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ACOs. Because the information can be sent electronically, EHRs erase the need for pa- per records. EMRs, on the other hand, are a transcription of the paper medical record. EMRs give companies better access to data than paper records, but don’t communicate with outside systems. In 2014, 19 percent of all residential care
communities used electronic health records, according to the Centers for Disease Con- trol and Prevention’s National Center for Health Statistics. The same year, the CDC reported that 74.1 percent of office-based physicians were using electronic health re- cords. Among all physicians, 10.6 percent shared data electronically with long term care providers. The CDC reported larger senior living
communities were more likely to have EHRs. Among those housing up to 25 residents, 12 percent used electronic health records. The rate was 32 percent among companies with more than 50 residents. “Providers have been focused in a facili-
ty-first mentality, and so they’ve been invest- ing most of their dollars in real estate and capital improvements,” said Patrick Hart, vice president of senior living solutions at MatrixCare. About 20 percent of senior living communities have adopted EHRs. Senior living companies that are not us-
ing EHRs are using some type of medical records technology. MatrixCare's Hart said some communities have a patchwork of programs that track particular aspects of resident care – medication, for example – but those systems might not communicate with each other or hospitals and ACOs. Many have electronic medical records, EMRs. Some senior living firms that haven't
adopted electronic health records have forged informal partnerships with ACOs by presenting the positive statistics they track. “It’s the cost of doing business," Fred Bentley, vice president for payment and delivery innovation at Avalere, said. “I can’t fathom a world five years from now or where you can exist without having some form of electronic health record system in place that is operating with a hospital and health IT systems. It’s just a nonstarter if you can’t work with a hospital or won't be able to deliver that kind of data.”
TIPS FOR ADDING ELECTRONIC HEALTH RECORDS
» Examine your workflows and decide if processes should be streamlined or redesigned.
» Get a clear understanding of how and if a vendor’s product will accomplish your EHR goals. Evaluate vendor’s stability and presence in your region and if the new software will integrate with programs you’re already using.
» Clarify and outline what start-up pricing includes before selecting an EHR system. Consider costs of router instillation or upgrades, computers, portable devices, software, maintenance and the option of phased payments.
» Decide if your community will connect to the Health Information Exchange and how much that will cost. (HIE is digital health information that moves among organizations according to nationally recognized standards.)
» Define implementation support with your vendor. Determine if the vendor will provide trainers, if the trainers will visit your site, and how your team will communicate with the vendor when they need support.
» Create a data migration strategy, defining how much data will be migrated to the new system, who will do the work and how much that will cost.
» Learn how the vendor software will integrate with programs your communities already use.
» Evaluate privacy and security and back-up plans in case of damage or power outages.
» Link vendor payments with meeting installation milestones, rather than dates. Consider including incentive rewards in the contract.
» Review the contract with legal counsel before signing. Source:
HealthIT.gov Elmcroft Senior Living began adding
EHRs in its 82 properties two years ago. When the company included skilled nursing and was part of a health exchange, it used EHRs for communicating with other orga- nizations, according to Elmcroft Director of Business Optimization Summer Blizzard. “We’re pretty much trying to streamline
and help efficiency in our buildings,” she said. “There is a lot value in things being electronic versus paper. It allows us to have better controls to make sure things are get- ting done. “When you operate 82 buildings, it’s
hard to do audits,” she said, adding the company values the quick access to infor- mation. “There’s a lot of benefits to being electronic, but quality control is definitely a part of it.”
28 SENIOR LIVING EXECUTIVE / JULY/AUGUST 2016
Investing in Today's Technology Electronic records systems can be accessed through various devices such as desktop com- puters, smart phones and tablets. To install an electronic records system, some senior health communities will have to upgrade their networks and existing computers. The Chief Information Officer Consortium includes senior technical executives from the long term care industry. In a 2011 study, its mem- bers designed a hypothetical long term care company with 25 communities and designed a software system and computer upgrades needed to host it. While costs will vary great- ly by company, for an in-house EMS system, the consortium estimated a first-year cost of around $2.3 million and a five-year cost of $6.5 million for a web-based system.
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