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new buildings Trefzger has built over the last several years, as well as in a phased approach to rolling out MatrixCare’s electronic health records (EHR) software in the rest of Affinity’s properties.

To learn more about this, I turned to Kelvin Darden, the Vice President of Business Systems Applications for Affinity. Darden comes from a skilled nursing background. He is a licensed nursing home adminis- trator and has an MBA in Healthcare Administration. In addition, he is MatrixCare Certified, so he clearly knows a thing or two about EHRs. He explains that he was brought on board at Affinity to lead the process of upgrading to MatrixCare software in all Affinity communities, as well as to set up a dedicated MatrixCare System Support Team comprised of a lead clinical instructor, corporate compliance officer and eight application specialists that serve as an im- plementation, training and support hub for all of the organization’s communities using MatrixCare.

Originally using a limited, “quick eMAR” type of product to address medication management, Affinity made the decision to upgrade to a more comprehen- sive and integrated solution and began systematical- ly rolling out MatrixCare’s clinical software in Decem- ber of 2017. With an aggressive schedule, Darden’s team is implementing the software in 78 communities during the first four months of 2019 alone.

Although MatrixCare offers comprehensive train- ing and implementation for its customers, Darden believes that Affinity’s approach offers a competitive advantage for an enterprise organization. “When we were doing one or two buildings at a time, it was easier to go to that one building and spend the day there, but then we were looking at doing 12-13 build- ings at a time and that approach was not feasible.”

That’s why Darden’s team developed a “train-the- trainer” methodology that brings the facility imple- mentation leads into Affinity’s Hickory, NC, headquar- ters for an intensive one-day training.

This initial training is supplemented by a monthly we- binar series that does “deep dives” into specific use cases, as well as provides training on new features that are introduced during subsequent releases. These webinars are recorded and then posted for on-demand viewing later as needed.

Although MatrixCare creates comprehensive documentation for its solution, Affinity—like many organizations—has unique clinical workflows that are configured in the software, so the team’s lead clinical trainer, Lisa Horton, developed an Affinity-specific

manual (complete with screen shots) that Darden and others refer to as their “MatrixCare bible.”

It’s unusual for a senior living organization to ded- icate this level of training and support for an EHR program, but Trefzger believes it is money well spent. “While our initial efforts were aspirational, it is now clear that the technology we’re employing is transformational—it is allowing us to streamline our operations with a positive impact on both our care outcomes and on the financial health of the organi- zation. We’re now fully leveraging the potential of technology to reap its benefits,” he added, “and our System Support Team ensures that we’re getting the most from our investment.”

Lesson #2) Hire great people and give them the right tools to do their job.

Darden and the dedicated System Support Team are evidence of this, but Affinity doesn’t stop there. An- other critical component of Affinity’s success is their weekly Executive Team meeting. Every Monday, the leadership team reviews key metrics that the organi- zation is tracking across the enterprise with the help of MatrixCare MyAnalytics software.

Chief Medical Officer, Dr. Kevin W. O’Neil, FACP, CMD, is another of those ‘great hires’ who joined Affinity in May of 2018. He was intrigued by Trefzger’s infectious enthusiasm for disrupting the industry and finding creative ways to deliver quality care. The Monday meeting is one example: Affinity’s leadership monitors and reviews financial information (collec- tions, fees, etc.), falls (falls with injury/what type of injury), medication compliance (accuracy, antibiotics, high-risk drugs like Coumadin, insulin use, etc.), hos- pital readmissions, staff retention and more.

By reviewing this data on a weekly basis, it’s easy to spot trends and anomalies. For example, one metric that stood out to O’Neil shortly after implementing this review was the rate of sliding-scale insulin ther- apy being used across the 150 Affinity communities. This method of treating diabetes is often used with the recently diagnosed to establish their overall insulin needs, but it is considered a more “reactive” approach for long-term treatment; one that is less effective in controlling blood sugar, while also caus- ing unnecessary discomfort and inconvenience to the resident (requiring finger pricks multiple times a day). When O’Neil spotted this trend, he introduced a quality improvement program that included educat- ing the clinical staff on the benefits of basal (long-act- ing) insulin therapy, supplemented by sliding-scale insulin only when required. Over the course of three


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