In a perfect world, all healthcare systems would be connected and seamlessly share patient information.
Imagine the possibilities if every provider involved in a patient’s care could access their complete health record, enabling fine-tuned treatment and more satisfying patient experiences. Dangerous inaccuracies could be reconciled and corrected. Aggregated data could contribute to population health studies and support clinical decision-making.
Adoption of electronic health records has grown significantly since 2010, bringing us so much closer to that reality. However, while many providers are using some form of technology for patient records, health data is often siloed within a single practice and disconnected from the patient’s full ecosystem of care.
The future of healthcare involves fully interoperable systems and patient health information sharing. In this article, I’ll explain how sharing data with other providers can help your practice keep pace with the changes in healthcare–and how to take the next step toward interoperability.
A Brief History of Interoperability
Years ago, U.S. healthcare policy wonks created a framework for improving our nation’s health systems. The framework was called The Triple Aim. The Triple Aim’s goals were to:
- Reduce healthcare costs.
- Improve patient care.
- Improve population health.
The Triple Aim has served as the framework for our changing healthcare landscape.
Congress passed a number of laws to promote adoption of healthcare technology. Congress’ legislative efforts supported the Triple Aim goals by moving all providers from paper records to electronic health records, promoting data sharing across all systems, and enhancing patient access to their health data.
The Center for Medicare and Medicaid Services (CMS) created programs to shift Medicare reimbursement from a fee-for service model to quality care. Its new value-based programs focused on sharing healthcare information across systems for seamless interoperability and collaboration.
One day, your practice may be connected to a number of different healthcare systems. You will retire your fax machine, save administrative time chasing referrals, and work closely with other practitioners to deliver high-quality, collaborative care.
Let’s explore the main ways that sharing health information can improve your practice’s success, from a clinical and business standpoint.
1. Better Care Coordination
Using an interoperable EHR means having the ability to close the referral loop. CMS and healthcare research support closing the referral loop as a means for improving patient safety and quality of care. Even though many states allow patients to access rehabilitative care, like physical therapy, via direct access, referrals are still the primary way for many practices to attract new patients.
Closing the referral loop requires bi-directional information sharing. In this process, a physician sends you a referral using a secure interface. You perform your evaluation and course of care and send this information back to the physician. The physician can review your documentation for an update on the patient’s care.
Why Is Care Coordination Important?
Collaboration between providers is a best practice for healthcare. Collaboration and communication avoid duplication of services and waste. All providers involved in seeing the patient understand the types of interventions provided.
Most importantly, sharing information with other providers sets your practice up for long-term growth and better patient experiences. It sends the message that your practice is in alignment with the future of healthcare. Other providers can work with your practice through seamless interoperability for ease of healthcare data exchange. The physician no longer has to wonder how the patient is responding to rehabilitation; the physician practice can review your documentation in its systems.
When a physician or hospital is considering where to send a rehabilitation referral, they may prefer your practice over a practice lacking interoperability that is still relying on faxes and phone calls.
2. Improved Safety and Quality of Care
Using a certified EHR that interfaces with other systems and has robust interoperability capabilities can improve patient safety and treatment outcomes by reducing the risk of medical errors and wasteful services, in favor of more tailored care.
Here are some ways that information sharing between providers can improve patient safety:
- Therapists can share health data with the patient’s primary care physician, making it easier to identify contraindications to your rehabilitation services.
- Outpatient providers can be notified when patients are admitted to the hospital and plan to suspend care or re-engage patients when appropriate.
- Providers can have access to a patient’s complete medication list, to inform their intervention approach.
Physical safety isn’t the only concern, of course—clinicians must also protect patient privacy. As such, EHRs that interface and share data must do so while protecting the privacy and security of patient health information, a key priority for patients.
3. Empowered Patients and Families
Patients want access to their health information. After all, many modern patients see themselves as the consumer of healthcare services. They want to know about their (or their dependents’) rehabilitation goals, recommendations, and additional educational opportunities. They may want to aggregate their health information and manipulate their data. Perhaps they want to “biohack” their health. Or they want a clear idea of how much their healthcare costs.
For those reasons and more, making health information freely available to patients is a clinical best practice—and, increasingly, a regulatory requirement.
What Is Information Blocking?
Information blocking is defined as a practice by a provider, health exchange, or health IT vendor that is likely to interfere with the access, exchange, or use of electronic health information (EHI). For more information about information blocking, see the HeathIT website.
What Are The Consequences of Information Blocking?
If you are engaging in information blocking, you may face steep monetary penalties. The Department of Health and Human Services Office of Inspector General began enforcing the Information Blocking Rule on September 1, 2023, with penalties of up to $1M.
Additionally, on October 29, 2023, the Department of Health and Human Services proposed new disincentives to CMS programs for health care providers that have been found to have committed information blocking under the 21st Century Cures Act.
4. Efficient Clinical Processes and Patient Intake
Using technology to facilitate the exchange of patient health information can help you optimize your growing practice.
For example, using an EHR that can interface with other health systems could allow you to more efficiently and securely receive eReferrals and medical records–helping you boost the speed and volume of new patient intake.
When it comes to clinical decision making, too, an EHR that can share information using a FHIR interface allows you to easily search for the right information about your patients, saving valuable time and energy. And sharing patient health information using the USCDI standards enables more effective collaboration with other professionals.
5. Preserve Medicare Reimbursement
Revenue is a top business priority, and many rehabilitation therapy practices rely on Medicare reimbursements to maintain their bottom line.
Practices that meet a certain threshold are eligible or required to participate in MIPS reporting, a system that assesses clinicians’ delivery of quality care. A MIPS score is made up of four performance categories—and one of them has everything to do with information sharing.
Promoting Interoperability
Practices that support the sharing of health information can earn valuable points for participation in the MIPS Promoting Interoperability performance category. This performance category comprises 25% of the total score.
The MIPS Promoting Interoperability performance category includes measures such as:
- Providing patients with electronic access to their health information using Certified EHR Technology.
- Supporting electronic referral loops by receiving and reconciling health information.
- Conducting a security risk analysis.
- And more. Explore QPP measures and activities here.
MIPS Reporting and Rehabilitation Therapy
Let’s zoom in on our corner of the healthcare world, rehabilitation therapy, for some important updates.
To date, rehabilitation providers (PT, OT, SLPs) were not required to participate in the Promoting Interoperability Performance Category. However, the 2024 Medicare Physician Fee Schedule Final Rule ends automatic reweighting the Promoting Interoperability Performance category for our specialty.
If you are using certified EHR technology (CEHRT)—such as Raintree’s EHR—you already meet one of the major requirements of Promoting Interoperability. That means you’ll stand a better chance of preserving your Medicare reimbursement at the current fee schedule (or higher!) and avoiding the impact of downward adjustments.
Sharing Patient Health Information Securely
To share patient health information securely and see the many benefits of interoperability, you need to put the right software in place.
That’s where we come in. Raintree Systems offers an all-in-one platform for PT, OT, SLP, and multi-specialty outpatient practices, including our certified EHR system that meets the strict certification standards set by the Office of National Coordinator. In fact, we offer the only ONC-Certified EHR designed for rehab therapy, leading the field in compliance and helping you tackle regulatory complexity.
So let’s keep the conversation going! Schedule a demo and learn how Raintree can help you optimize clinical documentation, intake, billing, RCM, patient engagement, business intelligence, and more—all in one, powerful platform.
Veda Collmer, JD, CIPP/US, Raintree Systems’ General Counsel, Chief Compliance Officer, brings more than 10 years of experience in health law, privacy and compliance. Veda received the Robert Wood Johnson Foundation Public Health Law Fellowship in 2012 and completed her fellowship at the Arizona State University Sandra Day O’Connor College of Law.
