In a health care system that’s adopted new ways to track patients with electronic health records (EHRs) and share structured data through health information exchanges (HIE), nursing homes have been a little slow to modernize.
But providing better documentation workflows and embracing more efficient technologies will be a must for SNFs moving forward, Dr. Frank J. Newlands, founder and CEO of South Carolina- and Florida-based Physicians Services Group, stressed earlier this week. That’s especially true when it comes to SNFs communicating with health system partners.
Physicians Services Group is a provider network that specializes in serving skilled nursing organizations.
“I was quite shocked even in 2016, when I started to work in the [skilled nursing] space. They were still relying on fax machines while in the hospitals,” Newlands said during a recent webinar sponsored by GEHRIMED. “What I was also struck by was there was not a lot of standardization and process. Most of these facilities are run by moonlighters on the medical side, which I didn’t feel was a good fit.”
Despite working with a lot of physician groups that are still utilizing paper and disconnected EHRs, Newlands and others in the industry say there is a lot for operators to look forward to.
“It’s a hot topic right now, in regards to people trying to get out in front of the baby boomers,” he explained. “People have a longer life expectancy, and assisted living, SNFs and rehab centers are going to be a bigger and more robust part of that ecosystem. That’s why people are making investments in it.”
To take a step forward on the technology front, nursing homes and physician groups need to seriously think about where they fit into the broader health system, Newlands added.
Investing in the right tech
After working in hospitals and around EHRs, Newlands admits that SNFs were not exactly given a seat at the table compared to other health care stakeholders. A lack of SNF engagement early gave the rest of the health care sector a headstart in modernizing documentation and information systems.
“I do not recall, anytime from 2002 to 2016, having a discussion about SNF and rehab and including them in the mix or having them part of the ecosystem,” he said
However, the focus has begun to shift.
“The irony is that all this took place in the hospitals in ‘07, ‘08 and ‘09. That’s how far behind we are right now, but it’s coming,” Newlands said. “If you do not embrace that technology, you’re going to get left out in the cold. You also have to have technology that’s easy to deploy and easy to use.”
Technology has grown even more important in light of the COVID-19 pandemic and increased focus on quality, particularly as patients are discharged from acute settings faster and sicker than in the past.
“Anybody who’s worked as a physician or in the ER, … There’s nothing worse than receiving a nursing home patient at 11 o’clock at night on a Friday as a ‘nursing home dump,’” Newlands said. “There may be a legitimate reason why that patient [has been] admitted, but nobody really knows why because there’s no notes available.”
The care handoff needs to be done much more efficiently, with the goal to assimilate and disseminate structured data from the facility to the hospital, and from the hospital to the facility.
Companies like GEHRIMED want to provide a simple fix for SNFs.
The mobile EHR platform provides a cloud-based option for operators. It was built specifically for — and by — long-term and post-acute (LTPAC) practitioners.
“With a system like yours, an automated note is available within 30 minutes of completion. It would be very beneficial to have those notes and to be able to pull that structured data. As a provider, all I need to worry about in the ER is the [the physical assessment],” Newlands said. “All the fluff is brought in through an integrated EHR, including medications, allergies, social history, past surgeries — stuff that really takes time as a provider to document.”
An integrated EHR allows providers to grab data in real-time and use that data for when filing a Medicare claim, he said.
“By having that data integrated, everybody knows what is going on with the patient,” Newlands said. “And that’s an important step from the provider group to the facility EHR, and that step needs to be taken because the hospitals are going to be relying on that data on these HIEs in the very short to near future.”
He thinks that physician groups should focus on helping SNFs and rehab facilities maximize quality outcomes while maintaining a steady referral source, doing so in a way that the hospital’s needs are understood.
“I think you’re going to see over the next five years an evolution in this, but the technology gap that exists today is going to be erased very quickly,” Newlands said. “And those that don’t embrace technology are going to get left out.”