2006 LTC HIT SUMMIT June 8th

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2006 LTC HIT SUMMITJune 8th 9th ,
2006Baltimore, MD

• DISASTER PREPAREDNESS CONSIDERATIONS for HEALTH
  INFORMATION TECHNOLOGY (HIT) in LONG TERM CARE
• Gary J. Schnerr
• Director, Bioterrorism Preparedness
• Health Care Association of New Jersey
• Hamilton, NJ 08691
• 609.890.8700
• www.hcanj.org

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Healthcare ContinuumPartners in Preparedness

• Preparedness For
• all hazards including natural and man-caused
• fire, flood, utility break, biological event,
  etc., etc.
• single facility, local, regional, national

Partners

• Acute Care Hospitals
• Primary Care Centers (FQHC)
• Long Term Care (SNF,ALF,CPCH,RHCF,ADS)
• Home Care

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Cross-Environment shalls

• Interoperable- protocols, formats, etc.
• SNOMED or other standard vocabulary
• National Incident Management System (NIMS)
  compliant-what, when ???
• Accessible to approved officials-epidemiological
  data flow facilitating biosurveillance and other
  TBD to/from information
• Person Portable- full record goal, Continuity of
  Care (CCR) record minimum (enough info for the
  receiving site to render adequate care)
• Support AHRQ-defined altered standards of care in
  a mass-casualty public health emergency (disaster
  mode)???
• Support almost real time queries on beds, other
  status indicators necessary for asset
  availability assessment during disaster

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Situational Comments-when disaster strikes..

• Acute care potential target, not LTCF
• If flood, hurricane, etcLTCF also target
• If not Ground Zero, acute care rapidly
  overwhelmed by victims AND worried well
• Xfer less ill to LTCFs-SURGE capacity
• Non-infectious not requiring acute level
  services
• LTCF sheltering decision
• Shelter in place- residents plus possible
  transfers- with PHR/CCR!!
• Evacuate- with PHR/CCR!!
• Some means of recording services rendered,
  eventual transfer of services records to
  facilitate payment- may sound mercenary but
  reality!!

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LTC IT

• Cavernous disparity in IT utilization
• Significant of LTCFs are not on-line 24/7
• Personal email accounts
• Many are paper-centric minimum IT as required by
  regulation (MDS) or outsource billing, etc.
• Many outsource limited IT support
• IT mysterious to many and daunting
• Regulatory environment very constricting
• Process redesign staff training along with
  regulatory reconciliation

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LTC IT- contd

• Relative investment requirement a hurdle even if
  ROI is favorable
• Incentives/Grants needed to push adoption
• Vendor certification critical
• Reduce risk to decision maker
• Build confidence that it will work
• Customer Support key competitive differentiator
• Speed adoption and time to effective utilization
• Care setting transparency
• Frequent occurrence of transfers
• Source of errors

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Lets Consider LTC I/O in a Pandemic Flu Scenario

• Standard biosurveillance protocols
• Thresholds tripped, public health emergency
  declared
• Notifications sent per state plan
• LTCFs may/may not receive it (24/7 challenge!)
• Frail elderly vulnerable
• May close facility to visitors
• Staff may not come in- staffing ratios reprieve??
• Disaster Mode in EHR system??

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LTC I/O in a Pandemic Flu Scenario contd

• SURGE capacity for acute care overload
• May be isolation/quarantine facility
• Could entail evacuation of LTC residents
• Requires accurate records to maintain resident
  location as well as care continuity
• Continuing information dissemination as pandemic
  evolves

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SummaryGaps and Challenges

• 24/7 Continuous Communications
• Continuous power for full/partial system
• Financial Barriers- equipment training
• Regulatory environment in sync with technology
  implementation-with Disaster Mode
• Realistic Evacuation plan
• On-person CCR with eMarimplantable chip
  bracelet with chip Flash chip??
• Auto person locator via chip interrogator??
• Real Interoperability and Continuous Improvement
  via a realistic release schedule that allows
  planning and technology to be used most
  effectively

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Lets Discuss Further..

• Health Care Association of New Jersey
• 4 AAA Drive, Suite 203
• Hamilton, New Jersey 08691
• Gary J. Schnerr
• gary_at_hcanj.org
• www.hcanj.org
• Thank You!