"We're seeing an uptick in that space," said Zane Burke, executive vice president of Cerner, based in Kansas City. "The rehab providers are preparing for bundled payments and how they will play in a world of accountable care organizations."
The same is true of other post-acute-care providers, including home care and hospice agencies and long-term-care facilities, he added.
Rusty Yeager, chief information officer of HealthSouth, said that his company started looking at how to computerize its facilities five years ago, before healthcare reform was on the horizon. "The value proposition for our clinical information system is improved patient safety, increased operational efficiencies, and an improved patient experience," he said.
Nevertheless, he noted, now is the right time to start rolling out the Cerner EHR to HealthSouth's hospitals. For one thing, he noted, the technology has become mature enough. He also cited "the opportunities for synergies that are going on within health IT and healthcare reform and our referral partners' use of health IT." And he agreed the prospect of payment bundling is part of that mix.
Rehab facilities are ineligible for the federal government's Meaningful Use incentives. But, as Yeager suggested, the increasing number of hospitals that are deploying EHRs to garner those incentives increases the value of similar information systems in rehab facilities, because they can exchange data.
In a statement about the HealthSouth deal, Burke pointed out, "Many of HealthSouth's hospital referrals come from acute care hospitals. Digitizing care in HealthSouth's hospitals creates the potential to link its hospitals with the acute care facilities, enabling a more efficient and higher quality patient care process."
Yeager confirmed that this is HealthSouth's intention. But it will require a multi-faceted strategy, he noted, ranging from point-to-point interfaces to participation in health information exchanges. Aside from the differences in how healthcare systems are approaching data exchange, he pointed out, HealthSouth's referral partners are "at different levels of maturation in their ability to exchange this information."
Some HealthSouth facilities, Burke said, are located near acute-care hospitals that also use Cerner Millenium. That would make it relatively simple to interface the systems, he said. In other cases, the rehab hospitals will have to use health information exchanges--most of which, he added, will be private networks that include the hospitals' affiliates and partners.
HealthSouth began testing the Cerner product more than a year ago at its Northern Virginia facility. It plans to go live on the EHR in its Glendale, Ariz., hospital this month, and will install Millenium in the new facility it plans to open in Houston this fall. Yeager says it will take five years to roll the system out to all of its facilities.
Not many vendors offer clinical information systems designed for rehab facilities. Cerner, which introduced its first such product at the Rehabilitation Institute of Chicago several years ago, had to do a lot of work to develop the content and workflow features of the EHR, Burke pointed out. But he said that the "core" system is the same as the one that Cerner sells to acute-care hospitals.
More than 1,200 inpatient rehabilitation hospitals contract with Medicare, according to the Centers for Medicare and Medicaid Services (CMS). Burke said he didn't know how many facilities there are in the country but that it was more than 1,000. "It's a large market," he noted.
The HealthSouth deal is significant not only for its size, but also for its implications, Burke added. "We're seeing this as a recognition that [health IT] is not just about the physician and hospital market. It's about how we provide solutions from birth to the end of life."
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