Robotics, intuitive software and devices, and innovations that can improve care and staffing are popping up all the time. However, budgets and funding for such technology are scant. While you may feel like a kid with empty pockets outside of a candy store, it’s important to stay on top of technology trends, and there are some innovative ways to bring them into your facilities.
From robots that can help with medication pass to devices that take vitals and send the information to physicians and other team members, many innovations can free staff from mundane tasks and the administrative/paperwork activities that weigh them down.
Tech That Takes Burdens Off Staff
“People aren’t using technology as effectively or efficiently as they could because there is a cost to being at the forefront of technological innovation,” said Rod Baird, founder of GPM, an Asheville, N.C.-based health information technology company. However, he added, “The balance is shifting to automation such as bedside monitors so staff don’t have to record information constantly. If you are still making people transfer information manually, it’s time-intensive and unsatisfying for team members who are already overburdened and would rather be spending time with their patients. We can expect to see more effort to implement electronic data exchange as part of efforts to attract and retain good staff.”
Elsewhere, Baird said, “Anything that facilitates the contemporaneous exchange of medication administration is critical because that is the root of so many things that can go wrong, especially post-discharge.” He added, “Anything you can do to close gaps in the electronic prescribing cycle is key to achieving better outcomes.” At the same time, technology that makes tasks more do-able and cuts risks will be welcomed by team members.
Role of Robotics
Robots will never replace human interactions, but increasingly robotics technology is showing promise for handling some simple but important tasks. Among the offerings:
- Stanley Healthcare has created Pria, a voice-enabled tabletop robot that gives caregivers day-to-day insights about a patient’s adherence with prescription and over-the-counter medications. The robotic system also can schedule up to 28 medication doses and provide reminder alerts. It enables quick access to family members or caregivers via voice command and built-in camera for video calls.
- The Mabu wellness coach, another tabletop robot, provides medication reminders and other alerts. It also monitors how the patient is feeling on a daily basis. This device is designed to encourage better patient engagement with practitioners and caregivers. The Mabu has a face and eyes to engage patients and interfaces that include voice response/activation and touchscreen interaction capabilities.
- Smile robotics, a Japanese firm, has develop the ACUR-C, a robot that can serve food and drinks or collect trays of dirty dishes. Other companies, such as Bear Robotics, Pudu Robotics, and Keenon Robotics, also produce autonomous service robots.
- The temi robot V3 is an autonomous personal AI assistant robot with pre-set locations that enables telemedicine visits, as well as connections with family and friends.
Other technological innovations include wearables that can connect, analyze, and share data. For instance, the TENA SmartCare Change Indicator™ attaches a reusable sensor to the outside of an absorbent product. When it detects urine, it notifies family or caregiver via a smartphone app. This enables decisions about when to change products without intrusive personal checking.
Elsewhere, Toto’s Wellness Toilet scans the user’s body and their output, analyzes it, and provides wellness recommendations accordingly. SafelyYou is a system that detects falls and notifies care staff who can immediately view video of the fall. This can help identify causes of falls and prevent similar incidents in the future.
The Cost Conundrum
While all these technological innovations hold promise for improving staffing and care, they come with a price tag. Particularly as long term care is coming out of a devastating pandemic, it’s hard to find the money for such expenditures. As American Health Care Association/National Center for Assisted Living (AHCA/NCAL) president and chief executive officer (CEO) Mark Parkinson has said, “Providers have spent tens of billions of dollars fighting the virus….Without adequate resources from lawmakers, financial challenges and access to quality care will worsen.”
AHCA past board chair Debbie Meade, CEO of Health Management in Warner Robins, Ga., added, “During the pandemic, we saw the value of technology, particularly the use of telehealth.” But although the Centers for Medicare and Medicaid Services (CMS) enacted waivers to expand coverage for these services, there is little financial support to pay the equipment and devices involved and training for staff.
Generally, while everyone seems to agree about the value of technology, it continues to be a low funding priority. As Alex Bardakh, MPP, CAE, director of public policy and advocacy for AMDA – The Society for Post-Acute and Long-Term Care Medicine, said during AMDA’s recent annual conference, “There was not one single mention of IT infrastructure [in the Biden Administration’s nursing home reform proposal]. We have to ensure we have interoperability and can work with our hospital partners and the entire health care sector.”
Baird noted, “There is a need for federal support for nursing homes to leverage and expand existing technologies and be able to access and implement high-tech innovations.” For instance, this may mean advocating for widespread use of up-to-date electronic health records (EHRs) and clinical surveillance in this care sector, as well as for legislation to incentivize facilities to adopt and use technology.
Nonetheless, Baird said, “Even though the capability to share information exists, facilities aren’t investing in seamless electronic communication. But the staffing crisis may prompt people to make the investment in those integrations to reduce otherwise required labor.”
Seamless and low-cost exchange of information in real time is possible. But, Baird said, “We haven’t gotten to the point where all parties involved can collaborate.” This hopefully will change moving forward as payors and regulators see and support collaboration, interoperability, and free exchange of information.
However, before investing heavily in any technology innovations, leadership should consider how these can streamline processes and help staff do their jobs better. A basic risk-benefit analysis can help determine where money spent on technology is likely to generate the greatest return on investment. At the same time, it is important to engage the staff who will be using the technology in these decisions.
Amber Bardon, CEO of the Parasol Alliance in Chicago, also suggested, “Before you can be successful with technological innovation, you need to make sure your core systems are updated. Some facilities are at the top of the life cycle on updates/replacements, staff training, and so on; others aren’t.” She also noted, “Start with an analysis of where you are and where you want to go. Establish a vision of your technology culture transformation.” This may involve establishing an IT committee to develop and execute a strategy, including identifying funding opportunities.
“There are no easy answers for bringing more technology into our facilities,” said Meade. For instance, she observed that few organizations are prepared for the cost of replacement equipment and upgrades. “There’s no funding available to replace computers, and outdated technology hurts patients and staff alike.”
It Takes a Community
Just as it takes a village to raise a child, it requires a community to invest in innovations that benefit residents and staff throughout the care continuum. “We need to partner with hospitals and other organizations and stakeholders with a vested interest in quality care to build telehealth systems and other technological innovations,” said Meade. “We need innovations that can help all of us work smarter, not harder.”
One opportunity is partnerships between nursing homes and technology stakeholders. “Partnerships with universities and other stakeholders can help provide facilities with access to innovative technology while they participate in pilots and studies,” suggested Meade. For instance, Susan Horn, Ph.D., senior scientist, Institute for Clinical Outcomes Research, and vice president of research, International Severity Information Systems, received funding from the Agency for Healthcare Research and Quality to create a nationwide project to integrate information technology in nursing homes and other long-term care facilities. As a result of the implementation of this technology, the prevalence of pressure ulcers was reduced by 33 percent among residents in 11 facilities.
Technology developers and vendors also can be partners for innovation. Meade said, “Facilities want technology, but they are struggling. Vendors can help us out be spreading out costs to make innovations more affordable.”
When census rebounds and various technologies become more affordable and accessible, it may be easier to take on new technology. In the meantime, AHCA/NCAL will continue to work with its members on ways to modernize facilities and use technology to provide quality care and attract and keep staff. Meade suggested, “We need to focus on what we do and not on the turmoil around us. We will be keeping an eye on technology issues and looking for ways to ensure a brighter future for long term care.”