EHRs are changing the way we care

Jayne Warwick, PointClickCare
Jayne Warwick, PointClickCare

When we think about what the long-term care industry was like ten years ago, technological innovation tends not to be top of mind. And yet, suddenly, we're surrounded by it. Which makes sense – technology has a track record of success in simplifying tasks and solving everyday problems. Just check your pockets – you likely have a smartphone that syncs with your car, telling you how to get where you need to go, and helps you contact someone if you're running late.

Adopting new technology, like any new idea, can be hard. The challenge for providers will not just be rolling it out, but also harnessing the power to do what you need to do. A piecemeal approach fails. Solving an immediate need with a single solution sets you up for redundancy in a year's time, when you try to remedy your next immediate need – only to discover the two technologies need to be patched together to ‘sort of' work. Take the time to understand your current needs as well as considerations for the future, and think about the plan you need to put in place.

The next challenge then becomes change management. Or, culture change management. Culture change is hard. It requires a clear idea of where you want to go and the patience and persistence to get there. In this first article of a three-part series, we'll look at factors in long-term post-acute care that have prompted our use of technology, specifically the electronic health record (EHR), and we'll begin to consider where we're headed as the technology we use continues to evolve.  

Quality is the new currency

By 2030, one in five Americans will be a senior citizen. Ten thousand people become senior citizens every day. Eighty year-olds are the fastest growing demographic. Two-thirds of all people over the age of 65 experience multiple chronic conditions. Thanks to modern medicine we're living longer, and as a result, more of us want to age in place.

Caring for our aging demographic has set the need for integrated EHR solutions. Early adopters started with a basic electronic medical record, or “EMR,” allowing them to store data and report on it. However, they were limited in the intelligence they could gather from the information these records contained. These early EMRs were built around digitized forms that held static content that you could report on. None of the data stored in early EMRs connected with other data, they were read-only and provided no support or guidance in care. But they were a start and focused on the key area: intelligent data that converted into actionable information.  

Today, we need to be able to collect the data in a system to help us make more informed decisions. Data needs to be collected and used to drive our clinical workflows to help improve outcomes. We need to be able to take data, aggregate it and analyze it. With an integrated EHR, we can monitor patterns and processes and identify trends. The data can be organized to tell us something – about risks, insurance claims, revenue and reimbursements, occupancy. We can act on the aggregated information quicker, more thoughtfully. This is more than a paper chart can ever do.

Right now you might be thinking, “Our paper system is just fine. It's not broken, so why fix it?”

Here's why.  

Quality is the new currency. Without data, you have nothing. The skilled nursing marketplace is highly competitive and sustainability is key. Without the ability to document and show the record of care, there is no proof. And without the ability to analyze the data for better outcomes, you cannot move forward.

What is an EHR?

An EHR is a digital version of a patient's paper chart. As a real-time, patient-centered record, it makes information available instantly and securely. There are three basic components to an EHR; the resident chart itself, integrated care-related documentation and financial information. Data can be captured for the entire resident stay – from admission to discharge. The EHR should also include decision support tools and enable you to connect with other providers in the healthcare continuum such as therapists, pharmacies and laboratories. Connected care is an important element to a smart EHR – an instrumental tool in strengthening collaborative care.

Leaving money on the table

Providers are losing tens of thousands of dollars each year by not using an EHR. They think they don't need an EHR, that it's too hard to implement or too costly. However, when you think about the ways in which providers lose out on reimbursement – accurate and complete documentation of all ADLs (activities of daily living) performed, using ‘Day 8' as the default ARD (assessment reference date), billing/coding errors – these costly omissions can easily be fixed with an EHR.

It's not free, it may be challenging, and EHRs are not a requirement.  

But what if you could also improve patient outcomes, eliminate redundant work, make staff happier and more efficient and, most importantly, improve resident satisfaction?

Where to start?

“So how do I start?” That's a great question but not always one with the most clear-cut answer. Historically, providers may not have had a complete view of a resident's history upon admission. Residents transitioning from the hospital often arrive with little or no documentation, requiring nurses and physicians to “reinvent the care wheel,” so to speak. Ideally, the necessary care information should be available upon admission. Unfortunately, we know this is not the norm, it's the exception. Often, caregivers are left to navigate the care of residents with very little history —let alone a documentation of that history.

An EHR serves as a great starting point. Providers need to look for a vendor with an offering that will help with the communication of care. There are some critical questions that you should consider when evaluating technology solutions:

  • Will the vendor help my organization securely exchange information with practitioners, hospitals or other members of the healthcare community?
  • Does the technology I use create a complete view for each resident?
  • What other aspects of care can be seamlessly integrated into the EHR?
  • Is there a tool for exchanging data with labs and pharmacies?  
  • Will the vendor grow with me and be able to keep up with the constant changes in regulations?

Technology that supports a provider's ability to interact and respond across the healthcare continuum will play a critical role in in how we provide care in the future.

Technology is a key element to sustainability

As we begin to deal with the pending demographic shift in the senior population we know technology is a must-have. The days of technology being “nice to have” are long gone. Technology supports us. Technology sustains our quality and operational objectives. Technology is not just a supporting function of senior care, it's a driver.  

Ask yourself, will it (technology) help me improve revenue or workforce productivity? Will it help me reduce my costs and minimize my risk? Can it enhance my staff time with residents? How will it fit into my strategy to reduce hospital readmissions and improve outcomes?

Data security is an absolutely critical consideration you'll need to look at before you begin the process of EHR adoption. You will have to make sure you are HIPAA compliant. You can't limit access to paper charts, but with electronic charts you can be more thoughtful about access.

Take the plunge. But do so with a solid plan that accounts for your goals and objectives, based on a reasonable timetable you and your team can achieve. The information and tools you'll have available to you may make you wonder how you ever lived without them.

Jayne Warwick, HBScN, RN, has more than 30 years of experience in long-term care. She is now the Skilled Nursing Segment Market Manager for PointClickCare Marketing team.

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