Plugged In With HIT – How Nursing Homes Can Actually Save Money.

PROVIDER MAGAZINE, SEPTEMBER 2012 – by Robert Kerr

Over the course of the past five years or so, health information technology (HIT) has been developed and fine-tuned to match the ever-changing needs of long term and post-acute care—delivering what caregivers and residents want and need.

From electronic health records and e-prescriptions to automated medication dispensing and in-room monitors, the right technology allows better care management and more time with residents to provide care.

Achieve Across-The-Board Efficiencies

Several key factors weigh in on this wave of technology developments: increased documentation requirements and the impact on an already overburdened staff, cost cuts by public and private payers requiring more efficient resource utilization, regulations spurred by provisions of the health care reform law that require short-cycle dispensing of medication, and constant efforts toward improving accuracy and quality of patient care.

Now added to the list are accountable care organizations requiring health care providers to adeptly collect, manage, and analyze critical patient data for gauging their own performance.

As demands grow and change, effective budget management becomes more challenging for providers every day. By identifying efficiencies achieved through new HIT systems and capturing new savings through labor efficiencies, waste reduction, and more effective patient care, the HIT systems can more than offset the costs associated with their deployment.

But reasons to implement them go much further than the savings achieved. Better accuracy and increased efficiencies that result in better resident-centered care actually create a method of attracting and retaining quality caregivers. And electronic health records, for example, provide a tremendous opportunity to reduce the massive fragmentation within long term care systems. Providers are better positioned to reduce errors, improve resident safety and quality, increase nurse satisfaction, and decrease costs.

Plus, improving the marketability of a facility to new clients and referral sources can result in higher occupancy rates and recognition as an innovative provider. What’s more, it demonstrates to the community a commitment to quality care.

Recent major technological advancements in health care, such as e-prescribing and electronic order entry, allow nurses, physicians, nurse practitioners, and physician assistants to electronically transmit new prescriptions or renewals to the pharmacy.

Electronic Ordering, Dispensing

Electronic ordering can eliminate three or more points of transcription—and the associated risk of error—from the medication ordering process. The order to delivery process is much faster and safer as a result.

Electronic ordering is also a critical piece in the accelerating move to electronic health records. By sharing medical prescription information, electronic ordering leads to a complete medical profile for each resident, and the delivery of real-time data—without transcription—eliminates the medication record turnover process.

At the same time, when done correctly, automated medication dispensing can eliminate waste, increase efficiency, and make medication administration safer and easier.

It is not only a life-saver for residents, but also a boon for nurses who, for years, fumbled with bingo cards and boxes; crammed, unorganized carts; missing pills; dropped pills; or co-mingled unidentified pills—especially those little white generics.

Consider Open Architecture

As technology decisions are being made, it is critically important to ensure that integration is possible now and in the future. Open-system architecture, which allows multiple vendors to create add-on products that increase a system’s flexibility and functionality, and the use of industry standards by technology providers allow facilities to keep ownership of and access to their data.They also enable future flexibility in choosing additional technology providers and partners and more nimble integration with newer technologies when available.

Today, there is an accelerated move to implement many of these solutions and systems. For many long term and post-acute care operators, the choices of what to implement can be daunting. Not only is there fear of change, but there are also major investments to consider.

To get the best return on investment, each decision should be carefully thought out. A complete, integrated and efficient approach must be taken to get the true value of technology. Administrators must consider all of the critical clinical components involved, including labs; dietary; treatments; and, of course, medications.

Vendors are making a significant investment in new technologies to benefit providers in lieu of federal funding. Long term care facilities are becoming much more sophisticated in keeping up with the demand of consumers, regulators, and others and are at the beginning of the advancing curve of adoption.

Facilities have to make the investment in technology to reap the myriad benefits.

IT Investment Options

Making initial investments now, like creating wireless campuses, adding nurse computer stations to enable electronic ordering and communication, switching to electronic health records, and converting from manual to automated medication dispensing will, at a minimum, level the playing field but could provide a competitive advantage.

When researching new technologies, systems, and solutions, there are several things to consider. Adoption of an industry-standard information exchange and communication protocols is the first step toward ensuring that the interdisciplinary environment of long term and post-acute care is effectively maintained through the ability to share and exchange information.

Executing due diligence ahead of time can help ensure the right product and right vendor have been chosen. Make sure the lab partner knows lab; the pharmacy knows medication order entry; and the electronic health record vendor knows administration tracking, documentation, and management.

Make It Easy

Also of great importance is the system’s ease of use. Changing the culture of long term care from a largely paper-based world to one that embraces technology does not come without its challenges.

Success of the HIT systems is driven by the competency of the users, which is dependent upon their ability to use the systems accurately and effectively. Therefore, even when a system is relatively easy to use, training is critical to successful implementation.

In addition, engaging partners with systems that can communicate effectively with one another is essential to achieving the systems’ full clinical, operational, and financial benefits.

Balancing complexity of features with ease of operation is a delicate task and one that should be thoroughly evaluated to ensure a successful outcome.

Everyone benefits by implementing these advancements. Using HIT will benefit operators financially and with greater efficiencies.

Clinical staff will be relieved of much administrative work in many cases, resulting in more time spent caring for residents. Residents benefit because not only do they get more quality care time, but technology can improve safety.

Robert Kerr is senior vice president of information systems for Remedi SeniorCare, Baltimore, an institutional pharmacy business serving a growing number of facilities extending from the Mid-Atlantic to the Midwest. Go to www.remedirx.com for more information.