A study released by the Government Accountability Office (GAO) last month highlights key improvement areas for Medicaid, which is overseen by the Centers for Medicare & Medicaid Services (CMS). One of its three primary findings is something that anyone in long-term care should pay attention to: care providers need better data.
Essentially, the GAO report notes that CMS doesn’t have complete, accurate, and timely data, and as a result it can’t ensure that federal and state dollars are being spent well.
One of the biggest benefits many assisted living and memory care communities see when they adopt an EHR system is financial savings from better data. In this post, we’ll explore what “better data” looks like with an electronic health record system and how that improved data can translate to financial savings.
What Better Data Looks Like in EHR Systems
The GAO highlighted three ways its current data is falling short: in completeness, accuracy, and timeliness. An EHR system can address all three:
- Completeness: When data isn’t digitized, it’s much harder to process and store. That means that you may end up with more data from days when things are less hectic and less data from busy days. This has the potential to be dangerous because incomplete data can paint false pictures: you might see an uptick in resident falls, for example, and attempt to figure out what caused them, when really, the “uptick” is just a result of a period of more thorough reporting. You’re not seeing a surge in incidents, but rather a surge in data recording. When you implement an EHR system, it’s easier to capture complete data because the process of capturing that data is simpler. ADLs are recorded digitally and therefore entered into the system in a single step, meaning CNAs don’t have to do double entry or transfer information from paper to a computer terminal.
- Accuracy: Inaccuracies can enter data many ways: if ADLs aren’t immediately recorded, for example, and a CNA tries to remember them later; if a CNA can’t read her own handwriting when transferring paper notes to a computer; if she mistypes in transferring data. Working from inaccurate data can lead to outcomes ranging from inconvenient to downright dangerous, especially when medication dosages are involved. Again, an EHR system can eliminate much inaccuracy by eliminating the need for data transfer. When an EHR is combined with mobile tablets for recording data, so CNAs can enter information in real time, accuracy increases further.
- Timeliness: The GAO notes that when it conducted the study in 2017, the most recent data from some states dated from 2012. Obviously, that kind of lag is useless if you’re trying to make decisions that will affect your community this month or this quarter. While most assisted living communities aren’t dealing with a five-year information gap, they may struggle to translate information gathered into actionable insights that can guide policies within the community. An electronic health record system can process data and produce visual representations of it (in charts and graphs) automatically. This means you can interpret data you gather in real time and react to trends as they happen rather than getting only a rearview understanding of your community.
So briefly: an EHR system can help you collect more complete and accurate data as well as help you interpret that data more quickly. The result for your community is that you can make financial decisions faster and have greater confidence that these decisions will yield improved outcomes for your residents, staff, and other stakeholders.
Using Better Data to Improve Financial Outcomes in Assisted Living & Memory Care
The improved data collection and processing that comes with adopting an EHR system can lead to better outcomes both within a single assisted living community and among multi-campus organizations.
In a single-community setting, data inputted into and processed by an EHR can quickly illustrate what’s happening for individual patients.
For example, if Mr. Jones has gradually, over the course of the year, requested more and more assistance with dressing and showering, a glance at a chart of his requests reveals it. This allows the nursing director to schedule an assessment for Mr. Jones to determine whether he needs to be scheduled (and charged) for additional care. If he is, the community benefits in both the short and long term: nursing directors can ensure (and fund) adequate staffing, which means the staff on duty avoids overwork and burnout. Mr. Jones is receiving the care he requires, which means he’s less likely to experience an incident that requires medical attention or hospitalization.
EHR data can also identify trends throughout a community and among campuses for multiple-location communities.
Imagine, for example, that your EHR shows that, within a community and across campuses, patients’ blood pressure collectively dips on certain days. After a little digging, you see that these dips happen after the group singing class you introduced, among attendees of those classes. With evidence like that, you can easily make the case to fund more similar programming or a campaign to encourage more residents to attend.
Maybe more importantly, you can make the decision to expand programming easily and confidently because you know that the findings were based on…
- Complete data, rather than data points entered at random (or worse: data points entered only by your most conscientious staff, which could have its own biases).
- Accurate data, entered into the system as it was gathered.
- Accurate and valid comparisons, because all data you looked at was in the same format, thanks to the uniformity enforced by the EHR system.
One final benefit of electronic patient records to keep in mind as you consider your EHR options: most of the time, the changes you make based on EHR data will be small. After all, if there were a big, sweeping savings move you could make, you’d probably already have made it by now.
In most assisted living and memory care communities, the most persistent revenue drains are not gaping holes but rather tiny leaks: residents receiving care they’re not scheduled for, extra hours staff consistently spend on administrative tasks. Fixing any one of these problems won’t dramatically affect your community’s bottom line, but the power of the EHR is that it lets you see – as they happen – many areas where small tweaks could lead to modest improvements.
Collectively and over time, the result is a more efficient community whose residents are receiving better care from staff members with a reasonable workload. The ripple effects continue outward from there.
Interested in hearing how your community can make more data-driven decisions? Get in touch!