GAO Calls for More Measurement of Efforts to Use EHR in Post-Acute Patients

February 28, 2017

The lack of measurement goes against the trend toward accountability in healthcare. Studies show there are savings to be found in post-acute settings.

HHS needs to measure efforts to promote the use of electronic health records (EHRs) among providers of post-acute acre, and the agency needs a thorough plan to meet goals in this expensive part of healthcare, the Government Accountability Office (GAO) has found.

The GAO report released Monday identified 5 key factors that affect how much EHRs are used in post-acute settings, which include skilled nursing facilities (SNFs) and long-term care hospitals. The factors are:

  • Cost
  • Variability of standards, including challenges with finding data relevant to post-acute setting
  • Workflow disruptions
  • Challenges with technology
  • Staffing, which in post-acute settings includes the high turnover rate and the need to constantly train new staff to use EHR.

According to GAO’s findings, HHS has worked to increase the use of EHRs among post-acute providers. This area of care both costly and in need of greater accountability; a new study in the Journal of the American Geriatric Society finds a huge share of the hospital readmissions from these facilities are avoidable. SNFs in particular have been a target for cost-control by Medicare, which has eyed both reducing variations in care and cutting fraud.

Among other efforts, the Office of the National Coordinator for Health IT plans to survey post-acute providers to develop baseline data on how much EHRs are being used. But, GAO noted, these surveys are not designed to measure effectiveness.

This lack of measurement by HHS goes against the overall trend toward accountability in healthcare, and it misses a chance to cut costs in a realm where studies show there are savings to be found. HHS also needs to do more to identify—and measure—outside forces that are working against its efforts to boost EHR use in post-acute settings, the report said.

“Without a comprehensive plna to address these issues, HHS risks not achieving its goal of increasing EHR use and the electronic exchange of health information in post-acute care settings,” the report said.