As a way of encouraging the adoption of Electronic Health Records (EHR) in healthcare, congress passed the Health Information Technology for Economic and Clinical Health (HITECH) Act of the American Recovery and Reinvestment Act (ARRA)in 2009. The HITECH Act encouraged the adoption and use of EHRs in healthcare by offering healthcare providers reimbursements, supplementing the EHR implementation costs.
However, the HITECH Act is limited to only providing reimbursements for some healthcare providers. It does not offer reimbursements for adopting electronic health records in long term care facilities. BMJ Journals notes that long term care facilities, such as assisted living facilities, skilled nursing facilities, LTC hospitals, and rehabilitation hospitals, were excluded from all incentive payments.
The lack of incentive payments means that nursing homes and other long term care facilities are slower to move from paper to electronic records. This creates further barriers to the implementation of EHRs in the long term care industry:
- Cost Constraints: Due to the high level of technological advancements, long term care EHR software requires a substantial investment that some SNFs struggle to finance the initial fees of EHR software.
- Technical Limitations: Long term care EHR software requires nurses, physicians, and other staff to understand what capabilities there are and how to use the nursing home software once it is installed. Unfortunately, some staff members are more tech-savvy than others, while others require more training.
- Standardization Limits: When transitioning from paper records to electronic health records in long term care facilities, the paper records will use a different data format from the long term care EHR software format. This can result in standardization problems during data transfer.
- Organizational Constraints: When implementing electronic health records in long term care facilities, the facility needs to ensure they have all the necessary electronic devices, such as wall-mounted PCs, desktops, wall-mounted tablets, and handheld tablets that staff can move around the facility with. This may be a problem, especially if the nursing home has limited PCs and equipment for nurses and physicians to use.
- Resistant to Change: People are creatures of habit. Some nurses, particularly older nurses who have been using paper records for decades, are accustomed and more familiar with using paper records. Therefore, they resist changing and transitioning to nursing home software.
Must-Have Features in Software for Nursing Home Management
Suppose a nursing home administrator is considering a new long term care software for nursing home management. In such cases, they should research the must-have features and modules for electronic health records in long term care facilities. Some must-haves that justify investing in a new long term care EHR include:
- Minimum Data Set (MDS): An MDS module is necessary for any long term care software. This ensures that nursing homes and other long term care facilities observe the federally-mandated processes for clinical assessments of residents, thus, decreasing the likelihood of medical errors.
- eMAR and eTAR: An eMAR (Electronic Medication Administration Records) module is used by nurses and physicians to ensure medication is administered accurately and reliably to residents.
- Cloud-based Hosting: Cloud hosting is a must-have for electronic health records in long term care facilities because it saves on hosting costs, as nursing homes and SNFs don’t need to buy additional servers. In addition, they offer data backups and security with polymorphic encryption, so facilities can rest assured knowing that their resident data is secure from data breaches.
- Point of Care (POC) Charting: Point of care healthcare and testing have increased in popularity since their introduction. POC charting allows nurses and physicians to collect data on all care activities administered to residents. This information can then be stored in the care plan software, where it is later accessed and reviewed when necessary.
- Admission Discharge Transfer: The Admission Discharge Transfer (ADT) module centralizes and tracks residents’ census numbers needed for billing. This way, nurses and physicians have all demographic information for their residents in one easy-to-access location.
- Resident Scheduling: Resident and resource scheduling modules allow for a quick and efficient schedule of residents’ appointments and activities. It also includes information on related resources, such as equipment and room allocation. Schedules are displayed in calendars and reports for individual residents, facility staff members, and the appropriate resources.
- Revenue Cycle Management: Revenue Cycle Management (RCM) allows for optimized financial workflows and seamless integrations with other software. With this module, facilities simplify their workflows by eliminating inefficient processing claims, causing them to lose time and money. Instead, they can maximize their reimbursements, giving them more time to focus on resident care.
- Training Modules: As was previously mentioned, the technical limitations of some staff members can be a barrier to adopting electronic health records in long-term care facilities. To overcome this, administrators should look for nursing home management software with accessible training modules in their standard package. Ideally, one should look for a software vendor that provides free online training modules with its software, so staff can train at their own convenience.
- ICD-10 and HIPAA compliance: ICD-10 stands for the International Classification of Diseases. It serves as the standard transaction code set for diagnostic purposes under the HIPAA Act. ICD-10 is used to track health care statistics, diseases, quality outcomes, mortality statistics, and billing. HIPAA stands for the Health Insurance Portability and Accountability Act. It sets the standard for patient data protection for electronic health records in long term care facilities. All long term care software must meet both of these requirements to comply with government regulations fully.
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10 Benefits of nursing home EMR and EHR software
For administrators who are still hesitant about implementing a nursing home EMR, it can help to understand the benefits of electronic health records in long term care facilities. Some of these benefits include:
- Better Quality of Care: When nurses and physicians use electronic health records in long term care facilities, they can document and analyze resident information more accurately, which results in better care for nursing home residents. The additional benefit of retrieving data more quickly allows nurses to respond promptly to residents’ conditions and changes, thus, giving them more time to care for residents rather than documenting information.
- Information Security: Resident data security is a huge concern. HIPAA is considered in long term care medical records regulations. Therefore, long term care EHR must be compliant with the best data security functions.
- More Accurate Resident Information: A significant problem with using paper records in nursing homes is that they are error-prone, potentially leading to medical errors with major consequences. This is especially true regarding resident information, as it is more difficult to update such information. Software for nursing home management reduces the chances of data being entered in the wrong field, mainly because EHR devices offer prompts when data is entered incorrectly. Also, when using nursing management software, legibility issues are eliminated.
- Interoperability: Continuity of care and care coordination is essential to providing optimum care. This is true, especially when a resident is transferred from one facility to another. Electronic health records in long term care facilities can interface with other systems, enabling information sharing. This interoperability facilitates continuity of care for residents in a nursing home even as they move between healthcare providers.
- Increased workplace efficiency: A nursing home EMR makes recording and retrieving resident information quick and easy. This eliminates inefficient practices that add hours of unnecessary documentation time, thus improving staff motivation and satisfaction.
- Increased revenue: The best long term care software comes with financial modules that can help manage billing, payments, and income. Also, a long term care EHR can automatically correct mistakes from claims while reducing coding errors, which would otherwise lead to the rejection of claims.
- Scalability: Effective nursing home software can scale with the long term care facility. This means that as more residents are admitted into a nursing home, the more the nursing home EMR can scale and process the additional information accordingly.
- Accessibility: The addition of cloud-based electronic health records in long term care facilities means that resident data is accessible remotely to all authorized staff.
- Customization: Each facility will have different needs and requirements. This is why customization is so necessary because the long term care EHR software will allow facilities to tailor the software’s features to meet their needs.
- Support: Most senior living software vendors provide customer support. This allows for better implementation and staff training, making the EHR software seamless once it is integrated.
The Value of Electronic Health Records in Long Term Care Facilities
The HITECH Act helped to incentivize the use of EHRs in the healthcare industry. But unfortunately, the HITECH Act does not offer reimbursements for the adoption of electronic health records in long term care facilities. This has resulted in the slow adoption of EHRs in long term care.
Nursing home administrators looking to implement a long term care EHR in their facility should ensure the software comes with essential features such as an MDS, eMAR, training modules, revenue cycle management, ICD-10 compliance, and HIPAA compliance.
Long term care facilities that implement an EHR in their facility can expect a range of benefits that include better quality of care for residents, increased revenue, increased staff efficiency, and better documentation.
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