Health IT

Nursing home cuts hospital stays, improves patient care by joining health info exchange

senior citizens nursing home residentsFor those of us in healthcare, “going green” isn’t a fad; it’s a business reality. Conserving resources and taking advantage of new technologies not only improves the environment – it improves the bottom line as well. Most importantly, streamlined communication means better care for our patients and more peace of mind for their families.
In Indiana, the Indiana Network for Patient Care (INPC) securely connects more than 19,000 physicians, 90 hospitals, 110 clinics, and surgery centers and other health care organizations throughout Indiana to provide “virtual” patient records so that health care providers can have accurate patient information in near real-time. The INPC is a service of the Indiana Health Information Exchange.

In April 2012, Golden LivingCenters became the first post-acute health care provider to join the INPC. Recently, the Indiana Health Care Association interviewed Golden LivingCenters to find out how this new technology affects their work.

IHCA: What are some of benefits to your staff?

GL: In the past, when we took a new patient [from a hospital], we might only have records about what sent that patient to the hospital this time. Maybe she fell and fractured her hip. Now we can see that she’s been hospitalized 10 times in the last five years. With INPC we can manage the long term underlying diagnoses. If we don’t, patients may end up back in the hospital because we haven’t really addressed the root cause of the hospitalization. Think of it like a picture. With INPC we have the whole scrapbook of a patients life, not just the snapshot of what brought them to Golden LivingCenters today. The INPC gives us a much more holistic way of taking care of our patients.


Let me give you an example. One woman came to one of our centers with a hip fracture. When we pulled up her information, we saw that she’d had four hospitalizations in the last two years, all brought on by high calcium levels. As caregivers, we knew to run frequent calcium level tests. Had we not known this, her calcium levels would have gone up and she would probably have gone into kidney failure. Instead, we managed her calcium levels and she was able to stay in our center and continue rehab instead of ending up back in the hospital.

IHCA: How does the INPC help Golden LivingCenters work more effectively with hospitals?

GL: We had a resident who had been with us some time. To her, the living center was “home.” When her cancer worsened. she was hospitalized. Because of the INPC, we could follow her tests and procedures in real time. We saw that they were putting a chest tube in her, but our center didn’t have much experience with that type of chest tube, so our education director and unit manger went to the hospital to receive training on it. She wanted to return to the living center; we were able to bring her back and make her comfortable in her last days because we were able to see what was going on through INPC.

IHCA: So using INPC improves communication between hospitals and your living centers?

GL: Absolutely. We can see procedures. lab tests and notes from physicians so that we are ready to care for a patient when he or she is discharged. There is wonderful cooperation between Golden LivingCenters and area hospitals because the hospitals know we are willing to be educated on how to best care for our patients. This willingness decreases hospitalization days and gets patients more quickly back to our centers, which is where they want to be.

IHCA: So INPC improves your ability to care for your patients – does it improve the hospital’s ability to care for them as well?

GL: Yes. Once one of our patients goes to the hospital, we can let the floor nurses know that there is information on that patient in INPC. The nursing staff can know the patient’s normal habits – read dietary notes, activity levels – so they can provide better care, make that person more comfortable and be alerted to abnormal behavior. In the past. the hospital staff may have only had the SBAR (situation, background, assessment, response). Now,the SBAR alerts the ER doctors that there is Information in the INPC on this person, making continuity of care so much better.

IHCA: So how does it work? How user-friendly is it?

GL: When you put in a patient’s name, you will first see all the hospitals and facilities – any place that has electronic information on that patient – available for you to look at. You can choose to view all patient records, or those from a particular facility. Then there’s a sidebar menu to choose from: lab results, admission and discharge summaries, cardiology notes, radiology notes. and an information sheet on the patient. You can look at notes by topic or in chronological order. You can click to read a doctors note on a particular procedure or test. Every medical record of that patient in Indiana since records started being electronically recorded is there at your fingertips.

IHCA: So what are the environmental benefits of using INPC?

GL: The amount of paper saved is staggering. In addition, it improves patient privacy and record accuracy. Before, we may have had a complete chart pionted out – discharge sum manes, labs, etc that can get lost or slipped into someone else’s chart. We no longer have pieces of paper that can be displaced or lost.

IHCA: How does using INPC benefit you financially?

GL: It’s too early to tell what the reduction will be in the cost of supplies and redundant laboratory tests, but we expect to see significant reductions If you are operating in silos, it’s not unusual to repeat tests. That not only increases cost. but means additional (and unnecessary) needle sticks for the patient.

Thanks so much for sharing your experience with us. Is there anything else you’d like to say to other living centers?

GL: Just do it. Begin where you are. Then you can continue to build upon your electronic health record. You will find that by having more efficient and better data from the onset, you will be able to provide the right care in the right place at the right time, reducing hospitalizations and improving the experience of the patient, which, after all, should be our top priority.

Interview conducted by Lise Caldwell and published originally in the Fall/Winter 2012 Indiana Health Care Association Newsletter.
[Image from flickr user Official US Navy Imagery]

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