Nursing Care Facility\'s Information Technology (IT) Improvements

Improving Health Care Delivery by Integrating Information Technology

In order to modernize the operations of their medical facility, Pleasant Manor nursing home should consider contracting to implement the Epic System of electronic medical record (EMR) and practice management throughout their campus. A pioneer in the march towards digitization of health care records, "Epic makes software for mid-size and large medical groups, hospitals and integrated healthcare organizations" using proprietary software that efficiently "spans clinical, access and revenue functions and extends into the home" (Epic, 2012). In accordance with Pleasant Manor's stated mission to serve as an "expanded geriatric clinic that provides basic services for seniors, general practice, counseling and education programs, radiology, complete blood work, and an osteo-care unit for citizens of the outlying communities," the facility will make this transition with the goal of standardizing its procedures and streamlining its processes. Located on an expansive campus in the retirement community of Vero Beach, Florida, Pleasant Manor is widely recognized as a regional leader in the nursing care industry, offering an impressive 1:3 caregiver-to-resident ratio, monthly in-house physician visits and regular podiatrist, optometrist, and psychologist visits to consistently deliver high quality nursing care services to the local community.

Today, Pleasant Manor has become a recognized leader in the "Skilled Nursing and Sub-Acute Rehab industry & #8230; (because) there are 44 nursing homes in Vero Beach but only four, other than Pleasant Manor, that can offer skilled nursing along with sub-acute rehab." The current restructuring of federal health insurance law means that the number of patients who now carry preventative care coverage has increased. Because Vero Beach lacks a full-fledged Community Care facility designed to the serve the area's burgeoning geriatric population, the majority health care needs are met by small 24-hour emergency clinics, private medical practices, and nursing home facilities like Pleasant Manor. The institutional objective set forth by Pleasant Manor is to provide superior in-patient and out-patient care in such a way that usage of integral facilities is encouraged to generate sufficient profit margins to maintain the facility's future viability. By adopting the EPIC system of electronic record keeping (EMR), Pleasant Manor can ensure that its continual process of modernization is conducted in such a way that patient acuity rates are preserved, while profit margins are maintained and even increased.

The first priority of Epic Systems during the implementation phase of their electronic medical recordkeeping structure is applying the methodology of their Model System to the health care center undergoing the transition, "which provides a starting point for validating pre-built configurations based on the best content and workflows used" (Epic Systems, 2012) at the hospital's facility. The Epic Governance structure separates the various departments within a hospital which utilize health care records information, ordering them in terms of importance to the overall delivery of medical services. Physicians and nurses are the most crucial links on the informational chain, followed by administrators, support services, and in some cases external users like pharmacies and hospice centers. Thus, ascertaining the ways in which the various users access and exploit the health care data at their disposal is of critical importance to both Epic Systems and Pleasant Manor during the implementation of electronic medical recordkeeping.

Due to the immense complexity and interconnected nature of a major nursing care facility like Pleasant Manor, "data is constantly changing based on information from doctors, nurses, patients and others" (Freudenheim, 2012). The electronic medical records provided by Epic Systems seek to streamline the operations of each of these users, by enabling them immediate access to diagnostic data, patient histories, and concurrent cases. It has been clearly established throughout decades of electronic medical recordkeeping implementation that "computerized record systems can actively search for and analyze information in ways that paper files never can, thereby improving patients' health" (Freudenheim, 2012). Under the new system, nurses, specialists and other health care professionals working at Pleasant Manor will be responsible for recording accurate charts on all patients, and those with chart discrepancies will ultimately be reprimanded or suspended. The reconciliation of all medical prescriptions, measurement of dosages, and the tracking of test results will also be standardized and recorded for use by physicians during time-sensitive cases involving imminent risk to the patient. In the same spirit of cooperation, the nursing staff of Pleasant Manor will now be capable of checking for medicine reconciliation on the fly, with the ability to immediately notify doctors in the event a mistaken dosage or diagnoses occurs. Administrators will also employ the Epic software to more efficiently schedule and assign their support staff, and to monitor medical operations for wasteful spending, theft, or other budgetary concerns.