EHRs Move Into Assisted Living Centers

10 Medical Practice Management Systems For 2014

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.

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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