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Assisted living: The final frontier for electronic health record adoption?

Assisted living: The final frontier for electronic health record adoption?

Seniors in the autumn years of their lives are as complex as any generation – whether it pertains to what they value or how they view the world, as well as their general health.

And so it’s no surprise that growing complexity is increasingly being used to describe the myriad settings in which this demographic is spending their remaining years. The lines that once defined skilled nursing, independent living and aging in place are getting a little fuzzier every day.

Not long ago, assisted living communities enjoyed a relatively simple mantra: Provide a safe, in some cases upscale, semi-independent place for mostly able-bodied seniors to enjoy life while reaping the benefits of occasional help with basic activities of daily living.

But as a massive wave of Baby Boomers now finds itself arranging for their final chapter in these and other settings, a great deal of focus is now on assisted living, where more and more residents are entering with multiple chronic medical conditions, creeping dementia and, unfortunately, serious behavioral issues. This is far from describing a former resident population whose biggest problems were high blood pressure and high cholesterol.

Many assisted living communities today are a technological wonderland filled with cutting edge devices that do everything from engaging seniors on tablets, allowing staff to manage schedules and chores on the fly, preventing frail seniors from falling or wandering, and keeping tabs on vital signs from sunrise to sunset.

Amidst all of this gadgetry is the electronic health record (EHR). This massive data-hungry aggregator of all things clinical is now front and center in assisted living — an essential, though not-yet required, tool that most argue will allow patient-centered care, the buzzword of the ACA movement, to revolutionize the way seniors are treated and cared for in the years to come.

The case for EHR in assisted living

Caregivers in skilled nursing settings have long enjoyed the benefits of EHR technology – the ability to chart, document and verify the ever-changing medical status of each resident in real time. There’s also the efficiencies gained in time, and the accuracy realized when vital medications are managed, or transitions from hospital to nursing home occur.

Until recently, making a business case for assisted living was no easy proposition, in spite of the clinical benefits EHR offered. That’s simply because it wasn’t required, or needed.

But as regulatory and financial pressures to reduce rehospitalizations have ratcheted and resident acuity risen, assisted living providers are now finding EHR an essential investment in order to engage in critical relationships while gaining referrals from coveted preferred provider status.

Large multi-site assisted living providers were among the early adopters of EHR for several reasons, none the least of which was data standardization and operational efficiency.

Obvious clinical advantages from working with electronic health records side, assisted living operators are finding that EHR can help do things like boost occupancy and profitability. And vendors are finding easier to promote EHR benefits around greater resident engagement, streamlined workflow and reduced staff turnover.

And as more and more millennials become the pivotal decisionmakers around where to place loved ones in senior care, the technological component EHR provides on so many levels can often make the difference when a final decision is made.

The state of EHR implementation

In 2017, a national study of long-term care providers found nearly 75% of all assisted living communities either had no EHR systems or were not fully making use of the vast complement of services and utilities they provide. This would explain why an even earlier study by a leading EHR systems provider found over half of these communities had actually invested in these systems.

Even in the face of such mounting evidence pointing to the positives of EHR, many assisted living providers are cautiously approaching investments in such systems.

Some are leery of the time, effort and long-term commitment required to make it work. With staffing levels at so many communities razor thin or vulnerable to seeking higher paying positions elsewhere, many view the move too risky.

Others lack the infrastructure, or what they perceive to be a dearth of expertise in their IT departments. After all, an EHR implementation is far more complex than installing Wi-Fi, as some experts argue.

And while many IT experts believe interoperability challenges have been tackled, there is evidence in some cases that too many glitches remain that could arguably complicate, or even doom, an expensive EHR installation.

And so, as recent evidence suggests, many assisted living providers are adopting EHR as the need arises. One of those needs is government Medicare rules, which currently impacts assisted living providers most acutely in places like Florida, California, Ohio and Washington.

One of the biggest “needs” is a health care system incredibly hungry for patient data – the stuff around which decisions are made about care and reimbursement, and policy decisions in general. EHR, after all, generates massive amounts of vital data, which has become more valuable than paper currency. As any real estate investment trust (REIT) will attest, this kind of data is used to make critical decisions around facility operations and efficiencies.

A third important “need” comes at the point when an assisted living operator decides that having an EHR system is a competitive differentiator, say observers.

As medication management in assisted living begins to populate national discussions around patient safety, the case for EHR in assisted living becomes exponentially compelling.

Consider only the rehospitalizations linked to poorly coordinated hospital-to-assisted living transitions, polypharmacy or the myriad cases around adverse drug events and diversion.

As one vendor has noted, “interoperability with acute care, private practice, skilled nursing, and other healthcare partners is going to force assisted living providers to put in place system interfaces for transitions of care and coordinated care. It’s going to be a snowball effect – the pressure starts with acute care, moves to skilled nursing and then to senior living.”

 

Whether cost, time investment or infrastructure, the move to EHR can seem daunting for ALs, though the case for it is compelling. ValueMed’s talented technology team can help you implement electronic solutions with EZ-MAR; a no charge eMAR system. If you already have an eMAR system, we seamlessly integrate with 15+ solutions and can make the transition painless. Contact us at ValueMed@PharMerica.com or 866-628-2583 to learn more.

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