With the landscape of the long-term post-acute care (LTPAC) arena changing drastically, now and in the very near future, having a Strategic Plan in place for your organization is more important now than ever. With value based reimbursement, consumer demands, and the hospitals’ mandate for data…the LTPAC market is more competitive than it has ever been! We have to do more for less, and having a plan to overcome this is vital. Furthermore, technology is no longer something to merely “keep up on” in this industry, it is one of the most valuable tools we have on our belt. It is probably the single most key component to taking our strategic plans from being focused on “surviving” to being focused on “thriving.”
What technology initiatives are most important to focus on when developing a Strategic Plan in the LTPAC arena? Here are ProviNET’s top 10:
1. Ensure that your EHR has “super hero status”
a. Many providers in our industry are “unhappily married” to their EHR. They are using it and know that it is here to stay, but it is far from their ideal. However, many organizations don’t do a great job of keeping up with new content as it is released with new versions, or they conform their EHR to old paper processes which are still cumbersome and inefficient. Unused functionality is not the same as absent functionality. Work with your EHR vendor or an objective 3rd party consulting company to optimize your EHR for user satisfaction, but most importantly, make sure the EHR is primed and ready to be the backbone of your organization’s answer to the changing and more challenging landscape ahead.
b. Also ensure you are set to take advantage of the newer/premium “add-on functionality” that will promote better data analysis, practitioner/user engagement, and interoperability.
2. Ensure that your enterprise applications are “best of breed”
a. Pretty much all of the modern EHRs do not offer a complete solution for all things LTPAC. They historically do not account for things like CRM, point of sale, accounting, and payroll. Instead, there are “best of breed” applications that handle these components better than any EHR could. It is a standard “jack of all trades, master of none” phenomenon. Organizations need to have best of breed enterprise applications that best propel those services of their business towards success, ease of use, and efficiency.
b. Review which of your ancillary departments (dietary, facility management, marketing, HR, etc.) are still relying on paper or spreadsheets and ensure they have an application that drives their department towards a resourceful future.
3. Establish some Business Intelligence across your EHR and enterprise applications
a. We are now in a competitive market, so monitoring of what metrics set our organizations apart is absolutely vital now. Quality metrics will be how our organizations live or die in terms of hospital referrals; and proving what care we are great at providing is now a necessity.
b. BI, analytic dashboards, etc. can’t begin and end in the EHR alone. Again, the EHRs of today do not cover 100% of our business, so to have truly actionable data, we must also be considering the data that lives in our enterprise applications. Payroll, CRM, Accounting, and facility management data are all important pieces of the puzzle that famously reside outside of the EHR. True Business Intelligence, the kind that provides insight that is capable of steering organizations to thriving, must be across all key applications.
c. Thankfully, our industry isn’t extremely complex. So things like machine learning and AI are not quite essential and are still in their infancy stages. There are a lot of low-risk, high-yield opportunities here.
a. As already mentioned, many organizations have a core EHR platform that drives the census, clinical, and financial components of their business, but then rely on separate best of breed enterprise applications. Organizations are then stuck with the challenge of these separate systems operating in silos and demanding dual entry. Instead, we need to integrate these software applications with the EHR as the center focal point.
b. There has already been great strides in integrating separate software applications and organizations can typically work with their vendors to achieve this. However, we must look beyond this too, and consider integration with our hospital partners and primary care practices.
a. If any of the items in this list are seen as “nice to haves” (which I don’t think any of them should be, if you don’t want to be playing catch up next year), this one absolutely shouldn’t be. We have so much of our resident’s information digitalized now, and LTPAC is behind in cybersecurity. Additionally, the information we are trusted to protect goes for a premium on the black market. So this makes our industry a prime target for cyber-crime. And the cost alone of a data breach can be disastrous to an organization.
c. Invest in education for your end users, define robust policies and procedures, and consider undergoing external audits to test your security and identify areas for improvement.
6. Moving to the Cloud
a. If your organization still has on premises servers to host applications, or even a full scale EHR, chances are that initiative costs your IT team a good deal of time and money to maintain. There are certainly benefits from being a self-hosted provider in some regards, but if you do not possess a full and strong IT team to maintain that structure, it can be a much bigger headache than a benefit.
b. Now that Wi-Fi and EHRs are commonplace in most LTPAC organizations, the case for moving applications to the cloud is stronger than ever. Organizations can now increase their capacity without the costly implications of adding servers, accounting for storage, or updating your infrastructure. And a main proponent for moving to a cloud network is that our EHRs now need to be portable. We need to provide bedside documentation, allow for better end user/physician engagement, and we need easily accessible systems from home or on the go since the care we provide never stops. Most software vendors will happily host your applications, but there are also some noteworthy 3rd party vendors out there providing a “boutique” style of hosting that allows for the flexibility and control of a self-hosted environment, but without the stress and investment that goes along with that.
7. Internet of Things
a. IoT each day becomes more than just a buzzword in our industry. Seniors are more tied to technology now than ever, and as they enter our organizations they are bringing a whole slew of devices with them. And these are common day devices that are now “smart” and connected to the internet and each other. Things like Nest thermostats, Apple Watches, and the various home assistant solutions are great examples of things that seniors love utilizing in their homes, and expect the same thing when moving to a senior living community or receiving care at home. Our industry now has to realize the potential benefits that these devices can bring to the care of our seniors, but also understand the challenges they pose too.
b. Security and HIPAA compliance is forefront in the debate on how IoT can or should impact our industry. The popular voice-activated home assistants, like Amazon’s Alexa, are not HIPAA compliant right now and can very well be overhearing and storing dialogue about the patient’s condition and care. Additionally, some providers are questioning the driving motive behind these devices, like Alexa being utilized to recommend products via Amazon. Establishing policies and procedures in our organizations that address these challenges, and looking for ways to best support their use for the enhancement of the care we provide, is paramount.
c. However, if we can address the challenges these devices pose, there is considerable potential benefit. These devices can promote some great monitoring and analysis of our patients and act as a lifeline for when they need urgent assistance. The idea of a patient being able to simply call out a voice command if they fall, or better yet, if a device can detect a potential fall and automatically call for help, has huge implications for the enhancement of senior care. Organizations should consider these devices and the potential benefits that some of them could bring, and weigh those benefits against the potential risks, to develop a plan for how to best regulate and support this grouping of new technology.
8. Assess the status of your IT infrastructure
a. Touting a strong EHR platform, with robust Business Intelligence and interoperability means nothing if your existing IT infrastructure can’t effectively uphold and deliver them! Too often organizations will create strategic plans to adopt some great new technology, but fail to look back at their current infrastructure to assess the impact that this will make and identify where there may be shortcomings. Organizations should regularly assess their existing infrastructure and be sure to include allocations in their strategic planning and budgeting to maintain and improve their network.
9. Assess the status of your hardware
a. Similarly to continually checking the pulse on your existing infrastructure in relation to your desired future state of technology, organizations should also always consider the same for their hardware. Are the laptops attached to your med carts up to the task of handling your desire to implement more of your EHR? And is your Wi-Fi architecture and access points capable of maintain a strong connection across your mobile devices? As your desired future state of technology grows, so must your allocation for appropriate hardware. Not to mention that many organizations are still using consumer grade devices for delivering care, which results in a much shorter life expectancy for your hardware investment.
b. Organizations should always plan for replacing devices that are nearing end of life, and consider upgrading their hardware from consumer grade to medical grade. And before adopting any new technology or applications, ensure that your existing hardware is capable of handling it.
a. Lastly, organizations must continually be looking to innovate in the way they deliver care, and how their technology bolsters their future vision. This is an opportunity for an organization to go the extra mile and set themselves apart from the local competition. Here are some potential areas where an organization can innovate and get ahead of these emerging technology trends.
b. LeadingAge/CAST recently identified patient engagement as a key area to focus on in strategic planning. Currently, patients are not typically well equipped at discharge to self-manage their care and are consequently becoming repeat/high-risk patients. However, finding an application to help drive patient engagement is not enough, but instead needs to be bolstered by good decision making on the part of the provider, which must be driven by meaningful and comprehensive clinical data.
c. Another potential area to focus is preparing for the “Silver Tsunami” and their desire to stay at home. Our industry is going to be moving away from brick and mortar in order to accommodate the upcoming surge of the senior population. Home care is an upcoming key care setting and has its own unique requirements for technology. Ensuring that your EHR is capable of handling care at home, that you have suitable mobile devices, BI, and security will be vital. But this also leads into the next point…
d. Embracing emerging technology like telehealth, remote monitoring, fall prevention, and sensors will be an area of focus in our communities, and for care delivered at home. Such technology is showing great promise in preventing increased morbidity and promoting early intervention. We are also seeing businesses like Amazon, Google, and Apple now trying to enter the senior living industry as potential disruptors. With the recent release of the new Apple Watch, with built in EKG and fall detection, it is guaranteed that these will begin entering our communities whether we are ready for them or not. Embracing this emerging technology and getting out ahead of it is what will separate proactive organizations with strategic plans set for thriving in the changing climate, from reactive organizations who may very well find themselves challenged to just survive in this increasingly competitive and transparent industry.