Why Many EHR Systems are Failing LTPAC Providers
The Medicare and Medicaid systems, whose funding accounts for approximately 25% of the federal budget in the U.S., has long suffered from inefficiency. Healthcare waste, duplicative services and lack of coordination of care has significantly increased the cost in healthcare services in the U.S. Electronic health record systems were created to promote transparency in healthcare provision and reduce medical waste.
With the use of EHR, patients could have real-time access to their own healthcare records, and providers can easily share these records, reducing lag time in transferring vital clinical information. In theory, EHR systems improve healthcare providers’ productivity and efficiency by consolidating data entry input effort across providers. In practice, however, LTPAC providers see drastic reduction in productivity when transitioning to an EHR system from physical health records. The reason is that these EHR systems and tools are not designed specifically for LTPAC practices.
Issue #1: Workflow difference
Existing EHR systems are designed for ambulatory clinic settings in which a physician is supported by a team of staff and nurses. These ancillary staff members all interact with the health records at some point and take part in the data entry process, reducing the burden on the physician themselves. Often, the only input from the physician is the actual visit notes.
The workflow is vastly different in a true LTPAC setting. Physicians and practitioners in nursing homes and assisted living facilities do not have a staff to support them through the data entry process. Thus, they’re responsible for inputting all information from insurance details, patient tracking to visit notes. This puts a significant burden on the clinicians and forces them to shift their attention from the patients to administrative tasks. At this point, EHR distracts LTPAC providers instead of supporting them.
Failure to understand, account for and address this fundamental difference in workflow is inhibiting the adoption of EHR in LTPAC industry.
Issue #2: Data migration and governance
CMS regulations on meaningful use of EHR focuses on data entry and maintenance. This means to receive the monetary incentive and avoid a penalty, care providers need to successfully migrate their current data to a certified EHR system and continue future input there. For physicians and practitioners without a supporting team of staff, the migration of data from physical health records to EHR is exhaustive enough to discourage them from adopting EHR.
Even if the physician chooses to adopt EHR, some data does not seamlessly flow into the systems. For example, the action of prescribing medications is traditionally performed within the facility’s record. For it to be recorded in EHR, the physician needs to enter the data manually. Maintenance of both record-keeping systems puts the physician in constant flux and may complicate care due to differing information in two disparate records.
Issue #3: Agility
In LTPAC industry, both physicians and patients are moving targets. LTPAC practitioners usually provide care in multiple locations and travel between several facilities each week. At the same time, the patient that they see in nursing homes comes with various needs that may change every day, bringing along different types of service and locations of care. Compared to a clinic setting with a single office location and a set type of service, LTPAC providers in nursing homes require significant agility in their EHR systems to be able to catch up with their workflow.
Issue #4: System integration and collaboration
LTPAC physicians have two customers: the patients and the facility. Physicians may have their preferred tools and technology to perform tasks associated with patient care. The facility often has its own separate technological system. It’s critical for physicians working in multiple locations that their technology is fully integrated with the facility’s tech stack.
Facility records were excluded from governmental incentive programs, so they remain technologically noncomplex. Integrating a physician EHR with the facility EHR presents a significant challenge to many LTPAC physicians. Instead of a productivity-boosting tool, non-LTPAC-specific EHR has become a major hurdle for physicians, pushing them further away from this system.
Traditional EHR systems have failed to recognize the specific workflows of the LTPAC industry and its underlying needs, making it a burden rather than a support for physicians in nursing homes. But the potential for productivity, efficiency and quality boost is tangible. For an EHR to provide real value to LTPAC clinicians to promote coordinated care, it must be designed by LTPAC professionals, for LTPAC professionals.
Issue #5: Big pond, little fish
LTPAC clinicians make up less than 1% of the medical professional community in the U.S. As a result, they are never considered a priority for typical EHR systems, which are designed to make the most money and cast the largest net (hospitals, brick and mortar buildings). On Feb. 3, the largest long-term care health record company, GPM or GEHRIMED, sold to another large player in the health record market, NetSmart.
The EHR landscape will continue to be challenging LTPAC practices as software companies continue to chase after the large fish. You shouldn’t be treated as a minnow. You’re providing valuable care to the most vulnerable population during a critical time. You deserve software tools and strategies that focus entirely on you and your experience.
We want to correct this. Saisystems Health has long been a trusted partner for LTPAC practices with over 30 years of strategy, management experience and clinical strategy. We’re introducing a new solution that brings the attention back to LTPAC practices and its unique challenges. Stay tuned for more details.
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