With the growing use of electronic data in healthcare to improve quality of care and lower provider costs, more long-term care organizations are making the transition from paper medication administration records (MARs) to electronic medication administration records (eMARs). The benefits are clear: a reduction in medication errors, paperwork and administrative costs, and improved quality of care. And, let’s not forget that in this new era of healthcare reform, accountable, quantitative evidence of quality care is crucial.
At a recent learning seminar on eMARs held at the Assisted Living Federation of America’s (ALFA) national conference last month, Carolyn Dibert, RN, director of clinical services, Country Meadows Retirement Communities, located in Pennsylvania and Maryland, shared her organization’s experience in transitioning from MARs to eMARS. It’s a process not without its challenges but ultimately it provided a win-win for residents and staff—most notably a 90 percent reduction in annual medication errors.
Dibert detailed key considerations in choosing an eMAR system including: a community’s needs—now and in the future; compatibility of the eMAR system with other EMRs (electronic medical records); choosing a specialty solution versus a total package; security of confidential information; accessibility of old records; training and end-user support; and the vendor’s vision and approach to innovation. Also, consider how the software is designed—whether it is to be cloud-based versus locally hosted; reporting capabilities; customization options; and staff usability.
From a hardware standpoint, consider these factors:
- Medication carts: What kind of alterations will be required to hold the computer and its additional weight?
- Computers: Durability—they’ll be moved around and subject to bumps and falls. Plan for spare computers, infection control (cleanable keyboards and screens); bar code scanners and remote servers.
Dibert recommended conducting site visits to communities using the eMAR systems being considered. “Observe the med pass in action,” she said. “Inquire about satisfaction with the software and support from the vendor.”
Questions to ask vendors include:
- System reliability: How long has it been in use?
- Scalability: How quickly can we get this implemented?
- Mobile access: Is the system available for tablets and smartphones?
- What are the remote reporting capabilities?
Dibert emphasized that once a system is installed, ongoing support is critical for success. She suggests periodic refresher training for staff, including eMAR training for new hires as part of orientation and creating quick reference guides as user resources.
Dibert reported that while a “tech phobia had to be addressed,” ultimately her community’s eMAR users offered “100 percent positive feedback. They loved the clarity, prompts and reporting [capabilities],” Dibert said, adding that “it’s a great recruitment tool.”
However, “eMARS are not plug and play,” Dibert said. “Success depends on the users.” Administrative buy-in and accountability is critical and leadership must be involved.
Pharmacy involvement is also crucial, Dibert said. The systems are joined and some process adjustment is required. “[eMAR] is still a new concept for most pharmacies,” Dibert said.
Ultimately, technology does not replace attention to task, Dibert cautioned. “eMAR supports quality care delivery. eMAR is simply a tool and only as good as the person using it.”