While electronic health records (EHRs) might appear financially feasible for larger senior living providers, the paperless record-keeping technology looks to play a bigger role as healthcare reforms change the landscape of senior care for providers big and small.
Despite relatively low adoption rates, those who have flipped the switch say EHRs are well worth it, especially as the technology helps to streamline operations, limit paper usage and significantly reduce labor hours for community staffs.
Preliminary data show that 79% of the largest LeadingAge members have an EHR system in place, according to results from LeadingAge and Ziegler’s jointly commissioned LZ 100 survey. While this might appear a staggering majority, there are several things to consider, says Majd Alwan, senior vice president of technology with LeadingAge.
First, says Alwan, is that this nearly 80% only represents about a 56% response rate of the largest 100 LeadingAge members to whom the survey was fielded. Second, the providers featured in LZ 100 represent larger, multi-site organizations that often have multiple business lines (e.g. skilled nursing, home health, etc.), though their “Yes” responses may not apply to all of their sites or business lines.
This isn’t to say that smaller providers aren’t interested, but it’s generally more affordable for larger ones.
“Larger organizations usually have more resources to spend,” says Alwan. Investing in EHRs, he adds, depends on a number of factors, such as a provider’s current business line or the type of EHR model they wish to adopt.
Of 81 senior living organizations that responded to a Ziegler-LeadingAge Technology Spending Survey last year, 46.3% invested in electronic medical records (EMR) in the past 12 months preceding the September 2012 survey. Looking forward, 70.1% said they plan to increase their investment in EMRs over the next 12 months.
Providers interested in rolling out an EHR system throughout their communities have to consider several options available to them, each with varying costs depending on the type of system rollout.
Under a Software as a Service (SaaS), where a provider contracts directly with an EHR/EMR vendor typically for an annual service charge, implementing the technology could cost up to $259,394 for a 25-bed facility over the course of five years, according to data from the Chief Information Officer Consortium (CIOC).
For a third-party hosted solution, the cost of implementing EHR/EMR technology could cost the same facility $254,279 over five years. An in-house solution, where providers purchase the EHR/EMR software then host their own data center using proprietary purchased equipment, is the costliest method, at an estimated $355,616 during a five-year period.
Throughout a five-year period, these costs would represent, on average, 0.50% of annual revenue for these facilities using the SaaS option; 0.49% of annual revenue for those using a hosted option and 0.68% of annual revenue for providers who opt for the in-house EHR/EMR solution.
“We believe that leading-edge long-term care providers must pioneer EMR adoption, and that those who lead the way will set the standard for the industry,” writes the CIO Consortium. “We further believe that EMR adoption leads to improved resident outcomes and will realize a return on investment.”
Last month, LeadingAge updated its EHR selection matrix for providers interested in adopting the electronic record-keeping technology, and has already seen its membership asking more about health information exchange, interoperability and clinical decision system capabilities.
Christian Health Care Center (CHCC), a LeadingAge member located in New Jersey with services ranging from independent living, assisted living, and skilled nursing to adult day service, has seen significant results after implementing EHR in 2008.
Through its adoption of SigmaCare’s complete EHR system, CCHC has increased its Medicare Part A rates by 11% without adding staff, cut staff hours 2% by reducing paper-based tasks and decreased nursing hours by about 80 hours per month.
After an initial three month rollout of the EHR technology, CCHC saw an immediate return on investment from its end of the month recap standpoint, according to Jennifer D’Angelo, vice president of information services and information security officer with CCHC.
While price is a big factor when it comes to adopting an EHR system, D’Angelo believes the costs are worth the investment, especially given current health care reforms.
“Things are changing from a reimbursement standpoint,” says D’Angelo. “Electronic health records can help position oneself with Accountable Care Organizations by being able to show your stats and having data streamlined.”
This can be especially important when providing re-hospitalization statistics, she adds.
“Providers won’t be able to stay current with reimbursements if they are not current with technology,” she says. “EHRs are absolutely the way to go, and sooner rather than later.”
