Working from the same page

Edition: December 2009 - Vol 17 Number 12
Article#: 3338
Author: Repertoire

Nursing homes and long-term-care facilities may still feel the squeeze of a tight economy. But, that doesn’t mean they have to do without – at least not where electronic medical records (EMRs) are concerned. According to one Denver, Colo.-based physician, it is possible to bring more long-term-care facilities on board with EMR without breaking the bank.

A practicing geriatric physician for 20 years, Gentry Dunlop, M.D., saw electronic medical records as a means of improving patient care in nursing homes and long-term-care facilities. With an interest in computer programming and a business school degree, Dunlop founded Mobile Physician Technology, LLC, whose goal is to provide entry level EMR for long-term-care physicians. Presently, Dunlop is working on a second start-up, Mobile Physician Network, LLC, which will reach out to long-term-care administrators.

“Physicians tend to be more interested in the clinical side of EMR, while [administrators] are more into the billing aspects,” says Dunlop. “I think there is a huge tie-in between the two.” EMR can help facilitate more efficient workflow processes in nursing homes and, in doing so, improve patient care, he notes. Indeed, nursing homes are often weak when it comes to tracking patient care and recordkeeping, which can lead to medication errors, he points out. “When patients are transferred from one venue to another (e.g., from hospital to nursing home), there is a greater potential for medication errors to occur.”

Also, a lot of nursing home care takes place over the phone, Dunlop continues. Often, a nursing home caregiver will call the physician for instructions. But, if the caregiver needs to follow up with another call later, he or she may get a new physician who is unaware of the full patient history. Physicians and other nursing home caregivers often require immediate access to patient records and histories, and electronic medical records can facilitate it, he adds.

What they want to know

Long-term-care physicians generally recognize the value of EMR, including its potential to improve care as well as revenues, according to Dunlop. But they are concerned about its cost and the learning curve associated with implementing it.

“For physicians, we emphasize increased revenue collection through accurate billing, user-friendliness, speed and no loss of productivity,” says Dunlop. EMR will improve patient care by providing immediate access to patient database information through process automation, such as medication and diagnosis lists, he tells physicians. Furthermore, through accurate coding and efficient billing, physicians should see an increase in revenue, he notes. And, while implementing EMR inevitably involves a learning curve, “our provider [customers] usually see no drop-offs in their number of patient visits,” he points out.

For nursing home administrators, Dunlop has set up budget-neutral pilot projects in two Denver-based facilities. Administrators’ main concern is the cost of implementing EMR and the benefits it will bring to their facility, he says. Dunlop believes that administrators, like physicians, will see improved patient care and fewer medication errors through better documentation and process automation. And, in the end, more efficient workflow should lead to lower operating costs.

By offering a basic, no-frills EMR package, Mobile Physician Technologies (and, in the future, Mobile Physician Network) can provide EMR to customers at a minimal cost, says Dunlop. Whereas it can cost as much as $10,000 per physician for EMR software, MPT keeps its price to about $4,000 per EMR license, he points out. He is still working out pricing for nursing home administrators who take advantage of the MPN package, but is determined to keep that price low as well.

“Nursing homes spend $171,000 annually on adverse drug events,” he says. In addition, “15 percent of custodial residents are hospitalized in any given six-month period, and 40 percent of transfers to the hospital are considered inappropriate.

“It’s becoming more obvious to more people that they can’t keep up with good patient care if they don’t invest in technology,” Dunlop continues. “And, [administrators] want their facility to be better than the long-term-care facility down the street.” This calls for a clinical and business savvy. “Our EMR would enable nursing homes to directly connect with their physicians to ensure we all are working from the same page,” he adds.