Nursing homes battle to keep technology advanced

By Waverly Colville, Lily Cusack, Gabe Dubois, Yutao Chen

Hospitals and other Medicare-funded facilities are transitioning from paper to digital records with help from government incentives. But for nursing homes, modernizing isn’t as easy.

Elizabeth Palena Hall is the long-term and post-acute care coordinator at the Office of the National Coordinator for Health Information. She said nursing homes are not eligible for government incentives under the Health Information Technology for Economic and Clinical Health Act. However, many still feel like they are obligated to make the investment.

“With multiple medications and many different types of clinicians, there’s a huge need to coordinate care around many of the people in these environments,” Hall said. “That is driving the need to have tools and help communicate and provide better quality of care.”

The Health Information Technology for Economic and Clinical Health Act currently invests in the adoption of health information technology. The new technology includes computerized records, referred to as electronic health records and electronic medical records.

For hospitals, it’s easier to make the transition from paper to electronic records because of more funding. The act spent $19 billion on incentives in 2009. Two billion of those dollars was designated to help hospitals implement the technology. Medicare and Medicaid provided the other $17 billion to those who switched to electronic records before 2015.

Long-term health care providers, such as nursing homes, do not qualify for the government incentives. In order to go digital, the facilities must provide their own funds.

Switching to electronic medical records can cost an estimated $162,000 upfront, according to the U.S. Agency for Healthcare Research and Quality. After installation, they estimate $85,500 in maintenance expenses in the first year alone. For smaller facilities, that can be a significant hit to their budget.

Sheila Rich is a nurse at Adams Street Place, a nursing home in Jefferson City. They made the investment in electronic records a few years ago. Rich said these records have made coordinating with other health professionals more efficient.

“It's better access for everyone,” Rich said. “You may have multiple people that need a chart at the same time, and with a paper chart, it's just not possible for everyone to get their job done. When [the doctor is] here, I can still be doing my job in my office in that same chart, and he can be doing what he needs to be doing or the nurses can be doing what they need to be doing. It's a lot handier that way.”

Despite the benefits, facilities are waiting as long as they can to make the investment, Rich said. This financial burden is putting them behind the curve.

“Not having a health IT system puts them at a disadvantage to be able to receive information from their referral partners, to be able to calculate quality measurement, to be able to coordinate care internally [and] to better manage admission information,” Hall said.

La Plata Nursing Home in La Plata is one of the nursing homes struggling to pay for this new technology. They considered different software programs for several years before deciding that better communication with fellow health care providers was worth the heavy price.

“It is expensive, but we are switching,” administrator Heather Witt said. “We have to do it.”

Nursing homes legally have the option to continue using paper. Realistically, they believe they have to make the change to stay efficient. Hall said the change is necessary.

“This is a key infrastructure for these providers to be able to better coordinate care and that is needed to be able to reach some of the goals for what we envision to be care in the future,” Hall said.