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IMPACT, which stands for Improving Massachusetts Post-Acute Care Transfers, is an Office of the National Coordinator grant-funded project designed to improve care transitions using an enhanced electronic Universal Transfer Form (UTF) and electronic health information exchange.
IMPACT will focus its efforts in Worcester County, a region where 85% of the healthcare for its 800,000 person population stays within the county. IMPACT will be able to analyze almost 100,000 patient transfers per year, as well as 20,000 Medicare Advantage patients whose claims data will be used for total cost of care analyses. A pre- and post-test model using claims and other metrics will be used to evaluate the success of the project objectives, using claims data and other metrics.
SAFE Health and Massachusetts’ statewide health information exchanges (HIEs) will be the nexus for the transmission of the electronic UTF between acute providers and the post-acute care settings. Recognizing that many long-term and post-acute care (LTPAC) providers will not have electronic health records (EHRs) for several years, IMPACT will create a system for information exchange between health care providers within pilot sites that allows groups with EHRs and those without to share information about their patients electronically. Tools to generate, translate, and view the electronic UTF will be added to these HIEs and made available to other states. The system architecture is called LAND and SEE.
IMPACT will not forget about the patient: part of the project will be to create a patient-friendly tool to help patients better understand what is happening during the care transition process.
IMPACT recognizes that care transitions are more than just collecting the appropriate data elements in electronic form: it is about the process. The IMPACT Learning Collaborative and Galaxy team will be reviewing the care transition process to make the process the best that it can be, using the new data and format of information exchange.