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6/17/2014
02:40 PM
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EHRs Move Into Assisted Living Centers

Assisted living centers find electronic health records help them accommodate residents with more complex care needs and the staffing needed to serve them.

10 Medical Practice Management Systems For 2014
10 Medical Practice Management Systems For 2014
(Click image for larger view and slideshow.)

Assisted living centers, facing rising levels of patients who require more complex care, staffing challenges, and need for risk-reduction programs, are turning to electronic health records (EHRs) for support.

Half of today's assisted living residents have three or more chronic conditions, and 42% have Alzheimer's or another form of dementia, according to "Senior Living By the Numbers," a May 2014 study by PointClickCare and McKnight's Long-Term Care News. To accommodate their changing population, 58% of assisted living organizations in the study said they need to modify staffing requirements. In addition, 44% of the study respondents said patients' new needs increase risk for things such as hospital readmission.

Having seen how EHRs have helped hospitals and medical practices succeed, some assisted living organizations are adopting the technology to improve operations, enhance staff efficiency, and reduce patient risk. And just like other healthcare providers, these facilities discover a wealth of benefits that extend far beyond simple automation of once manual tasks.

(Source: PointClickCare)
(Source: PointClickCare)

Assisted living centers typically interact and collaborate with multiple members of the healthcare ecosystem, such as payers, affordable care organizations (ACOs), hospitals, hospices, pharmacies, and labs. Therefore, they need software that enables this communication and coordination, said Dave Wessinger, CTO of PointClickCare, which provides cloud-based software for senior care organizations, in an interview. Yet many centers combine paper and electronic systems, he said.

"Mixing systems and processes often creates poor data integrity and inconsistent workflows, which leads to compliance issues, inaccurate documentation, and health risks for the resident and business," said Wessinger.

That was the case for American Baptist Homes of the West, which operates 10 continued care retirement and 32 affordable housing communities in California, Arizona, Nevada, and Washington, with more than 2,300 employees serving 5,000-plus residents. Facing growing dissatisfaction with its existing mix of paper- and computer-based software processes, American Baptist Homes began exploring EHR options, finally selecting cloud-based PointClickCare due to its ease of use, usability, integration with existing financial and clinical components, and comprehensive approach to assisting living facilities, said Jean McGill, clinical services director, in an interview.

Rather than simply using the software to replace existing workflows, American Baptist Home redefined processes, developed new ways to present care, and figured out methods to present its processes, she said.

"The whole opportunity is to create a workflow that allows caregivers more time with the residents," said McGill.

Whereas facilities once had one computer used by the healthcare administrator, nurses today are equipped with tablets or laptops, which they use at patients' bedsides, she said. Although there was some concern that nurses would spend more time looking at screens than interacting with patients, the opposite has proven true, McGill noted. Instead, clinicians access patient data immediately, allowing them to quickly respond to patients' needs, she said.

"It makes a difference how one is using an EHR from the perspective of being able to guide documentation and decision making. It helps caregivers focus on what is important," said McGill. "To get the right information at the right time to the right people means better decision making."

Despite initial resistance by nurses who were unfamiliar -- and uncomfortable -- with technology, American Baptist Home eventually realized the benefits early champions predicted. Nurses came aboard when they no longer had to search endlessly for paper files, said McGill.

Typically, organizations report labor savings, said PointClickCare's Wessinger. The platform is designed to "increase compliance, mitigate risk, and improve relationships with referral partners, like ACOs and hospitals. Also, organizations can improve medication management, prevent adverse drug events (ADEs), and avoid service creeps with qualified billing functionalities," he added. As more acute-care patients enter facilities, it's getting even more vital for assisted living centers to address all these concerns, Wessinger said.

At American Baptist Homes, the EHR improved long-term care as a whole and is in line with the Centers for Medicare & Medicaid Services (CMS) recommendations, quality assurance, and quality improvement plans, said McGill. Having a computerized record allows the organization to turn data into information. Instead of having 70 charts sitting on a wall; nurses search a database; pull out data points; and locate usable information to improve performance, programs, and outcomes for patients, she added.

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Alison Diana has written about technology and business for more than 20 years. She was editor, contributors, at Internet Evolution; editor-in-chief of 21st Century IT; and managing editor, sections, at CRN. She has also written for eWeek, Baseline Magazine, Redmond Channel ... View Full Bio

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David F. Carr
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David F. Carr,
User Rank: Author
6/17/2014 | 3:33:58 PM
Another example of EHR specialization
Note that the EHRs popping up in long term care tend to be specialized products, rather than those sold into hospitals or physician's practices. One of the reasons it's so hard to achieve integration across EHRs is there are so many different needs being answered by different projects.

I recently spoke with AOD Software, which includes an EHR in its Answers product for long-term care facilities (which would include assisted living as part of a broader spectrum stretching from healthy senior communities to nursing homes). They don't expect to see EHR vendors like Epic and Cerner coming into their market niche unless one of those firms buys a specialist vendor like themselves or one of their competitors.
Alison_Diana
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Alison_Diana,
User Rank: Author
6/18/2014 | 9:12:24 AM
Re: Another example of EHR specialization
Great point, David. Long term care facilities have very specific needs that the more EHRs from big-name developers don't usually address. They also have to work across many different partners, which can include multiple hospitals if they're in a competitive market.
carevium
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carevium,
User Rank: Apprentice
6/19/2014 | 8:09:54 PM
Cloud and Mobile Technologies Help Cut Costs of Legacy Software
Assisted Living centers and memory care communities had to live with paper based records for a long time as the cost of deploying and maintaining legacy software was too big for these organizations. 90% of assisted living facilities are fragmented and owned by professionals and small businesses who cannot afford the legacy investments.

Thanks to the mobile (smart phone and tablets) technologies and cloud centric computing, the cost of assisted living software has come down significantly. Even mom and pop firms can afford these solutions. Also, the software is easy to use, no need for upfront investment and no need for consulting / training either!

For instance our Carevium EHR software for resident care management in senior living industry is adopted quickly even by residential care homes with 5 or 6 residents!

Above all, consumers, i.e. family members whose loved ones are residing in assisted living centers, are asking for the deployment of technology tools and demanding access to care information on 24x7 basis.

Another factor contributing fast adoption of EHRs in the assisted living sector is the proliferation of digital health apps and monitoring devices. This helps spread the knowledge (there is an app for that!) among the caregivers, administrators and owners of assisted living homes.
Alison_Diana
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Alison_Diana,
User Rank: Author
6/20/2014 | 2:26:44 PM
Re: Cloud and Mobile Technologies Help Cut Costs of Legacy Software
Thanks for sharing information about Carevium EHR for assisted living facilities. As you say, cloud and mobile technologies have done a lot for this market, both in terms of bringing down the price and the complexity. Since these facilities did not get the same financial incentives (or deadlines) as healthcare providers, it's easy to see one reason they are not generally as advanced in their EHR adoption as physician practices and hospitals. But you can definitely see the benefits, both from your comments and from the example I wrote about in the article.

Paper creates a lot of drains -- nurses and caregivers spend time looking for files; they are prone to errors, and are time-consuming to create, compared with the automated templates of EHRs or other electronic forms or checklists. With cloud-based systems, assisted living centers don't have to worry about hiring a lot of experts or buying expensive hardware. And mobile apps make accessing these tools much simpler than ever before, eliminating many hours of training. 
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