Catch 22

1
Catch 22

• Information Technology in the Long Term Care
  Industry
• Lisa Bembenick
• Jeff Gallagher
• AnnE Rice

2
the long term care industry has entered the
computer age grudgingly--that is, slowly and with
great difficulty. Healthcare Informatics
Bankruptcies among the skilled nursing providers
reached an alarming level today as post acute
provider IHS filed for Chapter 11 protection,
bringing the total number of bankruptcies across
the U.S. to 1,651 nursing facilities.
American Health Care Association
3
The Problem

• Unsophisticated data collection tools
• Lack of decision support
• Lack of cost analysis tools
• Inability to conduct electronic transactions
• Linking of clinical data with financial and
  statistical data, and
• Capturing unique clinical data--Minimum Data Set
  (MDS), outcomes, and clinical care plans

4
The Problem, cont.

• Industry history of minimizing IT investment
• 1 of LTC operating budgets on IS
• Major healthcare vendors have stayed out of LTC
• LTC vendors have historically been under
  capitalized
• no frills software

5
Driving Forces of Change

• Government
• Medicare PPS
• Complete MDS to determine RUGs
• HIPAA
• Standards to facilitate electronic data gathering
  and e-commerce

6
Driving Forces of Change, cont.

• Managed Care Payers
• Low penetration of LTC market (1)
• LTC facilities need to provide cost data
• Utilization and outcome data
• Case management

7
Driving Forces of Change, cont.

• Clinical Care Givers
• Comprehensive care plans to include
• Interdisciplinary admission assessments
• data analysis to formulate resident-specific
  problems and measurable outcomes
• individualized interventions based on clinical
  protocols
• evaluation of outcomes and revisions to care plans

8
Industry Needs

• MDS
• PPS billing requirements
• Automated care plans
• Case-mix management
• Quality management
• Integration of financial and clinical data

9
Vendor Solution

• CARE Computer Systems
• strategic alliance with SMS
• VistaCARE product
• Clinical Application
• Financial Application

10
Vendor Solution, cont.

• Strategic alliance is a positive sign
• Meets minimum industry requirements
• MDS, Care Plans, PPS billing, etc
• Lack of integration between clinical and
  financial modules
• Additional development needed for Managed Care
• For example Contract/Credentialing