FrancesBonAmi.jpgWhen Village on the Isle, Venice, Fla., redesigned its technology, company Chief Executive Officer Tom Kelly had a simple rule: no bosses allowed. “There were no managers in the meetings,” he says. “The vendors had to prove their works to our people. The only thing our staff was told was, ‘Pick out the thing that you think will work the best.’”
The staff duly met with vendors and asked Kelly for … the most expensive system. “But because it was chosen by the staff and so enthusiastically endorsed, the people who chose it were their peers, we went with it,” Kelly says. “They went back and convinced everybody that this was the greatest thing since sliced bread.
“Having been in the business for 37 years, I knew that if I had somebody telling me what to do, I’d resent it,” he says. “And I figured, if I resented it, why wouldn’t these people” as well?

‘Money We Were Throwing Away’

Whatever hesitation Kelly and management had about spending $150,000 up front on new technology, they’ve since had their answer. “It’s worked beyond our wildest dreams,” he says. “The payback on it in improved revenue earned enough in the first 14 months that it totally paid for the rest of the EMR [electronic medical record] implementation. We didn’t realize how much money we were throwing away.”
Village Administrator Elaine Boyer says that the new systems have not only improved staff morale and saved countless hours; it has also been “much safer for the residents.”
“The nurse just scans the medication, and if it’s a wrong medication or a wrong time or anything, the computer alerts them to that,” she says. The computer displays pictures of both the appropriate medicine and the resident.
“If there’s been a change in orders or something, they are visually alerted immediately by the computer,” Boyer says. “If there is a potential of a negative interaction between medications, the computer gives out strident warnings. It really enables the nurse to use the tools that are available but aren’t typically available in a nursing home.”

Piecemeal Revolution

If what has happened at the Village is a tech revolution, it wasn’t an abrupt one, Kelly says. “We really quickly figured out that the first thing we needed to do is, we need to piecemeal this in so you don’t overwhelm anybody,” he says.
Too many providers foist their technology on the staff, Kelly says.
“They want to bring in a big, canned system and say, ‘Here it is. You’ve got a month, two months. Get confident,’” Kelly says of many long term care executives. “You’ve got management that thinks they’re smart. And I’ve told my colleagues that they’re not as smart as they like to think they are.”
And the Village’s tech price tag could have been higher. But the company decided to keep its main operating system, instead seeking vendors that could integrate pharmacy, time and attendance, and other systems with the home’s operating system, Kelly says.
“Nobody has the perfect system. There are a lot of different components that are really optimal,” he says.

High Tech At Low Cost

Cases like the Village prove that high tech doesn’t have to mean high cost, says Juli Ochs, engagement director at the auditing firm of Clifton, Larson, Allen. “I don’t know that I personally would advocate for a whole new system,” she says.
One of the best tech solutions might come from the lowest tech resource: a human being, Ochs says. “I would argue for a full-time, experienced IT person,” she says. Companies are going to want “somebody who knows their needs and where they need help. My guess is, a lot of them are doing a lot of things right.”
Privacy and compliance officers can also make life easier for homes, as well as drawing up a disaster recovery plan. “It’s the slow process of going through and assessing the risk, whether they hire somebody or they do it themselves,” she says. “Taking care of things on the front end will help make sure that there’s no panic at the back end.”

Anchor Institutions?

There may even be ready cash for those providers that are ready to embrace modern technology, says Elaine Eshbaugh, associate professor of gerontology at the University of Northern Iowa. A home not far from her campus has just won a federal grant to buy computers for its residents.
The Federal Communications Commission, in fact, has set aside millions in broadband grants for what it calls “anchor institutions”—schools, libraries. There is no reason that a community nursing home couldn’t be considered an anchor institution, experts say.
“Until recent years, we’ve been just so concerned about meeting the minimal needs in the home,” Eshbaugh says. “With the baby boom generation coming up, we’re going to have to do better than that.”

Culture Change

Back at the Village, the tech upgrades have led to a culture that’s increasingly open not just to new technology but to new ideas. Expensive ergonomic chairs, for instance, have slashed back injuries for the staff, Kelly says. “The changing future is going to require people to do business differently. I knew the technology existed. It was just a matter of making it happen,” he says.
Elaine Boyer, the Village’s administrator, says that “when I saw the potential” of new technology, “I was tremendously excited.” But the staff response has exceeded even her expectations, Boyer says.
“It brings the job into the current century,” she says.