Home Healthcare Interoperability & Record Retention Requirement


The ability to exchange health records has become a major business factor for home health care providers. In a study, 99 percent of hospitals and physicians who refer patients for home-based care report they would change which care providers they send patients to if they have an opportunity to achieve better interoperability. With post-COVID-19 healthcare models shifting to a mix of in-facility, hybrid and home-based care, electronic health record (EHR) applications for home health care providers need to be equipped to share records upstream and downstream, including with patients. About two-thirds of home health care providers say their current EHR isn’t equipped to do the job.

Home Health will benefit from interoperability

The rise in home health care is driven by three things: Post-COVID-19 care models, the increasing number of older people in the country, and the ability to achieve cost reductions over providing services in skilled nursing facilities or hospitals. With the shifts in where services are being conducted, home health care providers need electronic health record (EHR) solutions and other technology tools that meet their needs for long-term health record compliance and information sharing.

What started as an effort to keep non-COVID patients out of hospitals, propelled home-based and virtual services into a popular and growing care model. About 58% of consumers have used virtual care in the last 12 months. And, a report found that since 2020, home health care services is the number one supplemental benefit offered by Medicare Advantage.

This market is expected to continue to grow, specifically with the volume of aging Baby Boomers. Growth from mergers and acquisitions (M&A) is dominated by a few payers and large-cap healthcare companies looking to broaden their range of services and banking on the continued growth in the home health care space.

Home health care offers convenient and cost-effective services outside of a hospital or physician’s office.

Home health care represents a wide range of health care services that can be given in the home for an illness or injury. Benefits include lower cost, convenience, and as effective care as would be received in a hospital or skilled nursing facility.

Home healthcare can be used for:

  • Skilled nursing
  • Home Health Aides
  • Physical Therapy
  • Occupational Therapy
  • Speech Language Pathology
  • Social Work

Home Health Care Evolves to Support an Aging Population.

Home-based care can help reduce hospitalizations by keeping non-RSV and flu patients out of emergency rooms. With 36.5% of ER visits ending in hospitalizations for seniors, obtaining medical care outside of the hospital can prevent unnecessary hospitalizations.

It makes sense that home-based primary care with physician house calls is also making a comeback and demonstrating better outcomes and cost reductions. An analysis of a Veteran Affairs’ home-based primary care program found that it resulted in 25.5% lower hospitalizations than expected. And, Medicare’s Independence at Home (IAH) program for evaluating home-based primary care, generated over $100 million in savings over a five-year period.

As the number of Baby Boomers continues to age, home health care is expected to grow as well. About 1 in 6 Americans was 65 or older in 2020, which represents about 55.7 million people. This is 38 percent growth since 2010, compared to just 2 percent growth in the under-65 population. Plus, projections note that 80.8 million residents 65+ are expected by 2040.

Medical care for the aging population will need to keep pace and home care services could support many of the chronic conditions that affect this demographic: almost half have arthritis, 25 percent have some type of cancer, and 20 percent have diabetes.

Rise in hybrid care models blends in-facility care with home-based services.

Hybrid care models – where in-home healthcare meets remote complements (virtual check-ins with home caregivers, wearable tech, remote patient monitoring, health apps, etc.) also is picking up. This model of care offers patients convenience and a way for them to more easily engage in care which leads to better patient outcomes.

Hybrid care, like home-based programs, will have patients and their families looking for easy access to their health record and seamless communication with other healthcare providers and privacy.

What are the record retention requirements for a home health care agency?

Record retention laws and guidance can vary state to state and are governed by federal, state and local laws; however, a home health care agency must maintain a complete and accurate record for each patient regardless of where they are seen. There also are numerous and ever-changing Medicare and insurance regulations that need to be monitored and documentation must be detailed to be compliant.

For example, the federal Center for Medicare Services requires reporting of outcome and assessment quality data by home health agencies every 60 days. This includes:

  • Evaluation. A complete intake evaluation of the patient that reviews the patient’s entire functioning and health status. This sets the groundwork for tracking treatment progress over the 60-day period.
  • Plan of Care. An overall plan that may include multiple clinicians such as occupational therapy, physical therapy, etc. Each area must include the treatment goals and measurements.
  • Treatment notes must show that the intervention or treatment is supporting the plan of care and progress toward the overall goals.
  • Specificity. The notes must be clear and precise for the clinicians and for Medicare and insurance reviews.

The National Association for Home Care & Hospice recommends agencies maintain patient records for at least 10 years to accommodate the requirements in the regulations and the statute of limitations in the Federal False Claims Act. This includes skilled nursing, physical therapy, occupational therapy, aide services or medical social work. Specific guidelines may differ in various regions of the country, so it is important to consult local authorities and professional associations for distinct record retention requirements. It also can be helpful to utilize customized EHR solutions specifically designed for home health organizations.

Home health agencies utilize many different Home Health EMRs, including: AxisCare, Alora, EpicCare Dorothy, Homecare Homebase, MatrixCare, MEDITECH, Home Health EHR, PointClickCare, WellSky and others.

 Interoperability’s Effect on Home Health Care

As record retention is a necessity, so now is the ability to share records. Recently, 99% of referral sources (physicians and hospitals) said they would switch which care providers they send patients to if they have an opportunity to achieve better interoperability in home healthcare. Equally as interesting is that 96% of survey respondents said they would send more referrals to post-acute care providers with strong patient engagement capabilities.

Post-acute care (PAC) home health care and hospice providers report:

  • 97% of PAC providers said they believe it is important to be able to exchange data electronically with their referral sources.
  • 65% of PAC providers said they’re not fully satisfied with their EHR vendor’s ability to meet their most important interoperability needs.

Home health and hospice providers may need to switch EHRs to compete. When that happens, an active archive supports access and interoperability for legacy records.

When EHRs are replaced with newer technology, often cost and complexity prohibit migrating all the older records into the new system. These records are still needed to comply with record retention requirements and sometimes for clinical care.

Implementing an active archive, like HealthData ArchiverTM , provides a cost-effective and interoperable for storing and accessing historical data. Our award-winning team of experts extracts data from your legacy system and migrates it to a relational database. It’s then made accessible in an easy-to-use, efficient browser-based platform for years to come.

Harmony Healthcare IT’s suite of data management solutions under its HealthData Platform™ provide secure options to enable stored data for home healthcare interoperability utilizing its HealthData Integrator® solution.

Is your home health care agency facing interoperability challenges and/or upgrading your EHR?

We can help.

Dec 04 2023

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