Tech-savvy senior living providers, including some of the largest national chains, have been adopting electronic health records in growing numbers. The drive to wire-up assisted living and similar communities with EHRs may soon gain even more momentum thanks to two recently announced initiatives.
While government funding to subsidize the cost of EHRs has been available for hospitals, physician practices, and other health care providers for years, long-term care providers have been shut out of the program. That’s about to change in a limited way. Now, federal and state funds will begin to flow to Medicaid providers such as LTC facilities, behavioral health providers, and substance abuse treatment centers, the Centers for Medicare & Medicaid Services (CMS) announced at the recent HIMSS conference in Las Vegas.
Also, companies that provide 90% of EHRs in the United States—including Epic and Cerner—have pledged to implement new interoperability standards, Health and Human Services Secretary Sylvia Burwell announced at HIMSS. This is noteworthy because several of these EHRs, which are tailored for acute care settings, have a reputation for being closed systems—meaning it’s hard for other providers to tap into them with their own technology for purposes of coordinating care.
Neither of these developments is directly incentivizing private pay senior living providers to implement EHR technology by, say, offering them subsidies. Still, there is likely to be a trickle-down effect that will result in more EHRs in senior living, say two authorities on how the industry is adopting technology.
“I believe it will speed up the process on the private pay side,” says Majd Alwan, Ph.D., senior vice president of technology and executive director of the LeadingAge Center for Aging Services Technologies (CAST).
Even though there have been no direct government subsidies for long-term care EHRs until now, the proliferation of the technology in the health care system overall did spur the development of senior care-specific EHR products, Alwan points out. Now, with the stage set for more skilled nursing and other Medicaid-focused senior care providers to adopt interoperable EHR products, other providers catering to this demographic will have more reason to be part of the technology ecosystems.
Part of the motivation could be referrals, given that hospitals may prefer to send patients to communities that can interface with the hospital discharge systems. This would support smoother transfers and lower the odds of readmission. And with the new interoperability commitment from the hospital-focused EHR vendors, the systems being used in senior care settings increasingly could have the power to connect.
“I look forward to seeing more and more of the [long-term and post-acute care]d EHR vendors participate in connect-athons and interoperatbility showcases demonstrating the actual exchange of information,” Alwan tells Senior Housing News. “That’s something we’ve been advocating for and pushing our members to do.”
Still, assisted living providers and others that serve lower-acuity seniors may be operating more on a hospitality rather than health care model, and still will not see the need for a fully outfitted EHR.
“We’ll definitely see an increase in the EHR adoption even though they may not be full-blown EHRs,” Alwan says. “They may be ‘EHR light’ types of systems.”
For instance, senior living providers might adopt systems that focus on medication management as a starting point, or those that have resident assessment functions to help better gauge the needs of their populations, he says.
No Longer Optional
One advocate for more robust technology in senior living, Avanti Senior Living COO Lori Alford, agrees that the latest initiatives will speed up EHR adoption.
Avanti opened its first community in late September, in the Houston suburb of Towne Lake, Texas. This brought to fruition the company’s plans to introduce a high-end offering to the market with cutting-edge technology in place. The provider is working with software vendor Eldermark on its health information exchange efforts.
Care partners at Avanti are equipped with iPhones that function as point-of-care devices. Data inputted into the iPhones go into Avanti’s EHR and EMAR (electronic medical administration record) and get uploaded to the cloud. The provider’s caregiving partners, such as home health agencies, physical and occupational therapy providers, and hospitals, have access to the cloud-based resident files. They can add their own information, and also refer to the files to see what’s happening with a resident in real time, in order to make more accurate diagnoses, Alford tells SHN.
“What these systems allow us to do is have data and be more proactive in the resident’s care planning,” she says. “For instance, just going to their regular cardiologist, the cardiologist now has access to data rather than just interviewing the resident. It also allows us to partner with hospitals and skilled nursing better. It allows us to say, hey, here’s a better view of what that resident looks like.”
Senior living companies have been “slow and cautious” to begin collecting and leveraging patient data through technologies such as these in large part because they haven’t had the same requirements and incentives from the government as other types of providers, Alford says. These systems also require substantial capital to get up and running, and senior living providers might be slightly short-sighted when it comes to return on investment.
“We may not physically get a dollar that passes back and forth from it, but if the doctors, rehab providers, et cetera like the idea they can get better data from Avanti, they’ll refer patients to us because we’re a better partner,” she says, echoing Alwan’s comments on referrals. “So, we feel as though we’ll have an advantage from that standpoint.”
In addition, a recent focus group with families revealed that they responded very well to the point-of-care technology and the data exchange that Avanti has with other providers, according to Alford.
With referral streams and family satisfaction tied to EHRs, and the technology set to become even more commonplace in post-acute settings thanks to the new Medicaid incentives, it appears that this technology may be going from optional to mandatory for senior living.
“They’ll have to [invest in these technologies] or they’ll lose that market share,” Alford says of senior living providers. “It’s almost not a choice anymore.”
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