The Journey to Interoperability: The Impact on Post-Acute Care

 

The PACIO workgroup objectives are to develop use cases and implementation guides (IGs) that identify standardized and clinically important data elements and associated technical standards allowing for health-related data exchange in PAC settings. Workgroup topics include physical functioning and engagement, speech, language, swallowing, cognitive-communication, and hearing, and transitions of care. Of particular interest to rehabilitation professionals is the Personal Functioning and Engagement (PFE) Workgroup that has adopted the World Health Organization’s International Classification of Functioning, Disability and Health (ICF) as a framework. IGs and use cases are tested during Connectathons which are events that determine if the implementation guides and specifications are complete and result in successful electronic data exchange.  In the video presentation, I will discuss the results of the PFE Connectathon.

As of today, PACIO has successfully published two IGs on Physical Functioning and Engagement (PFE) and Advanced Directives.  The PFE IG is of particular interest to rehabilitation professionals.  To develop easily adoptable, clinically relevant, internationally recognized technical standards, multiple and disparate professionals need to work together.  Challenges associated with professional backgrounds, preferred terminology, and domain-specific perspectives are evident however workgroup discussions have resulted in robust discussion and consensus-based decision-making. The future implications of a national, interoperable health data system will challenge and benefit all stakeholders including clinicians and researchers.  Further participation and support are warranted from rehabilitation communities. The presentation will also discuss the possible impact of the PACIO project on related health service

With the government’s growing support of an interconnected and interoperable healthcare system with standardized data elements, the U.S. is getting closer to establishing the structures required for a learning health system. This work is essential to having clinically meaningful health information that can lead to more informed and person-centered care, robust quality measures, comprehensive datasets for research, and an evidence-based, fair payment system. The rehabilitation researcher is an important stakeholder in these initiatives as they understand and engage with complex health systems, are focused on learning and outcomes, and can address the challenges and opportunities associated with developing learning health systems.

This case discusses the effort in developing post-acute care (PAC) standardized data elements, implementation guides, and use cases to advance interoperable data exchange among PAC settings through the Post-Acute Care InterOperability Project (PACIO). PACIO is a collaborative and consensus-based effort to advance interoperable health data exchange using internationally accepted technical standards (HL7 FHIR) among PAC settings and providers, patients, their caregivers, and key stakeholders across healthcare. The PACIO Project is sponsored by the Centers for Medicare and Medicaid Services (CMS) and led by The MITRE Corporation and supported by APTA, AOTA, and ASHA. 

The PACIO workgroup objectives are to develop use cases and implementation guides (IGs) that identify standardized and clinically important data elements and associated technical standards allowing for health-related data exchange in PAC settings. Workgroup topics include physical functioning and engagement, speech, language, swallowing, cognitive-communication, and hearing, and transitions of care. Of particular interest to rehabilitation professionals is the Personal Functioning and Engagement (PFE) Workgroup that has adopted the World Health Organization’s International Classification of Functioning, Disability and Health (ICF) as a framework. IGs and use cases are tested during Connectathons which are events that determine if the implementation guides and specifications are complete and result in successful electronic data exchange.  In the video presentation, I will discuss the results of the PFE Connectathon.

As of today, PACIO has successfully published two IGs on Physical Functioning and Engagement (PFE) and Advanced Directives.  The PFE IG is of particular interest to rehabilitation professionals.  To develop easily adoptable, clinically relevant, internationally recognized technical standards, multiple and disparate professionals need to work together.  Challenges associated with professional backgrounds, preferred terminology, and domain-specific perspectives are evident however workgroup discussions have resulted in robust discussion and consensus-based decision-making. The future implications of a national, interoperable health data system will challenge and benefit all stakeholders including clinicians and researchers.  Further participation and support are warranted from rehabilitation communities. The presentation will also discuss the possible impact of the PACIO project on related health service research, based on a claims-based research project. We hope that electronic health record vendors and health systems will use the PFE IG to develop systems to exchange functional health information in a standardized manner. 

 

About this
Applied LeaRRning Case

Ken Harwood PT, PhD, FAPTA,

Adjunct Associate Professor George Washington University Case background: This case will review the US government’s support for an interoperable and shareable healthcare system and its potential effects on rehabilitation practice and research.  The case will focus on the  PACIO,  a collaborative and consensus-based effort to advance interoperable health data exchange using internationally accepted technical standards (HL7 FHIR) among Post-Acute Care settings and providers, patients, their caregivers, and key stakeholders across healthcare.  A demonstration of the exchange of PAC data is included using the PACIO implementation guide and use case.

The PACIO project is a great example of a collaboration of different stakeholders (e.g., clinicians, informaticists, technicians, vendors, and government employees) working together to develop a system for the exchange of important health information in post-acute care settings. It is a foundational step to developing a nationwide learning health system.

Ken Harwood, PT, PhD, FAPTA