Electronic Medical Records (EMRs) in a long-

term and mental-health care

setting Douglas A. Struyk, President and CEOJennifer D’Angelo, Director of Software

Implementation

Christian Health Care Center

Our programs for the elderly and mentally ill

Elder-care programs• Heritage Manor Nursing Home – Post-acute Care Unit [PACU],

Long-term Care Unit, Special-care Unit – 252 residents• Southgate behavior-management unit – Special-care unit – 40

residents• The Longview Assisted Living Residence – 95 residents• Christian Health Care Adult Day Services – Wayne and

Wyckoff• Hillcrest Residence - 39 residents• Evergreen Court - 40 affordable apartments

Mental-health programs• Ramapo Ridge Psychiatric Hospital - 58 beds• Ramapo Ridge Partial Program – For post-acute adults• Pathways partial-hospitalization program – Developmentally

disabled/mentally ill adults• Christian Health Care Counseling Center – Traditional

outpatient

Unique needs of long-term care (LTC) facilities with EMR initiatives• Differ from acute-care setting needs

• Acute-care more focused on diagnosis, treatment, and communication speed.

• Implementing acute care-oriented systems in LTC settings encounter limitations due to larger records and longer lengths-of-stay.

• LTC facilities need extensive histories and descriptive information with less treatment information and provider communication.

• Improvements in QI/QM data, in addition to survey outcomes

• Reduction in errors (resident/patient safety)

• Improved staffing efficiency• Interoperability with lab, pharmacy,

rehabilitation, radiology, etc. to minimize transcription errors and streamline information

• Savings with third-party vendors

Direct benefits of our EMR

Barriers surrounding implementation

• Financial - Christian Health Care Center invested $750,000 for hardware, software, training, and wireless set-up costs

• Staff - Adaptation/computer literacy- Fear/change

- Time-sensitive

Our implementation process

• Three phases designed– Back-order entry, CPOE, Progress Notes– Care plans, MDS, CMS forms– Assessments, nurse instructions, CNA

assignments, policy and procedure revisions

• Staff awareness began 12 months prior• Letters sent and meetings with families• Kick-off party and celebrated project• Implementation begins!

Daily documentation totals

9129

53383953

18420

0

2000

4000

6000

8000

10000

12000

14000

16000

18000

20000

CNADocumentation

OrderseMAR/eTAR TOTAL

ElectronicMedical Recorddemonstration