Walk Before You Run: The Blueprint and Top Considerations for EHR Adoption (Part 1)

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

When we think back to what the long-term care industry was like 10 years ago, technological innovation tends not to be top of mind. And yet, suddenly we’re surrounded by it. Which makes sense – technology has a track record of success in simplifying tasks and solving everyday problems. Just check your pockets – you likely have a smartphone that synchs with your car, telling you how to get where you need to go, and that helps you contact someone if you’re running late.

Adopting new technology, like any new idea, can be hard. The challenge for providers will not just be rolling it out, but also harnessing the power to do what you need to do.  A piecemeal approach fails. Solving an immediate need with a single solution sets you up for redundancy in a year’s time, when you try to remedy your next immediate need – only to discover the two technologies need to be patched together to ‘sort of’ work. Take the time to understand your current needs as well as considerations for the future, and think about the plan you need to put in place.

The next challenge then becomes change management, or culture change management. Culture change is hard. It requires a clear idea of where you want to go and the patience and persistence to get there.  In this first of a three-part series, we’ll look at factors in long-term care that have prompted our use of technology, specifically Electronic Health Records (EHRs), and begin to consider where we are headed as the technology we use continues to evolve. 

By 2030, one in five Americans will be a senior citizen.  10,000 people become senior citizens every day. 80 year olds are the fastest growing demographic.  Two-thirds of all people over the age of 65 experience multiple chronic conditions. We’re living longer, and more and more of us want to age in place.

Caring for this aging demographic has set the need for integrated EHR solutions. Early adopters started out with a basic electronic medical record, or “EMR,” allowing them to store data and report on it, but were limited in the intelligence they could derive from the information the records contained.  These early EMRs were built around digitized forms that held static content which you could report on, but do little else with.  None of the data stored in early EMRs connected with other data. They were read-only and provided no support or guidance in care.  But, they were a start. 

Today, we need to be able to collect the data in a system that helps us make more informed decisions.  Data needs to be collected and used to drive our clinical workflows to help improve outcomes.  We need to be able to take data and aggregate it, analyze it.  With an integrated EHR, you can monitor patterns and processes. You can identify trends. You can have the data organized to tell you something – about your risks, your insurance claims, your revenue, your occupancy. More than a paper chart could ever do.

Right now, you might be thinking, “Our paper system is just fine.  It’s not broken, so why fix it?”

Here’s why.  Quality is the new currency.  Without data, you have nothing.  The skilled nursing marketplace is highly competitive, and sustainability is paramount. Without the ability to document and show your record of care, you have no proof.

What is an EHR?

There are three basic components to an EHR: the resident chart, care related documentation, and financial information. Data should be captured for the entire resident stay, from admission to discharge.  The EHR should also comprise decision support tools and connect you to the outside world – to be shareable.  Connected care is an important element to a smart EHR, an important topic that will be covered in an upcoming segment. 

So where do you begin, how do you start?

Leaving Money on the Table

Providers are losing tens of thousands of dollars each year by not utilizing an EHR.  They think they don’t need an EHR, that it’s too hard to implement or too costly.  But, when you think about where providers lose out on reimbursement – accurate and complete documentation of all ADLs performed, using ‘Day 8’ as the default ARD, billing/coding errors – these costly omissions can easily be fixed with an EHR.

It’s not free, it may be challenging, and EHRs are not a requirement. 

But, what if you could also improve patient outcomes, eliminate redundant work, make staff happier and more efficient and, most importantly, improve resident satisfaction?

Miami Jewish Health Systems deployed PointClickCare in August 2014. In a recent interview with Leading Age, director of information technology, Bernardo Larralde, recently noted a drastic improvement in their operations.[1]

“In the past, we did not have timely access to metrics and the collection process required a great deal of manual effort from the clinical management team and custom reporting from IT. The implementation of the new [PointClickCare] EHR has totally changed that issue and we are now almost instantly able to measure and identify any area of concern.”

Considerations in EHR Adoption

Schools of thought vary when considering the best way to approach EHR adoption.  Should we take it slow, or tackle it all with a big bang approach?  Take a look at your current operation.  Think about what data you’d like to collect and how you’d use it.  Plan for the team members you’d like to be involved in the setup.  Consider your current hardware, network, and training resources.  Develop a plan you can build on.  A plan designed to address more than one issue, and that will make your care delivery and business operations stronger.

Ask yourself, will it help you improve revenue or workforce productivity? Will it help you reduce your costs and minimize your risk? Can it enhance your staff time with residents? How will it fit into your strategy to reduce hospital readmissions and improve outcomes? Data security is also a critical consideration you’ll need to consider prior to the process of EHR adoption.  You will have to make sure you are HIPAA compliant.  You can’t limit access to paper charts, but with electronic charts you can be more thoughtful about access.

Take the plunge. But, do so with a solid plan that accounts for your goals and objectives, based on a reasonable timetable you and your team can achieve.  The information and tools you’ll have available to you may make you wonder how you ever lived without them. 

In our next piece, we’ll look at best practices for EHR adoption.


(Click here to read Part 2 of this article.)



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[1] https://www.leadingage.org/Quality_Assessment_Is_Your_Technology_Doing_Enough_V5N1.aspx?mkt_tok=3RkMMJWWfF9wsRonva7IZKXonjHpfsX56%2BglUaOylMI%2F0ER3fOvrPUfGjI4JTMJ0aPyQAgobGp5I5FEKSbTYTK5mt6MOXw%3D%3D


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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