Micky Tripathi, CEO of the Massachusetts eHealth Collaborative, says that adequate home care IT is not widely adopted in Massachusetts. A new survey aims to identify gaps in home care providers' IT infrastructure and use. The survey will assess providers' IT capabilities across four tiers of preparedness and make recommendations to help providers improve connectivity and exchange of health information, particularly by connecting to the state's health information exchange. While some home care providers have basic electronic records systems, the survey findings thus far indicate that many still have significant IT gaps.

1. Home care IT needs upgrade, says
health policy expert Micky Tripathi
Micky Tripathi, CEO at the Massachusetts
eHealth Collaborative (MAeHC), said
adequate home care IT is not widely adopted
in the Bay State. A new survey aims to
identify the gaps.
Home care IT is one of the orphans of meaningful use, a branch of healthcare
that has not received much federal attention and has beenafflicted by serious
interoperability problems.
Now Micky Tripathi, founding president and CEO of the Massachusetts
eHealth Collaborative (MAeHC), is looking to boost home care IT in the
nonprofit consulting group's home state, starting with a survey of home health
organizations. Similar to long-term care and behavioral health, home care has
not been eligible for meaningful use incentive payments.
Partly as a result, many home healthcare agencies have little, inadequate or
not fully functional IT infrastructure making patient transfers and access to
patient health records trickier than they need to be in an age of widespread
EHR adoption.

2. Tripathi says home care needs IT
"A lot of [home care providers] have been left out of meaningful use. That
doesn't mean they can stand still. They can't," Tripathi, who is closely
associated with an international health ITinteroperability initiative called the
Argonaut Project, which MAeHC is oversees, said.
Tripathi and his MAeHC team are working on behalf of the Home Care
Alliance (HCA) of Massachusetts and home healthcare providers that are not
members of the trade group on a survey of providers' IT gaps, according to
Brittney Darner, a spokeswoman for MAeHC.
The $50,000 home IT project is partially publicly funded with $10,000 from the
Massachusetts eHealth Institute, the state health IT agency, with the state
portion going to expand the scope of the survey MAeHC is conductingto
include non-HCA providers, Darner said.
Identifying home care IT gaps
The home care survey is designed to show where providers are on a four-tier
ranking of IT preparedness and establish a roadmap for how each
organization can improve.
The tiers are:
The organization may have an electronic-record-keeping system
or some kind of EHR, but the system is rudimentary.
The organization may have some kind of documentation technology, but
it interfaces only a little or not at all with other providers or with
patients.

3. The organization may have a federally certified EHR, such as one from
a major vendor, but the provider is only using it to manage and
document home care data and not taking advantage of interoperability
features.
The organization is fully implementing its EHR and using it to exchange
information with other organizations.
While early survey returns show most home health providers are using some
sort of electronic technology, there are still many IT gaps at most agencies,
Tripathi said.
Bridging the gaps
Once the survey of 200-plus home care providers is done, MAeHC will
perform a gap analysis for each organization to identify at what points it needs
help.
The main strategy to bridge those gaps will probably be the same for most
home care agencies: connect them to the Massachusetts health information
exchange, Tripathi said.
How they connect could be via several health information exchange tools,
such as HL7, Direct messaging and possibly even Fast Health Information
Resources (FHIR) -- a new health IT exchange standard still in development
by the Argonaut Project and Health Level Seven International. However,
Tripathi cautioned that widespread use of FHIR likely is still several years
away.
Improving interoperability in home care

4. Home care providers could also have gaps in staff expertise, Internet
connectivity and ability to finance IT upgrades, Tripathi said.
Another common problem is that providers may only be using CMS' outcome
measurement program of Medicare eligibility for home healthcare agencies,
which can't be exchanged easily.
They also may not be able to create or exchange CCDAs, the
ConsolidatedClinical Document Architecture documents developed by HL7
International for health data exchange in meaningful use-certified EHRs.
Tripathi said MAeHC could help agencies develop CCDA-like patient records
that could be more easily transferred to or be received from other healthcare
providers.
Let us know what you think about the story, or share your thoughts on home
care IT; email Shaun Sutner, news and features writer or contact @ssutner on
Twitter.
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