Computer Technology


Highlights from HIMSS

The Healthcare Information and Management Systems Society (HIMSS) has always focused on information technology systems in hospitals, but through the years its annual meeting has more and more encompassed the interests of long-term care (LTC) organizations. Its meeting this past February, attended by more than 25,000 members in institutions, academia, government, and industry, was no exception. Several topics addressed had a direct bearing on the future of LTC information management.

National Health Information Network
David Brailer, MD, PhD, National Coordinator for Health Information Technology, presented the federal government’s latest planning to encourage information technology (IT) adoption by providers. The major goal is a National Health Information Network (NHIN) that will integrate health information for electronic health records (EHRs), consumer empowerment, chronic care, and biosurveillance. His agency pro-jects a ten-year investment of $100 to $200 billion to develop the NHIN. The Office of the National Coordinator for Health Information Technology (ONCHIT) plans to support the development of tools that can be used by Regional Health Information Organizations (RHIOs) to locally implement networks with local funding and governance. The ONCHIT is supporting demonstrations and research with a budget of $116 million this year.

It will pay for LTC organizations to become familiar with the acronyms mentioned above. They will be in your future. Long-term and post-acute care providers must be participants in these efforts, or the results may not be consistent with the needs of our facilities and residents. There are more questions than answers in this, which makes LTC involvement essential now as plans are being formulated. The benefits for nursing homes and other long-term care providers will be great-for example, communication to and from hospitals might be smoother and timelier, and operations will be trammeled with less wasted time and money.

How will your institution integrate with your local RHIO? Have you talked with your clinical vendor to find out what its plans for integration are?

Disaster Planning
Tom Ridge, former Secretary of Homeland Security, laid out the lessons from Hurricane Katrina as they affected healthcare. Medical records were lost for many of the residents of New Orleans. Even if their records were intact, they were not available to the providers where they were evacuated. This disaster has given new emphasis to the need for electronic records that can move with people. The plan is that the NHIN will be the key to continuity after natural or man-made disasters.

How does your disaster plan account for sudden evacuation or computer failure?

Electronic Health Record Certification
Although many vendors claimed to have the EHR “in a box,” official specifications and certification of EHRs are yet to come. At a town hall meeting of the Certification Commission for Healthcare Information Technology (CCHIT), Chairman Mark Leavitt, MD, PhD, discussed the expected timeline for certification: Guidelines were to be tested this past March, with ambulatory care’related products to begin testing this summer. Although no timeline for testing nursing home products has been released yet, the American Health Information Management Association (AHIMA) is developing guidelines and test cases specifically for nursing home products (see “Moving to the Next Generation of IT,” Nursing Homes/Long Term Care Management, January 2006).

Several technical sessions at HIMSS explored approaches and case histories of healthcare organizations implementing EHRs. The promised benefits are significant, but so are the issues of implementation. All providers should be looking at the technology, budgeting for eventual acquisition, and planning for implementation in both the near and mid-term future. Positive return on investment has already been demonstrated in many settings, but the technology is still evolving and it’s essential for LTC organizations to continue paying attention and evaluating their needs and solutions.

How does the EHR figure in your future? What does your particular information system vendor have planned?

Assistive Technologies
Jim Albert of the Masonicare organization in Wallingford, Connecticut, updated the Long Term and Post Acute Care Special Interest Group (which I chair) on the newest assistive technologies to support residents in the home, assisted living, or nursing home environments. They include:

  • remote measurement of vital signs with telephonic alert to a care provider
  • electronic pill dispensers that alert a provider or family member when a resident’s medications are not taken
  • a telephone that shows a picture of the person calling with information to remind a cognitively impaired person about whom they are speaking with
  • monitoring/automatic switch devices that turn on lights or alert a caregiver when a resident gets out of bed
  • “smart” appliances that shut off water if a tub or sink overflows
  • smart stoves that shut off the heat if there is no pan pressure on a burner
  • smart refrigerators that monitor use and inventory of food content

These and many more assistive technologies are available today, and more are being developed, to keep our residents as independent as possible for as long as possible.

Are there technologies like these that could be adapted by your institution now? (The short answer: probably.)

Keeping Informed
I strongly recommend that you regularly visit to keep up with the changing technology of healthcare. Consider joining the Long Term and Post Acute Care Special Interest Group to keep current with the technology, issues, and planning pertaining specifically to long-term care. And watch for the special interest group’s educational sessions during the year using various techniques, including Web-based, to minimize continuing education’related travel-although, considering the issues at stake, personal attendance at next year’s HIMSS meeting would be an excellent idea.

David M. Oatway, RN, is a long-term care IT consultant based in Key West, Florida. He is Chair of the HIMSS Long Term and Post Acute Care Special Interest Group and a member of the American Health Information Management Association (AHIMA) and Health Level Seven (HL7). A contributor to the development of MDS 2.0, he developed one of the first clinical/MDS systems (CHAMP). To send your comments to the author and editors, please e-mail

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