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EHRs beyond the hospital and doctor's office: One assisted living community's story

June 10, 2014
by Rajiv Leventhal, Healthcare Informatics
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At American Baptist Homes of the West, technology proves its value

Assisted living communities are providing services for residents with more complex healthcare needs than just a few years ago. In fact, some statistics say that 50 percent of the nation’s assisted living residents have three or more chronic conditions, and 42 percent of them have Alzheimer’s disease or other forms of dementia.

A variety of market factors have led to the reality of rising acuity in these communities: the increased prevalence of seniors delaying their entry into retirement settings due to aging in place, reduced hospital stays and economic trends forcing seniors into managed care communities. As such, care providers are finding it necessary to respond with more clinically oriented staffing models, sophisticated technology solutions for medication management and a greater focus on re-aligning their business models to support higher acuity levels among their resident populations.

As acuity levels continue to rise and the assisted living industry comes under more scrutiny, government regulations will continue to change and become more complex. To that end, electronic health record (EHR) platforms have the potential to provide the tools needed to better manage regulatory changes—giving providers the peace of mind knowing that they’re in compliance.

Additionally, due to the enormous documentation requirements in these facilities, nurses must spend a vast majority of their time just documenting what they are doing—daily charting activities, progress notes, weekly and monthly medication and treatment summaries, service planning and more. Studies indicate that nurses spend an average of two hours per shift at the bedside and six hours documenting it, says Jean McGill, clinical services director at American Baptist Homes of the West (ABHOW), a Pleasanton, Calif.-based provider of a range of senior housing and services.

According to a National Center for Health Statistics data brief released in September 2013 that relied on the 2010 National Survey of Residential Care Facilities, however, 17 percent of the nation's assisted living and other residential care communities use EHRs. Larger locations—those with 26 or more beds—were more likely (25 percent) to have had an EHR in use than smaller ones (14 percent) consisting of four to 25 beds, whereas those co-located with another care setting had even higher rates (29 percent) of EHR use, according to the data.

Meanwhile, on the hospital and physician practice side, the federal EHR incentive payment program established in 2009 has helped boost EHR adoption to approximately 80 percent of doctors in the United States. But Congress, in establishing the program, excluded nursing homes, other long-term care facilities, assisted living and other residential care providers.