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COMPUTER

BY DAVID OATWAY. RN

Revising strategic planning for IT support

The Healthcare Information and Management SystemsSociety (HIMSS) annual conference this winter gave aglimpse of what the future of healthcare automation can be. With more than 23,000 attendees and over 700 vendors, this annual conference showcased the latest and greatest hardware and applications that support healthcare. More than 20 vendors offered long-term care systems or support in the well-attended exhibit area. Moreover, the LongTerm and Post AcuteCare Special Interest Group provided a forum within HIMSS for technical and management discussions of long-term cares relevant technology.

In fact, many ofthe educational sessions and technologies pre- sented at the conference can be applied to long-term care as the field embraces (or is forced into) electronic medical records, point-of-care data entry and access, and just keeping up with rapidly evolving clinical and regulatory demands. Increasing information systems support to all of healthcare seems to be the expected solution to solving everything from medical errors to Medicare fraud, and to relieving the nursing shortage as well. The danger to facilities is tbat knowing the latest technology or buzzword can lead them to make demands tbat cannot be met with current systems—but someone will try to sell it to tbem anyway.

How can tbe long-term care administrator and clinician make sure they are getting the appropriate support from their infor- mation technology (IT) investments? Knowing the latest and greatest technology is only part ofthe solution. A strategic plan tbat coordinates a facility's needs witb tbe availability of systems is essential. A part of tbe strategic plan sbould be a method to

harvest tbe benefits tbe investment promises. In reality, tbe IT strategic plan should be a part ofthe overall facility strategic plan, since the benefits of IT are achieved only through making other operations more efficient.

However, few facilities are getting all of the possible benefits of tbe computer support they bave now. All nursing facilities must bave some level of computer support today, if only to transmit MDS reports and review the statistics the state has calculated for tbe facility. But so much more is possible, and shortly computersupportwill be necessary for botb regulatory compliance and billing.

Facilities need to start planning now for optimum IT support and to maximize the benefits from tbeir current and planned sys- tems. In sbort, administrators must become informed consumers oi IT—Hkeitor not. At the same time, most long-term care facilities

aretotallydependenton their third-party vendors to supply their IT needs. Even so, the facility is responsible for maintaining operations and compliance. (Just check the State Operations Manual)

Vendor Partnerships Vendors like to market tbeir services as a partnership witb facilities. It is an appropriate relationsbip if the partnership is equal. No doubt you are keepmg up with your support payments to your vendor, but wbat is your assurance that tbe vendor is keeping you in compliance and making your facility as efficient as possible by using tbe best tecbnoiogy? You can plan for your facility only if you know tbe plans ofthe businesses on wbich you rely for support.

Your IT vendor is mission critical to tbe success of your opera- tions. The strategic planning you do for your facility depends on tbe services and products delivered by your vendor. You must know your vendor's plans for introducing new capabilities, its commit- ment to regulatory compliance, its ability to evolve its system witb the environment, and the timetable for doing so.

Open a dialogue with your vendor. Periodically (at least once a year) review your current system with your vendor to see if you can improve its contribution to operations. Reviewing tbe vendor's commitment to keeping your facility in compliance with current and future regulations is essential.

A good time for this review is before the annual maintenance contract is up for renewal—since you have more leverage when money is on the table. It you are unhappy with any aspect ofthe vendor's plans, performance, or service, this is the time to discuss it

52 • MAY 2005 WWW.NURSINGHOMESMAGAZINE.COM

inperspective C O M P U T E R T E C H N O L O G Y

Information Resources • Oatway D. Electronic records in long-term care. Nursing Homes/

Long Term Care Management 2004;9:84-9.

• CMS's monthiy communication channei with facilities.

www.cms.hhs.gov/opendoor

• The official source of CMS manuals, including the State Operations

Manual, www.cms.hhs.gov/nianuals

• CMS's provider education site, www.cms.hhs.gov/medlearn/

matters

Healthcare Information and Management

Systems Society (HIMSS) providing a forum for facilities,

clinicians, researchers, and vendors to improve management of

healthcare automation at www.himss.org.

American Health Information Management Association (AHIMA) helping manage heaith information atwww.ahima.org.

Agency for Healthcare Research and Quality (AHRQ) supporting research in clinical and information technology to benefit citizens

and patients at www.ahrq.gov.

and get assurances that these issues will be resolved. If the vendor's response is inadequate, it may be time to start searching for a new system. However, pay the maintenance contract then, since it takes at least a year to find and implement a new system!

Planning Is Essential Since all nursing facilities already have at least some computer support, planning begins with your current system as the starting point.

Any change has costs associated with it—and changing vendors has major costs and shouid be carefully considered. Uyour vendor

Giving You tiie Time to

OFFERING 3-DAY MDS CREDENTIALING WORKSHOPS

NATIONWIDE! Do the Medicare Math:

1 ADL Coding Error = $46.65/day x 45 assessments per month X 30 days = $62,978/month

COURSES iNCLUDE: SEVEN CORE ( R E Q U I R E D ) COURSES

OBRA Timing and Scheduling for ihe MDS 2 0 Resident Assessment Protocols (RAP'S) and the MDS 2.0 Care PUnning and the MDS 2.0 PPS Timing and Scheduling fOT the MDS 2.0

• Resource Utilization Groups 111 (RUG'S) and tbe MDS 2.0

• Billing and the MDS 2.0 k MDS 2.0 Coding for OBRA and PFS

THREE ELECTIVE COURSES • Q u a l i t y I n d i c a t o r s a n d t h e M D S 2,0 » Q u a l i t y M e a s u r e s a n d t h e M D S 2.0 * A c c u r a t e l y A s s e s s i n g A c t i v i t i e s of

D a i l y L i v i n g a n d t h e M D S 2.0

VISIT: www.aanac.org CALL: 1-800-768-1880

cannot assure you that it will continally evolve, though, it may he better to absorh the cost of change at a time of your choosing instead of becoming out of compliance or left without support. Many vendors have been acquired by others in tecent years, with varying effects on their clients. In our experience, the most likely candidates for corporate acquisition are those vendors who can- not evolve their systems because they lack resources or who have overextended themselves with promises they can't keep. While you undoubtedly checked your vendor's financiais as part of due diligence before you bought its offering, have you periodically checked their status since then? Is the system evolving as you need it to? Are the potential opportunities and benefits from alternative systems worth the cost of conversion? The answers depend on your strategic plan and bow well your curtent vendor supports that plan.

Tbe budget is an essential part of any plan. As long-term care IT evolves, it will require a larger portion of the operating budget to stay current. Budgeting just to replace obsolete computers (any over three years old) is jusc part of what is needed. Meeting the requirements for privacy, security, eventual electronic medtcal records, electronic claims, revisions to tbe MDS, and opportuni- ties for better clinical systems must be considered. New hardware, software, training, and process improvement are all necessaty. The payoff is better care and greater efficiency in delivering it.

In a future column, I will discuss some ofthe newer IT options on tbe tnarketand tbeir potential relevance to long-term care, and the gradually evolving push toward the electronic medical record. •

Dave Oatway, RN, a long-term care IT consultant based in Key West, Florida, was the Department of Defense Project Officer for the initial clinical require- ments phase of the Composite Health Care System (CHCS-I). He worked with HCFA/CMS on the Prospective Payment System for SNFs and contributed to the development of MOS 2.0. He developed one of the first clinical/MDS systems (CHAMP). He is the chair of the Healthcare Information and Management Systems Society (HIMSS) Long Term Care and Post Acute Special Interest Group and a member of the American Health Information Management As- sociation (AHIMA) and the Health Level Seven (HL7) organization. He was the vice-chair for the American Association of Nurse Assessment Coordinators. A sample IT spreadsheet and strategic plan form are available. To request this information or to send your comments to the author and editors, e-mail [email protected]. To order reprints in quantities of 100 or more. cail(866) 377-6454.

NOTE; We views expressed in this article are the author's and do not necessarily represent the officiai views of any organization.

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