The Centers for Medicare and Medicaid Services (CMS) has unveiled the Data Element Library (DEL), which is a centralized resource for CMS, allowing the public to view specific types of data that CMS requires post-acute care facilities to collect as part of the health assessment of their patients.
Post-acute care settings are currently grappling with challenges in the following areas:
- Lack in uniformity in assessments across providers
- Communication between acute care providers and non-acute care providers is not standardized
- Gap in Care Communication
- Lack of coordination in care management processes and interventions
- Repetitive documentation by providers
- Assessment data is not interoperable
Quality measures only measure quality in one setting. To address the above pain areas, CMS announced what is called Data Elements Library, aimed to help advance electronic health record interoperability in long-term and post-acute care settings.
The impetus for this change comes from the Impact Act 2014, which requires the submission of standardized assessment data by different settings in different ways. The Act required reporting of standardized patient assessment instrument categories. Standardization and hence interoperability among these post-acute care providers is aimed through DEL. The settings targeted include:
- Long-Term Care Hospitals (LTCHs): LCDS
- Skilled Nursing Facilities (SNFs): MDS
- Home Health Agencies (HHA): OASIS
- Inpatient Rehabilitation Facilities (IRFs): IRF-PAI
- Hospice (HIS)
What does DEL include?
DEL database includes Post-acute care assessment questions and their response options, as well as other associated details including the assessment version, item labels, item status, copyright information, CMS item usage, skip pattern information, look back periods and linked health IT standards (e.g.: LOINC, SNOMED).
The data sets applied and validated by each data consumer are as follows:
- Care Planning: Medication required, symptoms, problems
- CQM Reporting: Patient and family engagement, patient safety, clinical process
- Payments (CMS/stats): Integrated delivery system
- Program Integrity
- Research
- Survey and Certification
- Patient Transfers
Benefits:
Some of the benefits of DEL are listed below:
- Healthcare organizations use this EHR-integrated patient health data to earn federal incentive payments and fulfill measures for quality improvement
- DEL takes up data standardization to the next level and aims to advance interoperability and achieves the primary benefits listed below:
- Lower burden on providers
- Enhanced communication among healthcare providers
- DEL now puts these standards and data elements in one place in a “one-stop shop”. It will be much easier for health IT vendors to incorporate them into electronic health records (EHRs) that are used by post-acute care providers
Conclusion
The law is first of its kind that has mandated the post-acute settings to incorporate certain pieces of information like demographics, health evaluation and any medical problems into the post-acute care, EHRs, including nursing homes and rehabilitation centers. This promotes a smooth exchange of patient information from one provider setting to the next.
With DEL in place, it is possible for post-acute care settings to reuse the data, share the standardized data and thus strengthen the interoperability and also keep everyone on the same track and guarantee that the patients will receive proper healthcare services.
Sanjay Patil