Walk Before You Run—Part 2: Best Practices in EHR Adoption for Today’s Providers

By Sally Webb, RN, RAC-CT, CEAL
Senior Manager, Clinical Implementation

(If you missed Part 1 of this article, please click here.)

In our last piece, we looked back to see how far we’ve come with technology in long-term care.  Ten years ago, we might have used technology to compile information, but we certainly weren’t using it to help us make decisions as we are today.  In this piece, we’ll examine some of the widely accepted best practices for adoption of today’s electronic health record systems (EHR).

Adoption rates for EHRs are above 80% in acute care.  The long-term care industry continues to lag behind at around 50% according to data collected by the US Health and Human Services.  This is in part because there has been no incentive payment made available to long-term care providers, while there have been significant incentives offered to hospitals and physician practices.

But, the benefits of using an EHR are worth consideration.  Yes, paper works—but, sorting through a pile of paper to pull a report together is time consuming, error prone and lends itself to paper cuts.  Today’s EHR solutions collect the data that’s entered, allowing users to easily report on and analyze it, empowering them to run their businesses more efficiently.  They offer tools that let caregivers get back to caregiving.  They help administrators run the operations more tightly.  They help providers become sustainable businesses giving the highest quality care possible.

Okay, so enough about why you should use an EHR.  Where do you start?

Laser Focus is Critical

The three most important things to consider before taking the plunge are:  organizational readiness, capital and time.

When looking at organizational readiness you need to think carefully about your organization and ask yourself what your goals are and how you plan to measure success.  Do you have a system that you need to replace?  Does it make sense to start small with a functional replacement of what you’re using and add later?  Or, do you want to take the big bang approach and tackle more. 

Look at your team.  Do you have the resources to dedicate to the project?  Do you want to start with the clinical side of the business, billing or both at the same time? You won’t have to lock an entire team in a room for 8 weeks to enter data.  But, you will want to assign specific staff to champion the project through the planning, implementation and go-live phases. 

Work With Your Vendor

Selecting a vendor is often the most daunting task.  LeadingAge CAST offers a tool for help selecting the right EHR for your organization as well as information on the various providers and offerings for long-term care. Since there are multiple models that follow various stages of adoption, you’ll want to work with your vendor to help you walk through which approach is best to help you achieve your goals.  If your vendor does not have a methodology they recommend, turn to Healthcare Information Management Systems Society (www.himss.org) or the American Health Information Management Association (www.ahima.org) for standardized adoption models. However, recognize these are designed primarily for acute care, rather than long-term care. 

Dedicate Resources

Who on your team will lead the project?  It is recommended that someone from the clinical team lead the clinical aspects of implementation, while a business office representative oversee the financial aspects.  These are the folks who will guide the rest of the team during important decisions regarding system set-up.  They’ll be the people who will ensure everyone is trained and that learning milestones are accomplished.  They’re the champions of their disciplines and will help build staff consensus and get you over the inevitable bumps in the road.  Plan for there to be bumps in the road.

Look at Your Practices Critically

So often we hear that someone wants a certain form created or data collected in a certain way—“because we’ve always done it like that.”  Don’t fall for it.  Ask why.  What types of data are you collecting now, and how often?  Does it benefit your operation to continue this way or is do you have a chance to improve your process? 

Think carefully about the security of your data.  Who will have access to which parts of the records?  Controlling who looks at a paper chart isn’t easy.  With an EHR it’s easier. 

EHRs at a Full Sprint

Healthcare is changing.  We need to move toward data growth and sharing.  We no longer expect our software to just collect data for it to sit in a repository.  We need data to be collected in a standardized method, so that it may be analyzed to improve outcomes management.  Communication with other facilities, other caregivers, consultants and families is going to be commonplace in the near future.   The more we can leverage health information technology, the better the information will be, the more predictive we can be in care and service for our residents, improving care across the continuum.

In our next piece, we’ll look at the future of technology in senior care.


Click here to read: Part 3: Caring for the Future: Where will EHR and Technology Take Us?


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About the Author

Sally Webb, RN, RAC-CT
CEAL Senior Manager, Clinical Implementation

Sally Webb is a registered nurse with 30 years of diverse nursing experience.  During her career, Sally has held several nursing positions within long term care, including MDS coordinator, DON, ADON, software trainer and corporate nurse manager. 

As the Senior Manager of Clinical Implementations, Sally oversees all clinical training for PointClickCare.  She is a member of the American Nurses Association, American Association of Nurse Assessment Coordination and has recently earned her CEAL certification. 


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