Nursing Homes - HIT

Various federal and state mandates are requiring health care providers to have interoperable electronic health record (EHR) systems and to use e-prescribing. Stratis Health is helping nursing homes meet these mandates—and most importantly, helping providers select and use HIT to improve the quality of care delivered and increase patient safety.

In 2007, the Minnesota Legislature mandated that all Minnesota health care providers must have an interoperable electronic health records (EHR) system in place within their clinical practice setting by January 1, 2015. According to a Stratis Health survey in 2008, 31.5% of Medicare-certified nursing homes in Minnesota indicated they currently have an EHR in place.

Information technology in health care is not new. Many nursing homes have used health information technology (HIT) for some time to support administrative and financial processes. Momentum is growing to use HIT to:

• Improve direct clinical care processes for safety and quality of care
• Achieve greater efficiency and improve use of resources
• Communicate across the continuum of care
• Accelerate diffusion of knowledge and reduce variability in access to care
• Strengthen privacy and data protection
• Promote public health and preparedness
• Engage individuals in their health maintenance and wellness efforts

With respect to nursing home care, these general goals can translate into:

• Improvements in reducing pressure ulcers and use of restraints, and improving pain management
• Targeted improvement in quality of care for individual residents
• Heightened satisfaction by residents and their families for care provided in your home
• Increased staff retention and consistent assignment of staff
• Support for MDS/RAPs (minimum data sets and resident assessment process) documentation and triggers for interdisciplinary care planning
• Integrated orders and e-prescribing, full electronic charting, and remote access to improve communications with providers
• Automated services for privacy and security management
• Enhanced coordination of care across the continuum

The goals for HIT are challenging in any setting, nursing homes included. Laying a solid foundation is a critical first step when building anything.

Minnesota Nursing Home HIT Survey

To make progress toward meeting the Minnesota legislative mandate, the Minnesota e-Health Initiative and the Minnesota Department of Health (MDH) set one of the e-health priorities for 2008 to assess the status of various care delivery settings in terms of electronic health record adoption, including assessing barriers and identifying solutions by delivery setting.

MDH contracted with Stratis Health to determine the level of health information technology (HIT) use in Minnesota nursing homes, by surveying all Medicare-certified nursing homes in the state. Of the 380 nursing homes surveyed, nearly 80% responded. Results show that 31.5% of Minnesota nursing homes indicate they currently have a electronic health record (EHR) in place.

Final Report (June 2008, 13-page PDF)

The Minnesota e-Health Initiative is a public-private collaborative with a vision to accelerate the adoption and use of health information technology in order to improve health care quality, increase patient safety, reduce health care costs and improve public health.

For questions about the survey or results, contact Sue Severson at 952-853-8538.

Health Information Technology Toolkit for Nursing Homes

The Health Information Technology Toolkit for Nursing Homes can be used for implementing a comprehensive HIT or EHR system, for acquiring individual applications, or for overhauling existing systems. While an overall organizational strategy is strongly recommended and supported through use of all the tools in the toolkit, each organization should construct its own timeline based on the applications, technology, and operational activities being undertaken.

For the nursing home, a carefully constructed foundation and the right tools to plan and implement HIT can mean the difference between systems that are not well-used or even add administrative burden, and those that achieve value. The purpose of this toolkit for is to supply tools, tested in this environment, that will help you plan and make the right choices, as well as to avoid having to re-invent the wheel.

Much like a carpenter's toolbox, the HIT Toolkit supplies a variety of tools for use at different points in your HIT adoption. Each tool includes:

• Brief statement of purpose - so you will know when to use the tool and what it should help you accomplish.
• Instructions for use of the tool - so you will be guided in effective use of the tool.
• Tool structure - depending on the tool itself, you may find you can customize the tool to help you perform a task or use it as a model to modify for your own needs.

The HIT Toolkit for Nursing Homes consists of seven stages categorized into three main sections. Descriptions of the individual tools are available on the Web pages for each section.

Section 1. Adopt: Assess - Plan - Select
Section 2. Utilize: Implement - Effective Use
Section 3. Exchange: Readiness - Interoperate

This toolkit was funded by Aging Services of Minnesota, Alliance Purchasing, and MHHA Service Corporation for use by nursing homes in Minnesota. Stratis Health developed the toolkit using our extensive experience in helping providers adopt HIT, working with nursing homes on quality improvement and patient safety, and developing toolkits.

Support

Stratis Health has extensive experience in working with health care facilities to help them adopt and utilize EHR systems and to prepare them for exchanging information.

For support using the toolkit, contact:
Stratis Health - Health Information Technology Services
952-854-3306, info@stratishealth.org

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