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Erickson Health Takes Long View with Technology
April 2007
Many long-term care providers are mom-and-pop organizations that operate a single facility on a shoestring budget. But even the largest chains still have made little use of automation. Most of these organizations, both large and small, have neither the time nor money to embark on automation efforts, even though their elderly patient populations need frequent, complex care, and the government requires reams of forms to be filled out on a regular basis for regulatory and reimbursement purposes.
Baltimore-based Erickson Health knew it would have to write a new chapter in long-term care automation when it embarked on an enterprisewide implementation of various electronic records systems for its skilled nursing, assisted living, physical therapy and home health facilities.
The linchpin to all these efforts is the automation of nursing documentation for all the various services Erickson Health offers, says Mark Erickson, COO and son of John Erickson, founder of the organization.
"Coordination of care is obviously much more complex for seniors because they have to see a number of different caregivers who are ordering treatments and medications for one problem but not addressing that patient's overall well-being," he says. "We needed to create a 'quarterback' that provides information on every aspect of that patient-their physical and cognitive condition, diet, activity level and so forth. And to automate to that degree you must have nurses involved in every step in the process."
The efforts by nurses at Erickson Health have earned the organization Health Data Management's 2nd Annual Nursing Information Technology Innovation Award.
The award recognizes innovation and excellence in using information technology in the field of nursing to directly improve the quality of care/patient safety and/or promote the effective use of nursing resources. More than 50 organizations submitted entries for this year's contest (see related story below).
Getting the house in order
Before Erickson Health went live with the nursing home EMR-the term it uses for the nursing documentation system-it had to set the stage for automation by standardizing nearly 60 forms used for documenting interactions with patients, says Beth Ann Muthig, R.N., senior director of clinical informatics, who was a project manager for the effort.
Erickson Health's 18 continuing care communities are campuses that provide a wide range of services for as many as 3,000 residents, some who live independently and others who live in assisted living facilities. The EMR project initially focused on seven of these locations.
In addition, residents often move between care settings. Some independent residents may have to be admitted to skilled nursing units, while others may have to be sent to area hospitals for acute care services.
The forms standardization effort involved communities in four states-Maryland, Michigan, New Jersey and Massachusetts. This first step was crucial to the project not only in terms of I.T., but in terms of staff buy-in, Muthig says. "Every community had its own forms for initial assessments and other common documentation, and while they looked alike they were different in what types of information was being collected and how it was being transcribed," Muthig says. "That was a challenge, but it also was a challenge because we had to tell nurses that how they did their jobs was going to change."
To manage that change, Muthig and her project team marketed the automation initiative by arriving at each community with "Coming to a Community Near You!" buttons as well as candy and food for pre-implementation parties. The initiative was dubbed POC3, meaning "doing the plan of care at the point of care brings the power of change," Muthig says.
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