Current Long-Term Care Practices, Healthcare Services - Thesis Example

Full Paper In this report we will discuss and review current trends with regards to long term healthcare. Moreover, current long term care practices, healthcare services and benefits accomplished by integrating information technology are also illustrated in the review. Furthermore, deployment for acquiring health informatics and challenges associated with IT-enabled long term care are also discussed in detail. I. Introduction to the Project A poet, philosopher and an artist of an early 20th century named Khalil Gibran, who lived in a pre-computer era, stated that (Pasupathy, 2006) “A little knowledge that acts is worth infinitely more than much knowledge that is idle”. It is surprising that he is concerned about the knowledge management systems in the 20th century. However, this idea has become more useful if this statement is meditative in the long-term care industry. In addition, by computerizing long-term care industry a massive enhancement has been noticed. But long-term care institutions still require a lot more knowledge associated with technology in order to enhance nursing homes, progress through administration techniques, improve the medical processes and gain knowledge associated with system management (Pasupathy, 2006). The administrator of a nursing home must understand the core objective of management system and the purpose of long-term care organizations before procuring, executing and promoting these systems, as it will consequently aid in understanding the characteristics and features of the system (Pasupathy, 2006). The national director of the primary care for the condition of long-term patients in England, David Colin-Thome state that: “Delivering improvements for people with long term conditions aren’t just about treating illness, it’s about delivering personalized, responsive, holistic care in the full context of how people live their lives. Our journey to achieve this has started, our challenge is to continue to take it forward and the evidence compels us to do this” (Bradbury, 2008). A reliable delivery of services is provided to the patients exclusively while ensuring the proper care regarding the patient’s health and patient’s life. It is made possible by the sound knowledge in health care that locate a new direction in the field of health and social care system (Bradbury, 2008; Robinson, 2011). A 24-hours care support has been established by the NHS that provides full support to the patients, as well as to the public keeping in mind the concept of primary self-care. However, the NHS must maintain the acquisition of new technologies and innovative working practices to facilitate people with long term conditions to live a healthy life (Robinson, 2011). Likewise, health services are provided to the patients via national ICT infrastructure that is designed to support multi-channel services in order to provide 24/7 constant recommendations and knowledge regarding self-management and the management of long-term health conditions (Bradbury, 2008). Moreover, many patients find it difficult on how to find adequate solutions related to any health condition or how to contact their regular care service providers in late working hours or in some cases after working hours. In 2004, the problem has been aggravated for several patients due to out-of-hours (OOH) services (Bradbury, 2008). The NHS direct has made this possible for patients to get reliable and useful information through any medium such as telephone, internet, digital TV (DiTV). In addition, NHS Direct is continuously providing sound knowledge to spread awareness among the patients (Bradbury, 2008). A number of communities are using different technologies such as, point-of-care (POC) documentation and financial software, as mentioned in a long-term living trend survey (Long-term livings survey of technology usage.2011). In that survey it was concluded that the latest technology acquisition will facilitate the organization to deliver services efficiently and effectively. Following are the names of the latest technologies that are used by healthcare organizational staff such as administrators, executives and staff members (Long-term livings survey of technology usage.2011): Financial software used by 72%. Clinical software used by 57%. Safety technology used by 50% Apart from the mentioned staff, resident monitoring and vendor management staff and others are also included. Moreover, the physical fitness or the rehabilitation technologies incorporate management associated with material and supplies along with POC documentation that is used by 32% (Long-term livings survey of technology usage.2011). Another survey that is based on the implementation of electronic health records shows that about 31% of the patients are using electronic health records (EHRs) (Long-term livings survey of technology usage.2011). Overall 33% of the patients are planning to implement and the remaining 18% are still considering about EHRs (Long-term livings survey of technology usage.2011). The other technologies that are also in used but not included in the top list are (Long-term livings survey of technology usage.2011): Telemedicine/telehealth. Brain fitness. Property management software. Asset tracking software. Business intelligence. One more survey revealed that about 44% will be implementing, adapting or improving their electronic health records (EHRs) while eMAR systems will be upgraded by another 41% (Long-term livings survey of technology usage.2011). Moreover, 28% will be acquiring clinical applications, whereas 25% will deploy or promote systems associated with paper work. Furthermore, other associated technologies will be updated within upcoming 12 months. These technologies will incorporate resident behavior, material management, business intelligence applications, asset tracking etc. II. Aims and Objectives of the Project The aim of the project is to comprehensively discuss the misunderstood concept of Long term care health services. Likewise, Long term care is a separate domain that specifically addresses patient care in a long run by utilizing information technology to keep track and monitor health conditions of the patients rest in bed. Moreover, there is a requirement of integrating communication technologies, computational technologies with the long term care health services. We will discuss all the technologies and services involved and what advantages are derived from them to the patients. A review of technology in long term care will illustrate benefits as well as challenges. The ultimate goal is to make once health better and to improve health care services for the long term care patients. III. Scope of the Project As patients suffering from diabetes, obesity and heart problems requires a continuous tracking mechanism that will monitor blood sugar levels, heart rates etc. The scope of the project is to address information technology that will enhance the practices of standard nursing procedures in terms of providing health care services on a constant basis to the patients. Likewise, the idea is to provide uninterrupted health services via different devices, tools and communication technologies to save one’s life by delivering health services on time. IV. Literature Review In the previous ages, telephones were used in emergency cases for patients and patient carers. However, it is generally understood that the majority of the patients seeking accidental and emergency care in the accident and emergency (A&E) departments only gets a possibility of routine or self-care to be considered as their first option (Bradbury, 2008). Currently, new methods are defined where health care delivery services are developed and incorporated with risk aversion. Likewise, as the software become more and more advanced and complex, required skills are also augmenting. (Bradbury, 2008) In the year 2006, the completion of a care episode from the initial telephone call was 34% i.e. no onward transfer of services to third parties. However, the figures of the previous year were 33% and the increase of this percentage was due to integration of healthcare service providers with the local urgent health care service providers (Bradbury, 2008). Moreover, in the year 2006/2007, emphasis was primarily given to enhance health care practices via PCT that is a strategic health authority and local authority in the United Kingdom (Bradbury, 2008). Likewise, the health care project was moved one step further by integrating more patients from other areas of Birmingham. Likewise, eastern and northern areas of Birmingham were focused via this program and continue to expand patients suffering from chronic obstructive pulmonary disease (COPD) (Bradbury, 2008). Currently, 2000 patients are getting treatment of health care services; in addition, the upcoming future objective is to introduce a tele-health facility that is a health monitoring equipment that will be used in homes of critical patients (Bradbury, 2008). However, the input from these patients can be evaluated and monitored by call center services or healthcare professionals. Likewise, this device will facilitate detection of disease or its condition at an early stage. For instance, blood pressure levels are critical to monitor for a specific patient due to their dependency on other critical organs in the body, obesity or weight gain that may increase risk of heart failure. Moreover, one more health care practice is facilitated by technology that is playing a major role for patients possessing long term conditions and staying within their homes (Bradbury, 2008). Likewise, older patients suffering from diseases of long term conditions such as diabetes, heart diseases, and hypertension will be treated within their homes via high technological home health care systems, enabling them to be healthy and reducing health risks. Moreover, a Telecare system comprised of electronic sensors capable of detecting flooding, smoke, temperatures along with a help button (Bradbury, 2008). Furthermore, tele-health technology embedded in devices is used for examining critical symptoms such as blood sugar levels, body temperature, body weight, peak flow readings, oxygen levels etc. Consequently, by incorporating technology within long term health care practices, nurses can develop an efficient and effective pathway for the patients. Moreover, healthcare staff will be able to provide customized health information (Bradbury, 2008). Moreover, the paramedical staff can also use handheld gadgets and even smart phones that are a more affordable way to spend more time with the patient along with enhancing efficiency for the caregiver (Williamson, 2012). Moreover, to enhance the quality of life, there is a hidden use of technology for the treatment of Alzheimers disease. An example of Jefferson Manor’s facility can be best suited here, as the facility utilized technology for enhancing quality of life. Likewise, it was established in 1983 and was considered as a residential care facility that was regulated by the new community based care program located in Oregon (Mason, 2006). Moreover, after its renovation in 2004, currently, Jefferson Manor currently houses patients with memory impairments (Mason, 2006). Likewise, to construct operational excellence, the facility has acquired technology from three separate organizations summarized as the hardware and software elements integration from Elite Care, Daverchi Technologies and for paperless operations associated with care delivery system, Vigilan Corporation is consulted. Moreover, a state of the art ECR care system is installed at Jefferson Manor’s facility that comprises of sensors allowing residents and employees to be examined anywhere within the facility (Mason, 2006). Moreover, a system based on passive resident-monitoring architecture known as the bedbugs facilitate staff to monitor the resident for risks of falling, examining sleep patterns and weights. The system based on modest technology addresses privacy of the patients, as it does not interfere with the personal life of the patients. Moreover, the facility is equipped with wirings known as the smart community that continuously monitors and examines the requirements of residents (Mason, 2006). Moreover, sensors installed within the bed monitors each person’s weight change and sleep disorders. Similarly, infrared motion sensors facilitate the staff to monitor and locate residents of the facility seeking for help (Mason, 2006). Furthermore, alerts associated with bed bugs inform the facility staff, if there is a risk of any patient’s fall from the bed. Every patient in the facility wears a badge that is integrated with technology that provides physical access to the patients along with a button for calling immediate health care support. Apart from the patients, the staff located at the facility also equips these electronic badges that facilitate supervisors to examine and monitor staff activities. In addition, supervisors can also utilize workstations to review staff performance summaries, statistics that may reduce manual paperwork. Moreover, touch screens are also installed within the facility that aid staff to monitor the community actions and behaviors (Mason, 2006). To support long term health care, one of the systems called as electronic medication and management is also introduced. Likewise, the primary purpose of this system is to construct a paperless electronic management system possessing features such as the time elimination medication techniques, tracking and order management. These techniques save a substantial amount of time along with an elimination of medication errors (Mason, 2006). Moreover, the system will also facilitate the pharmacy services by lowering the costs and increase in better service (Mason, 2006). The user interaction of the system comprises of an easy user friendly device, monitored embedded with touch screen functions, barcode scanners, finger print sensors and handheld computing devices. With all these features, the system is highly accessible and easy to use for the medical staff (Mason, 2006). Moreover, interactive care systems were also introduced by Vocollect Health care systems and Preferred care partner management group in the United States, as these systems were able to display real time data and instant care intervention (Andrews, 2011). A term known as Long-term and post-acute care (LT-PAC) incorporates a broad category of services addressing the precise requirements of the population that is divided into two groups i.e. Functional or cognitive constraints generally linked with age, type of disease or disability (Goldwater & Harris, 2011). The misunderstood concept of long term care that is only limited to inpatient care that initiates from a skilled nursing facility has already started to change, as more and more patients are seeking a wider range of services. Currently, LT-PAC is providing health care services at home along with facilities associated with institutions. Likewise, these services cover almost every aspect starting from short term rehabilitative services for patients requiring terminal illness (Goldwater & Harris, 2011). In the past decades, the American people have linked the ‘long term care’ concept with the hospital bed located in a patient ward (Goldwater & Harris, 2011). However, this concept has robustly evolved, as the long term care has been also evolved to precisely treat the patients with a broad variety of services. However, there is a primary contributor of this healthcare evolution i.e. Health informatics or Health Information Technology (Goldwater & Harris, 2011). Likewise, health IT facilitates the health care service providers to virtually access medical information of a patient. Moreover, health IT also enables patients and healthcare staff to communicate precisely with each other and exchange rich information via tools for providing required services on time and without medical errors (Goldwater & Harris, 2011). Electronic Medical Record (EMR) plays an important role in provision of capturing clinical and non-clinical data for healthcare specialist that can also be transferred among other health care organizations. Moreover, EMR also minimized redundancy of data related to patients and resident care. Some of the examples are a duplication of tests, treatments and time spent. Studies show that an electronic Health Record (EHR) system that is customized for long term care has been proven to provide substantial and noteworthy benefits such as minimized turnover rates for health staff, condensed hospitalization fee, effective and standardized daily clinical procedures and enhanced job satisfaction. All these features enable the healthcare staff to spend more time with residents (Long-term livings survey of technology usage.2011). In addition to this, a conclusion of a report produced by BearingPoint for the National Commission for Quality Long-Term Care demonstrated a conclusive statement as (Long-term livings survey of technology usage.2011): “EHR within a nursing home allowed nursing staff to move quickly from one resident’s records to another, permitted multiple staff to review and document a resident’s records at the same time, increased efficiency by allowing instant access to resident information for care planning, and supported the timely dissemination of information to families” a. Long Term Care Health Informatics Implementation Aspects In order to ensure the safety and the effectiveness of the technology a there are certain aspects that need to be addressed. These aspects are illustrated below: All the technologies that are in use must be listed. A maintenance program must be developed. Training programs must be introduced to the technologies that being implemented in the organization. Provision of adequate training for new users and monitoring of all users to ensure compliance with best practices, standards and procedures. A comprehensive review of all the technology utilized by healthcare services to ensure value delivery. However, replacements can be made where necessary. Performing system audits to evaluate system performance, alignment, effectiveness, compliance with policy, effective documentation, violation logs, recommendations and replacements of ineffective controls, procedures and guidelines. User acceptance is another critical aspect of incorporating healthcare with IT. Satisfaction surveys can be carried out to judge the level of user acceptance among users. Moreover, feedback forms will provide opportunity to gain suggestions from end users for system improvement. Furthermore, questions regarding training issues along with any new requirement of tools are also discussed. b. Challenges to the Project As there are numerous advantages for long term health integrated with health IT, there are some challenges as well. The prospective to control the technology in order to transform Americans age is quite genuine. In fact, in the coming years several legal and social aspects should be taken under consideration in order to understand clearly about long-term health. The implementing cost of this technology limits its deployment and consumption widely. As a result, the number of American patients pay heavily to the health insurance as, well as to the health care professionals without any endorsement of improved care or protective care. Hence, the insurer has realized that by implementing the latest technology an enhanced care management as well as, reduced cost can be obtained. On the contrary, implementing cost of latest technology must be defaulted to the patients or the service providers. Moreover, technology associated with health such as ventilators, monitoring devices and wheelchairs are manufactured and designed to sustain or improve the life of the patient. Apart from these advantages, they can also result in stigmatization and social exclusion in the patients (Gibson, Upshur, Young, & McKeever, 2007). The implementation of latest technologies such as, an Electronic Health Record (EHR) in a nursing home can be expensive. In addition, it depends upon the several factors such as the product, the size of the nursing home and the functionalities of the system. However, cost related to the system upgrades and ongoing operational cost is high even after paying the initial cost. The pass on hospital or any health care provider charge the facility cost from the patients in order to provide the information in the community. Likewise, an additional cost is charged with the patients using the full facilities in the form of membership fee. However, the cost related to the EHRs will lower down as the cloud computing is developing as a result; electronic systems will become more affordable. The tele-health technology also needs a huge investment in the beginning whereas, health organizations such as, Medicare encourage the patients to utilize telehealth services. The remote monitoring service is only provided by telehealth as the element of their treatment procedure (U.S. Department of Health and Human Services 2010 a, b, c). In addition, tele-health technology is more effective and cost saving as compare to the other health providers. Although, the entire Medicare authorized organizations do not use this technology. This is because the devices for remote monitoring are much expensive. The cost related to acquiring these devices is much higher due to the advancement in technologies for example the potential of Smartphones and the competition in many organizations. The CMS have verified that the cost related to the implementation of latest technologies can be restored. In previous years computer systems and the technologies were only used for limited purposes in long-term health care. However, in modern days technology related to the long-term health care must be managed properly in order to get the most of it. The cost related to the implementation must be managed carefully in order to facilitate patients, clients and other who needs care or support. An additional cost is required in order to hire staff members that can maintain and use the technology and helps to provide better health care services to the patients. The set of laws and the recent performance states that the fully designed, planned and recognized care must be provided to the clients. In addition, the care that is being provided to the patients must be safe, effective and accurate. This will include the wander alarms, fall alarms, out-of-bed alarms, call systems, automatic medication dispenser and others for the patients and residents safety and security. The above mentioned resources must be managed properly and needs a better action plan to make good use of the resources. The long-term care is provided by the nurses, professional health care providers, social workers, physicians and others to the people. In fact, a number of issues related to the health care can be solved with the help of the technologies such as, MDS, RUCs, QIs, OASIS, QIS and RAPs. The bills must be collected via electronic machines in order to get on time payments but still there are not enough resources to utilize this technology. The change is expected because the laws regarding the healthcare technology implementation are changing frequently, that will bring many solutions and fulfill numerous needs that are still not satisfied. The factor that is controlled by the organizations is to select the correct technology to get the most of it. c. Methods We have comprehensive stated systematically, the current technological acquisition and usage of these long term care information technology services in the United States and United Kingdom. All the statistical figures were quoted directly from journals, articles and case studies carried out by researcher in this domain. d. Results The research was divided into three sections. The first stage was comprised of statistical information extracted from surveys along with some misconception about long term care in the United States. The second section comprises of detailed review on technological devices integrated with long term health care services. The third section highlighted the challenges and pitfalls along with an implementation strategy for health informations. V. Conclusion In the introductory paragraphs of the report, we comprehensively discussed the history, trends, statistical figures, values and percentages extracted from different reports and surveys associated with long term care and the role of Information technology. Moreover, we have also backed arguments and statements by adding valuable comments of experienced senior management professionals associated with this field. Moreover, after defining the goal, we have discussed a comprehensive literature review of long term care in association with health informatics. Likewise, the literature review started by discussing the misconception of long term care in the U.S alone. Moreover, different healthcare projects were discussed providing long term care health care services to the patients, as most of these projects were started in 2006-07, giving a boost to this sector. The review also throws light on numerous IT enables services, applications, tools and techniques. Likewise, these techniques were utilized for monitoring blood pressure levels, sugar levels and various other values depending on the disease a patient is suffering from. Furthermore, tele-health system functionality, treatment of Alzheimers disease is also discussed in detail. In addition, electronic medical records are also discussed along with their benefits in accordance with long term care. After the review, challenges and constraints for implementing, maintaining and monitoring IT enabled health care services are discussed. VI. Recommendations A more effective way of deploying health care services is to introduce a mobile health care system that will address the need of every patient seeking health care. As mobile phone devices can be used to continuously monitor health conditions and most importantly it is a cost effective solution. Moreover, there is a requirement of constructing an electronic health care infrastructure at a federal or government level that will be integrated with companies providing mobile phone services. However, apart from the infrastructure there will still be a requirement of connecting the mobile device with special health monitoring devices that will acquire the information required by the health care staff. This may result in funding and the subsidiary of the government of the respected country. Annotated Bibliography 1. Andrews, J. (2011). Unbeatable combination. McKnights Long-Term Care News, 32(12), SF1-SF3. This article addresses on some of the long term care providers located in the United States and have successfully implemented health care services for enhancing interactive care for long term care patients. 2. Bradbury, P. (2008). Improving care for patients with long-term conditions through the use of technology. Journal of Care Services Management, 2(4), 309-314. This journal demonstrated enhancement in healthcare services for long term conditions of the patients. Moreover, a comprehensive integration of IT within health care services is discussed along with inputs by experienced healthcare professionals. 3. Gibson, B. E., Upshur, R. E. G., Young, N. L., & McKeever, P. (2007). Disability, technology, and place: Social and ethical implications of long-term dependency on medical devices. Ethics, Place & Environment, 10(1), 7-28. doi:10.1080/13668790601150685 This article contributed to challenges that can be faced by implementing advanced technogical devices to the patients requiring long term care. 4. Goldwater, J., & Harris, Y. (2011). Using technology to enhance the aging experience: A market analysis of existing technologies. Ageing International, 36(1), 5-28. This journal focuses on person-centered care that offers tremendous promise to improve both the quality and efficiency of care. It also added unique features in the review, empowered by IT in long term care settings. Likewise, for supporting these features, IT drives care coordination, enhancing access, and empowering residents within the nursing home setting while also offering vehicles to provide needed services in home and community-based settings. Moreover, Electronic health records can be used to increase efficiency, support care coordination, and provide caregivers timely access to information at any time or location 5. Long-term livings survey of technology usage.(2011). Long-Term Living: For the Continuing Care Professional, 60(7), 65-65. This journal article was selected to share statistics, figures and values for providing an overview to the reader about technology utilized in this domain. 6. Mason, C. A. (2006). Using technology to improve delivery of care. Generations, 29(4), 70-72. This journal also contributed to demonstrate ways of enhancing healthcare services from Information Technology based services. 7. OATWAY, D. (2011). Actively managing technology: Create a plan for implementation. Long-Term Living: For the Continuing Care Professional, 60(1), 40-41. This article journal demonstrated deployment of these long term health care Information Technology services and their long term maintenance, in order to provide seamless healthcare services. The objective is to inform the reader about the monitoring and maintenance phase of these IT enabled services is absolutely critical. 8. Pasupathy, K. ". (2006). Knowledge management in long-term care: What you need to know. Nursing Homes: Long Term Care Management, 55(7), 18. This article added another dimension to the review, as knowledge management for IT enabled systems in the long term care is discussed in detail. 9. Robinson, F. (2011). Incentivising wellness for long-term conditions. Practice Nurse, 41(6), 9-12. This journal article focuses on a need of upgrading the infrastructure of the NHS and keeping it up to date in order to provide and support advanced long term health services along with maintaining better working standards. 10. Williamson, J. E. (2012). Quality care at hand. McKnights Long-Term Care News, 33(1), 36-38. This article demonstrated the importance of handheld computing devices that are utilized by long term care operators. Likewise, these devices facilitate operators to quickly capture critical health data at the point of care along with staying portable. This article contributed to the concept of integration of IT with long term care. Read More