PHOENIX — It remains difficult to quantify how well investments in technology are paying off, but some skilled nursing providers say they're buying more options because they can't afford to miss out on opportunities at current profit margins.
Executives at some of the largest technology companies in post-acute care and three health care providers said they are adopting a range of technologies to prepare for the changing norms, from virtual reality treatments to advanced electronic medical record systems and staffing calculation tools.
“Ultimately, the theme in health care is shifting from fee-for-service to pay-for-performance,” Chris Airmiguel, chief financial officer of Creative Solutions in Healthcare, the largest single provider in Texas, said at last week's eCap West summit. “That's the direction we're heading, so it's really important that we invest in technology solutions that enable better clinical outcomes.”
Whether it's partnering with providers on remote patient monitoring to reduce readmissions or creating proprietary metrics to capture broader staffing information, Creative has stepped up its efforts with technology tools over the past decade.
AirMiguel’s work improving data collection at Creative led to the founding of a sister company, DataIQ, which serves about 1,200 venues across the U.S. Other operators often ask him about the return on investment.
This is the perspective that Air Miguel would like his peers in the field to shift towards.
“The reality is, every business is different. They have different ideas about what's important to them, what works for them and what doesn't,” he said. [question] The question is, “What opportunities are we missing by not investing in technology?”
Back Office Capabilities
Eamiguel was inspired to create back-office solutions because he was personally responsible for creating daily reports, including holidays.
Working from income statements produced on a 45-day cycle, or statements that contained too high-level figures to offer much insight, wasn't helping company leaders influence managers to make meaningful changes. AirMiguel's goal became to produce statistics that explained what was happening and asked why.
One area that needs looking into is overtime pay and meal break allowances, he said, and the team has created performance metrics to track and manage those numbers at the building level.
“Ultimately, it will save us about $3 million, which could equate to about $10 million at the current scale of our operations,” he said.
Clinical Concern
“We're lagging behind in post-acute care,” said Sue Coppola, RN, clinical adviser to Sabra Healthcare REIT, citing a commonly heard refrain in the industry.
But it's not just a lack of government funding that's slowing innovation: Some investors still don't understand how automation can improve performance.
“How many people are still measuring vital signs with a blood pressure cuff? How many are using Dinamap, which is automated but doesn't connect to an EHR,” Coppola asked. “These are just simple things that impact the accuracy of vital signs and team members' time, two important factors.”
She said she was asked similar questions about return on investment when she tried to convince the board to make a $2 million EHR investment.
“I said, 'You've made the financial investments, you have the business intelligence that tells you your financials, but I have nothing. I run 376 buildings across 38 states and I can't see anything.' I said, 'I need data. I need systems. I need processes.' If we want to get better operational outcomes, we need to start looking at clinical and the intersection of clinical, quality and operations.”
The argument was persuasive: Two years after her request was upheld, she was able to show a “huge” ROI in the areas of quality and staffing. She believes the implementation of the right technology is essential in this area, and encourages Sabra to help operators move forward.
Sabra has partnered with Ignite Medical Resorts to invest in pilot development of in-room monitoring to reduce falls from 28% to 8%. Ignite CEO Tim Fields moderated the panel.
Fields and his colleagues also explained that the company is using virtual reality programming, where patients are rehabilitated with the help of a headset and therapists can monitor the patient's experience and outcomes on an iPad. Chief Therapy Officer Matt Tengill said this programming is a great option for patients who prefer or need to receive treatment in the isolation of their own rooms.
Regardless of the use case, Coppola argues that a key element to achieving results through any technology initiative is to engage staff input and ensure any solution can be integrated into their workflow on a daily, monthly and quarterly basis.
“The challenge that's happening now is, are we engaging our team members? It's not that the technology isn't working or that it won't work without some tweaks. It's about engaging our team members,” she said. “Technology is the solution. [Staff] Some people may be very against AI. But if you take a nurse and [certified nursing assistant] And if you tell your team members what they get in return, they will follow.”
Security Practices
Meanwhile, EHR giant PointClickCare has made security and insights a top priority, CFO James Yersh said.
“AI is the hottest buzzword right now,” he said. “Our responsibilities are many, but we're particularly focused on AI. Number one, making sure our customers' data is safe and how we use it with AI is in line with any regulations we have to comply with. The world is evolving, and the rules will continue to change.”
He is excited about predictive AI that can “surface insights” to staff rather than leaving them reactively depending on the situation, which can help with staffing shortages and also improve patient outcomes.
“Leveraging all this data and flagging people up is definitely what's going to drive our success,” he said. “There's just not enough time in the day. [manually] They comb through files and non-electronic records to find out what happens overnight.”
Being able to see, react and share results will be even more important in an increasingly value-based environment, Air-Miguel added, where data is needed to win referrals, contracts with accountable care organizations and higher-paying contracts.
“Without a foothold in data points, metrics and quality, you're going to get trapped in contract negotiations,” he said. “You have a unique opportunity to cherry-pick and focus on what you do well, rather than having the other side just lecture you at length about what you need to improve.”
This story was originally McKnight's Long-Term Care News, of McKnight A brand focused on skilled nursing.
of McKnight's Tech Daily teeth, McKnight Long Term Care News, McKnight Senior Living and McKnight Home Care.
