Center Life Publication
Winter 2008 Issue
Innovative technology has translated into enhanced personalized direct care for residents at Christian Health Care Center (CHCC). With the implementation of electronic medical records (EMRs) this fall, physicians, nurses, dietitians, social workers, and activities staff have been able to improve efficiency in documentation and reduce paperwork, which, to date, has resulted in more time devoted to one-to-one care at Heritage Manor Nursing Home and Southgate behavior-management unit.
“The shift to EMRs has been a tremendous benefit to our residents because the process allows for more time dedicated to direct patient care and improves resident safety because medical information is current, accurate, and easily accessible,” says Jennifer Vitrano, Software Implementation Director at CHCC who spearheaded a multidisciplinary team charged with selecting an appropriate EMR system. “In turn, improved efficiency and accuracy result in cost savings and increased reimbursement. We’ll also realize cost savings by implementing EMRs now rather than when mandated by law in a few years.”
The EMR process, which utilizes a system developed by SigmaCare, provides up-to-date clinical information at the point of care. Currently, the full system is in place at Heritage Manor and Southgate. Components of the system are also in use at Ramapo Ridge Psychiatric Hospital. Eventually, the full system will be utilized in The Longview Assisted Living Residence, Hillcrest Residence, and Christian Health Care Adult Day Services of Wayne and Wyckoff.
“CHCC will be the model for the assisted living module of SigmaCare. We will be a beta site,” Ms. Vitrano says.
The EMR flow begins with resident photo-identification bracelets. Clinical professionals scan the bracelet with a handheld device in order to view the individual’s medical data and to input information about care provided. Certified nursing assistants, for instance, enter details about activities of daily living while nurses log health data and observations. Dietitians record nutritional instructions and notes, and social workers document necessary referrals to other CHCC and community services, appointments with outside physicians and surgeons, etc.
“Physicians use the EMR system on and off campus to chart medical status and prescribe medications directly to ChemRx, CHCC’s pharmacy partner,” Ms. Vitrano says. “Improved medication monitoring and administration is one of the most beneficial aspects of EMRs. Electronic prescriptions improve accuracy because they eliminate errors due to illegible handwriting. Nurses utilize touch-screen computer tablets on medication carts to review a resident’s drug regimen and document administration.”
The SigmaCare software allows clinical staff to perform resident-specific drug-interaction searches, review the resident’s medication history, and access a comprehensive drug reference guide. It also alerts the staff if duplicate medication therapies have been ordered. This results in fewer adverse drug reactions.
EMRs also provide the ability for all clinical professionals to simultaneously view a resident chart or input information. Previously, only one paper version of a resident’s chart existed. If one person was using the chart, no one else could access it for information or to make any documentation,” says Nancy Mericle, RN, Heritage Manor/Southgate Nursing Services Director. “Bulky resident charts created with pen and paper are a thing of the past, as is the tremendous amount of time that was necessary to manually record patient information.”
The elimination of a paper medical record also enhances resident confidentiality and ensures adherence with the Health Insurance Portability and Accountability Act. Only necessary clinical staff are authorized to access EMRs. To further enhance security, each person needs a unique user name and password.
“Staff members can quickly lock handhelds and tablets to prevent non-authorized personnel from viewing information,” Ms. Vitrano says.” Additionally, the equipment doesn’t work outside CHCC buildings. It only works inside and on the CHCC network.”
In the event of a power outage, emergency generators enable the EMR system to function as usual. If the high-speed Internet line off campus goes down, a backup offline component of SigmaCare kicks into gear so most resident information can still be accessible. Some data may need to be documented the “old-fashioned way” while the Internet service is down and entered manually once the connection is back online.
“The bottom line is resident care is never interrupted,” Ms. Vitrano says.
While the EMR system is user-friendly, putting the process in place required weeks of intensive training for 400 employees – nearly half the CHCC staff – who utilize the system. To help underwrite the cost of training, CHCC received a $115,000 grant from the New Jersey Department of Labor and Workforce Development. The Center was the only facility in the state to receive the grant for EMR training.
“Our commitment to EMRs reflects our commitment to those entrusted to our care,” Ms. Mericle says. “The less time the staff devotes to manual data entry, the more time they can spend caring for our residents and interacting with them one-to-one.”
This article was reproduced with permission from the Christian Health Care Center (CHCC) 301 Sicomac Avenue, Wycoff, New Jersey 07481. For more information about CHCC please visit their website.