Executive Vice President for the National Association for the Support of Long-Term Care (NASL)

Cynthia Morton is a national expert on Medicaid, Medicare, and other public policy affecting the long-term and post-acute care sector. She serves as the Executive Vice President for the National Association for the Support of Long Term Care (NASL), where she advocates for her members’ interests in Congress and with the Administration. NASL is the exclusive national trade association representing providers of ancillary services to the long-term and post-acute care sector. NASL member companies provide speech-language pathology, physical, occupational and respiratory therapy; portable x-ray and clinical lab; long term and post-acute care electronic healthcare software systems. She was named by Roll Call magazine as one of the top nursing home lobbyists.

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