🔒Skilled-nursing homes leverage technology to improve care

Mention the terms electronic records, monitoring, compliance or some special gadget, and most long-term care providers seem to start twitching and get nervous at the mention of technology. Then, they start to tell you all the reasons why technology won't work, that staff are not trained or there is no funding. Whatever the reason, it does not do much to enhance the image of post-hospital care.

But the tide is changing.

Even though the Affordable Care Act (ACA) overlooked the post-acute sector in terms of funding, smart long-term facilities are taking advantage of a robust industry of IT companies producing hardware, writing software and integrating with other developers' products that are achieving ACA-demanded increased levels of productivity and improving patient care.

It starts with the electronic health record. Skilled-nursing facilities should be using electronic file storing systems as the building blocks for patient information, including detailed biographical information, medical information, assigned medical professionals, payer sources and billing data.

Additionally, skilled-nursing facilities need to use a common assessment form: the Minimum Data Set (MDS). The MDS is a 38-page, over 500 response resident assessment instrument, which is completed by an interdisciplinary team at admission and on a regularly scheduled basis. Developers have created functionality so that this form can be completed using software that allows reports to be generated, viewed and electronically transmitted to the federal government. The government uses this data to assess the quality of nursing home care and reports it on NursingHomeCompare.gov.

The MDS collects patient characteristics regarding care, and is the basis for billing Medicare. Due to the importance of MDS data, third-party software has been developed to check the integrity of the responses, yield quality-of-care information, and create predictive analytic models forecasting a patient's probability of falling or being returned to the hospital.

As the fee-for-service world is being replaced with a value-based payment approach, information management and technology are becoming more important.

For example, a Pratt & Whitney jet engine produces almost a terabyte of information flying across the ocean. Monthly, a skilled-nursing facility generates a terabyte of information caring for 200 long-term and post-acute patients. To improve patient care, this amount of data needs to be managed, analyzed and find its way to patient-care plans.

The digital highway in a facility must be a secure, fast, wireless network. Wireless connectivity allows mobility and real-time access to information.

Recent additions to the IT arsenal are applications like vital signs equipment, which allow for more accurate measurements delivered on a timely basis that permit individualized warnings for patient-centered care.

Other examples include ZOE machines that monitor fluid buildup impacting cardiac recovery and bladder scanners that alert staff to residual urine lingering in the bladder.

Nurses, personal-care assistants, therapists, dining staff, administrative, social services, medical directors, building services staff and others all have a footprint in this digital world by using specialized software, technology and tools to improve care. All staff can learn, apply and contribute to the patient's medical record and improved plan of care.

Paul T. Liistro is the managing partner of Arbors of Hop Brook, Manchester Manor and Vernon Manor, all nursing homes in Connecticut.