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Secrets to EMR success

February 25, 2015
by Lois A. Bowers, Senior Editor
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A CCRC shares selection and implementation tips
Click on the image to see what motivates and informs EMR selection.

Aging services providers generally lag behind hospitals and medical practices when it comes to purchasing and using electronic medical records (EMR) systems, in part because government incentives—and penalties—weren’t implemented with them in mind. As the government and other health system sectors increasingly recognize the vital role that entities traditionally serving seniors play in the care continuum, however, the necessity of EMRs in long-term care settings is becoming a reality. One continuing care retirement community recently shared its EMR selection and implementation experience with those attending a Long-Term Living webinar.

The webinar, “Transform Your Organization with Information Technology: 5 Steps to Success,” is available on-demand through Jan. 22, 2016.)

The Jewish Association on Aging (JAA) realized that an EMR system could bring benefits to its CCRC, said Deborah Winn-Horvitz, MS, president and CEO. Among the advantages: enhanced coordination of care thanks to a seamless flow of patient/resident information across its service lines; improved availability, accuracy and reliability of data to enable decision-making and reporting; and enhanced efficiencies leading to cost savings—all resulting in improved quality of life for patients/residents and job satisfaction for staff members. The changing healthcare landscape and requirements related to ICD-10, the IMPACT Act, healthcare information exchange, new payment models, an increased focus on length-of-stay rates and rehospitalizations and other factors converged to convince the CCRC that the time had come to select and implement a system, she added. (Click on the “Go Live” image, upper left, to discover the motivations and information sources of webinar participants implementing an EMR.)

Four main challenges

“Funding was a big challenge for us,” Winn-Horvitz said. The Pittsburgh-area CCRC is a nonprofit, faith-based organization that includes a 159-bed skilled nursing facility; an outpatient rehabilitation center; two personal care facilities with a combined 120 units and including independent living; hospice, palliative care, home health and adult day services; and Meals on Wheels and other community resources.

JAA sought grants from local foundations and contributions from individuals to cover some of the cost of system selection, purchase and implementation, Winn-Horvitz said, and operations will cover some of the cost. Support from the organization’s board was critical, however, she added.

“It’s going to be very important from the beginning to have board participation, so when it comes time for you to be in front of your board asking for support for the EMR, they will have a vested interest in this and have an understanding as to why it’s so important,” she told webinar attendees. Because the JAA board was involved in planning from the beginning and had been educated about the project, she added, members permitted funds from its endowment to cover much of its costs.

A second challenge, Winn-Horvitz said, was ensuring sufficient information technology (IT) support. Before implementation, JAA had outsourced its help desk function to one person. “We really needed to put some type of infrastructure in place,” she said.

At the beginning of the project, the CCRC hired a full-time project manager who had an IT background. As implementation loomed, JAA hired an EMR nurse clinician. “One of the looking-back lessons learned is, I would have hired that EMR nurse clinician earlier in the selection process as opposed to waiting until implementation,” Winn-Horvitz said. The Pittsburgh Regional Health Initiative and Pennsylvania REACH West, a federally funded regional extension center (REC), provided assistance as well, she added. (JAA was one of the first long-term care providers to benefit from REC services, Winn-Horvitz said. Find out how a REC can help you by listening to the webinar, “Transform Your Organization with Information Technology: 5 Steps to Success,” available on-demand through Jan. 22, 2016.)

A third challenge related to JAA’s EMR journey, she said, was upgrading the CCRC’s hardware and networks. What JAA had was “bare-bones minimal and clearly not adequate to support the implementation of an EMR,” Winn-Horvitz said. “And so we ultimately rolled that cost up into the entire implementation.”

Actually selecting the system was a fourth challenge. “We knew what our core components were of our IT strategy,” the CEO said. “We had an idea of what we were looking for—there are, of course, a number of systems out there on the marketplace—but we really didn’t know where to begin in terms of the selection process.”