Changing Medicare requirements for risk-based programs are putting new pressure on seniors housing operators and skilled nursing facilities that provide post-acute care (PAC) to people recently released from hospitals. Standards for the quality of care are becoming stricter just as innovations in record keeping, data analysis, voice recognition technology and smart room sensors are maturing.
These new technologies — including many powered by artificial intelligence (AI) — combined with electronic health records (EHRs) can help operators adapt to the enormous changes coming to the seniors housing business.
“We really put artificial intelligence at the center of the experience within the EHR,” says Lee Kilmer, vice president of product management for MatrixCare, which provides software solutions for healthcare outside of hospitals.
Change Is Coming to PAC
Seniors housing operators that provide PAC are already challenged by a labor shortage. Talented caregivers are more expensive to hire and more difficult to keep.
At the same time, payers, such as private insurers offering Medicare Advantage plans, expect seniors housing operators and skilled nursing facilities to quickly transition to risk-based programs — programs that reimburse healthcare providers based on the outcomes for patients. High-quality, low-cost care is incentivized. Coordinated, preventative approaches are rewarded.
A risk-based program is one in which a healthcare provider, such as a seniors housing facility, agrees with a payer, such as a Medicare Advantage program, to share in the responsibility for the total cost and quality of care delivered to beneficiaries. These relationships incentivize facilities to provide high-quality care and produce high-quality outcomes supporting lower patient total cost of care. For example, if a patient suffers a fall with injury or a preventable infection and must return to the hospital, the total cost of care for that patient would go up. If these events are not well managed at a population level, the healthcare provider could be at risk for downside risk impact, lower quality ratings and losing network partnerships and referrals.
AI Helps Caregivers Provide Better Care
AI systems are especially good at finding patterns and correlations in huge sets of data, and the world of seniors housing generates a large amount of usable data. Seniors housing operators can use AI technology to identify opportunities for proactive, prioritized, more-effective care that achieve the positive outcomes rewarded by risk-based programs.
“Our customers look to technology such as AI to help sift through the mountains of data in their EHRs,” says Kilmer. “AI can offer insights on the risk of somebody going back to the hospital or having a decline. The technology can also help provide more proactive and preventative care.”
The Centers for Medicare & Medicaid Services expects all Medicare beneficiaries to be in risk-based programs by 2030. “That’s a huge shift,” says Kilmer. “It requires providers to really think through how they leverage technology to help manage risk and improve quality of care.”
Other new technologies bring even more information into EHRs — helping seniors housing operators achieve better outcomes. For example, wireless sensors in a bed can detect whether a resident’s movement has decreased and combine that with EHR data allowing the EHR to surface relevant, comprehensive insights for the clinicians to act upon.
AI systems can, for example, identify that lack of movement as a sign that the senior could develop a pressure ulcer and alert staff or signal changes in patterns that might indicate early onset of a health-related complication.
Ambient technologies such as smart room sensors can monitor for both falls and factors that indicate a fall risk. AI systems connected to the EHR can sift through this data to both identify seniors who are at higher risk of falls and recommend possible ways to lessen that risk.
Built-in protections ensure that the data collected and the alerts generated comply with security and privacy laws. Some examples of the measures that help ensure residents’ dignity include cameras that only turn on when a fall is detected or systems that help de-identify data.
Technology Trends That Streamline and Save Time
Because many seniors housing properties also struggle to find enough staff to care for their residents, mobile technologies can help make better use of EHRs. Employees can access records on smartphones or tablets while they care for patients.
“Staffing shortages and staffing mandates are forcing providers at all levels of acuity to think through how they optimize their staff’s time,” says Kilmer. “We’re focusing on technology that puts everything that the caregiver needs into their hand with a mobile device. This means they’re not unnecessarily walking back to a nurse’s station or going out of a room to a wall kiosk.”
When using conventional technologies like wall kiosks or desktop computers to access EHRs, caregivers typically spend 35 percent of their time documenting the care patients receive in ERHs, explains Kilmer. They spend another 15 percent of their time just accessing patient information.
MatrixCare’s proprietary software can operate on both Android and Apple devices. Staff members can even use their own internet-enabled devices to access EHRs, by downloading the MatrixCare app. The data is encrypted by the MatrixCare app to protect the privacy of patients and comply with the Health Insurance Portability and Accountability Act (HIPAA) of 1996.
“The caregivers and the family members of residents are often Millennials and Generation Z,” says Kilmer. “There’s definitely an affinity for using mobile technology in their personal and professional lives — and now this data on residents is available at their fingertips.”
New Frontiers for EHRs
While technology can never replace caregivers, it can assist with manual tasks that take time away from providing direct care to residents. For instance, voice technologies can be used to capture clinical documentation, saving time for nursing staff by not requiring them to enter data into EHR systems.
“Taking care of people tends to be a two-handed job,” says Kilmer. Voice recognition could let nurses use their hands to care for a patient without constantly interrupting that care to update the patient’s EHR.
Secure, internet-enabled devices can also be used to send photos to update a patient’s record and help document conditions — using encryption to protect images and comply with rules protecting patient privacy and confidentiality. Artificial intelligence systems can also analyze all these potential additions to the EHR — from photos to voice recordings to smart room sensors — to identify opportunities to provide better care and promote better outcomes for seniors.
“When you consider mobile devices, voice technology and sensors that can be placed in residents’ rooms, it all comes together as a kind of smart ecosystem. This assists the residents from multiple vantage points. Ultimately, it drives better care outcomes, higher quality care for the organization and better data security. This approach means better engagement and better experiences for the caregivers too.”
— By Bendix Anderson. This sponsored content was written in conjunction with MatrixCare, a content partner of Seniors Housing Business.
Learn more about MatrixCare technology and the impact it can have for your clinical team.