EHRs can provide a better way in SNFs

Sol Lizerbram
Sol Lizerbram

Most medical practitioners servicing nursing homes and other types of long-term care facilities while also seeing patients in the office have found that their existing EHRs are not designed for the unique workflows of facility care. 

Ordinarily EHRs have been designed for either office or facility care, but not both. This has caused providers who see patients in both locations to put in long hours documenting and communicating patient care for patients in facilities, or to incur additional expense by investing in separate software for each. 

This impacts LTC facilities with increased labor to input patient records into the facilities' systems, delays receiving the latest visit information, and other problems.

Some of the challenges providers have experienced included:

  • Mobile charting
  • Multi-patient fax and print of patient records
  • Data upload
  • Dual mode scheduling
  •  On-site patient registration

At HealthFusion, we believed that it was possible for one EHR to meet the needs of both types of locations.

Mobile charting

Servicing patients at nursing homes is all about mobility. An EHR designed from the ground up for use on the iPad allows for fast, efficient charting at the patient's bedside without losing the human contact patients need and want. The EHR must also work just as well on a desktop or laptop computer – Windows or Mac.

Multi-Patient Fax and Print 

When a provider has completed all the visits at a facility and it's time to communicate the documentation, if their EHR only supports single encounter fax and print it's going to delay communication. The best way to get documentation to the facility and into the nursing home patient chart is to fax or print in bulk. This communication should be done in three easy steps:

  1. View the Roster for a Facility
  2. Select Patients
  3. Bulk Fax or Print

Data Upload

Setting up billing and EHR software is a challenge for all practices, but because of the volume of patients, locations (facilities) and referring providers, the challenge is steeper for medical practices that care for patients at nursing homes. A provider should be able to cut the data entry time to migrate information into the system with easy to use upload file functions. If a provider needs to add hundreds of patients, multiple locations or referring physicians, thousands of keystrokes can be saved with simple data file uploads, such as: 

  • Patient Demographics
  • Locations (Facilities)
  • Referring Physicians
  • Clinical Data Conversion

Dual Mode Scheduling

Time based scheduling just does not work with long term care. When a provider visits a facility, they need a roster of all the patients that reside in the home and an Encounter Tracker that tracks which patients they visited with that day. When the provider gets back to the office and sees patients, they need the standard time-based schedule. In addition, they need a time-based calendar to track which homes they are scheduled to visit.

Ideally, to work in both care settings an EHR needs:

  • Patient Roster View
  • Time-Based View
  • Patient Encounter Tracker
  • Multi-Schedule View
  • Drag and Drop Appointment Management

On-site Patient Registration

Patient registration for long term care patients should not have the same workflow as office-based ones. If the patient address is recorded as the nursing home address, it's a waste of time to enter that data repetitively. Instead, providers should be able to simply associate the patient with the facility and the address data pre-fills.

What happens when a provider arrives at the facility and the staff asks them to see a new patient? Does the EHR have a scaled down registration form built specifically for providers who need to register a patient at the point of care? Why not? This is one of the features an EHR should offer for physicians seeing patients in both locations, and it should not require complex toggling between practice management and EHR interfaces:

• Pre-fill Patient Registration Data based on Facility

• Abbreviated Registration for Providers that are On-Site

Long term care should not mean longer workdays for physicians. With the right software, providers can shorten the time they spend charting and managing nursing home patients and communicate effectively with the facilities they serve.

Sol Lizerbram, M.D., is chairman and co-founder of HealthFusion, a provider of EHR, practice management, clearinghouse and patient portal software that offers the features described above for office-based providers who also need long-term care facility patient management.

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