ONC Will Not Support Coordination of Care for Home Care

From the NAHC Report article 

Home Health Plan of Care Implementation Guide Affected

Office of the National Coordinator (ONC) for Health Information Technology’s (HIT) which directs the funding of the Standards & Interoperability (S&I) Framework announced today that it has decided to discontinue funding activities that support longitudinal coordination of care and the development of electronic health information exchange standards for home care.

Since the fall of 2011, home care stakeholders have participated in public-private partnership to develop a national standard for the electronic exchange of health information leveraging the home care plan of care data set. The Longitudinal Coordination of Care (LLC) Work Group was informed during National Health IT Week of ONC’s decision to cease funding for the development of the Home Health Plan of Care (HH-POC) standards .

ONC has stated that the original goals for establishing a national health information network were to improve quality, safety, efficiency, and reduce health disparities with the advancement of health information technology. Unfortunately, ONC’s decision to deprioritize HIT enabled longitudinal patient centered care in home care reinforces a fragmented care delivery system and creates costly barriers for information exchange that stifle innovation and competition.

The National Association for Home Care & Hospice (NAHC) and its affiliated Home Care Technology Association of America (HCTAA) is disappointed with ONC’s decision as it will inhibit home care’s ability to participate in a rapidly advancing and interoperable HIT ecosystem. In order to improve care coordination and transitions in care, home care should remain at the nucleus of the health care ecosystem. NAHC and HCTAA fully support the development of the HH-POC as a national standard of care coordination to benefit home health patients and as a model for longitudinal coordination of care across the spectrum of care.

The Home Health Plan of Care (HH-POC) Use Case was originally developed by the EHR/HIE Interoperability Workgroup. This work group was comprised of HCTAA staff, the Visiting Nurse Service (VNS) New York, home care EMR vendors and the New York eHealth Collaborative (NYeC), a state health information exchange (HIE). In January of 2012, the S&I Framework’s Longitudinal Coordination of Care (LCC) Work Group adopted the HCTAA endorsed Homecare POC Use Case for further development and selected it as a model for the work group’s Longitudinal Care Plan concept. Under the LCC’s guidance the HH-POC Use Case was formally approved by majority vote of the work group members. The Use Case was also included in the whitepaper “Meaningful Use Requirements For: Transitions of Care & Care Plans for Medically Complex and/or Functionally Impaired Persons” ( A copy of the report is available here) that was provided to ONC). The newly released LCC whitepaper not only contained strong recommendations for the development of the HH-POC Implementation Guide but also includes input from home care and other stakeholders which recommend better approaches to align Long-Term Post-Acute Providers (LTPAC) and Meaningful Use eligible providers.

The Implementation Guide for the HH-POC is a crucial next step to have the standard certified through the HL7 Balloting process and establish the technical specifications required for vendors to make an interoperable HH-POC available to home health care providers and their physician partners. NAHC is seeking other avenues to certify the HH-POC standard and is committed to creating an open source standard for national health information exchange.