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The Need for Speed: Tech-Enabling Nursing Homes


Nursing homes are an important part of the U.S. healthcare system, providing care to one of the country’s fastest growing, most vulnerable populations.

But unlike the acute care space, nursing homes have been slow to adopt technologies like electronic health records (EHRs) and clinical surveillance capabilities – technologies that harness the power of data to more accurately identify at-risk patients, prevent infections and control spread, and improve patient outcomes.

The Centers for Medicare & Medicaid Services (CMS) attributes the slow rate of tech adoption in the nursing home environment partly due to the lack of federal funding available to these facilities. Additional barriers to widespread EHR adoption include initial costs, user perceptions and implementation problems.

As a result, many nursing homes rely on old-fashioned, manual, paper-based patient recordkeeping. Those that do have EHRs are largely not using them for clinical surveillance.

Viral transmission in a high-density environment like a nursing home is not just likely, but probable, without technology that enables staff to quickly identify the presence of infection – and stem the spread with strict infection control practices.

Consistent access to electronic data is key to preventing infection and providing quality patient care in the nursing home setting. At no time has this been more evident than during the COVID-19 pandemic.

The virus wreaked havoc on the nursing home population. Research shows that winter 2020 saw the biggest spike in cases in the U.S., a season that coincided with 24 states reporting the highest number of new cases in nursing homes, up from four states each in the fall and summer, and up from six states last spring.

COVID-19 accelerated in nursing homes because the residents are generally vulnerable to its complications and more susceptible in the contained space of the facilities. Now more than ever, providers in the nursing home setting need technology solutions to track infection and help guide appropriate clinical response.

Fortunately, Premier is working with both Congress and the healthcare sector to implement.

We’re advocating to get EHRs and clinical surveillance into more nursing homes.

We need federal support for nursing homes to leverage already existing and easy-to-integrate technologies that are widely in use in the acute care setting – and Premier is stepping up on behalf of providers, caregivers and patients.

In June 2020, Premier urged Congress to designate funds specifically to ensure nursing homes can implement clinical surveillance technology that will provide meaningful assistance with infection control.

We advocated for legislation to incentivize nursing homes that already have EHRs to adopt and integrate clinical surveillance technology. For those facilities that don’t have existing EHRs, we recommended that Congress designate additional resources to implement that foundational technology, and to also adopt and integrate clinical surveillance technology.

In March 2021, we reinvigorated our push for federal funding to get EHRs and clinical surveillance into these facilities by submitting a statement to the Senate Finance Committee hearing on nursing homes.

We once again put a spotlight on the need for surveillance, tracking, documentation and reporting of infections for COVID-19. We reemphasized that these technologies could also be used to better position nursing homes for future outbreaks and other indicators that would result in improved quality of care.

We’re expanding our existing tech capabilities into nursing homes to provide the same level of clinical surveillance as the acute care setting.

Premier already has a large tech footprint in the acute care setting and we’re using that experience to address the needs in nursing homes. Our clinical surveillance capabilities provide a comprehensive, real-time workflow solution for infection preventionists and clinical pharmacists in more than 1,000 facilities today, including nursing home sites.

Our technology can detect, manage, control and alert to improper treatment for infection-related conditions during COVID-19 and beyond by enabling:

  • Automated alerts, including COVID-19-specific alerts, for patients suspected or confirmed for infections.
  • Automated flags on patient records to allow for robust tracking of patients in an outbreak group.
  • Comprehensive documentation forms, including a custom set specific to COVID-19 and routine infections such as Methicillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile (C. diff) and urinary tract infections (UTIs).
  • Electronic submission of infections, including COVID-19, to the Centers for Disease Control and Prevention’s (CDC’s) National Healthcare Safety Network system.

Our clinical surveillance capabilities can also be used to manage the challenges facing the nursing home population, including:

  • Reducing the number of infections.
  • Identifying overuse of antibiotics and drug-bug mismatches.
  • Better tracking of at-risk patients.
  • Reducing time-to-appropriate therapy and enhancing therapy for difficult-to-treat pathogens.
  • Sharing data among sites of care.
  • Decreasing administrative burden on staff.
  • Enabling robust data analysis that improves overall quality care of patients.

Premier is driving hard to fast-track change and get much-needed technology into nursing homes sooner rather than later.

Since the onset of COVID-19, infection prevention has never been more important in the nursing home setting. Regulations have been issued that require routine screening and CMS requires reporting of COVID-19 cases to the CDC.

For most nursing home facilities, there’s no centralized or dedicated infection prevention team. That, coupled with the new reporting requirements, escalates the need for EHR and clinical surveillance technology to provide the data that’s needed to help prevent and control infection in these vulnerable populations.

For a more in-depth look at why technology implementations are critical to controlling infections and improving care quality in nursing homes – and the steps Premier is taking to make it happen – download our white paper, Solving the Actionable Data Challenge in Long-Term Care Infection Prevention.

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