Inside the Balancing Act of Personal Technology Use Among Nursing Home Staff

Managing personal technology devices is a common concern among staff at businesses across the nation, and nursing homes are no exception.

While policies for personal technology use at nursing home organizations run the gamut – from completely restricting cell phone use to limited use to even encouraging use among employees – nursing homes have had to evolve in this regard as they attempt to balance privacy concerns with benefits for staff wellbeing, and ultimately retention rates.

A large concern for nursing home operators is the potential for violations of HIPAA, the Health Insurance Portability and Accountability Act, which aims to protect patient data and information and prevent breaches of patient privacy. Yet for many healthcare workers, using phones is part of the job — for communicating internally and accessing information.

Operators told SNN that striking the balance between using phones effectively and protecting patient privacy is key.

Stuart Almer, the CEO of Gurwin Healthcare System, is one leader whose organization shifted its approach to allow skilled nursing staff to use personal technology during the pandemic, and discovered some advantages.

Acknowledging the importance of maintaining a balance between technology and resident care, Almer emphasized the need for flexibility, particularly given the generational differences and increased reliance on cell phones in today’s workforce.

New York-based Gurwin Healthcare System is a non-profit which operates skilled nursing, assisted and independent living facilities across the state.

In general, Almer said, there is a restriction on the use of personal devices, with a particular emphasis on ensuring that technology, such as cell phones, was not used when staff members were interacting with residents.

Balancing act: personal technology

Almer said that the changing landscape of technology and the generational differences among staff makes it imperative for organizations to accept on-the-job use of cell phones and technology in the current day.

“We have to be a little bit more flexible, as long as staff are doing things safely and appropriately,” he said.

For instance, strict guidelines were set in place for prohibiting video recording of residents, family members, or fellow staff. Gurwin also conducts regular education programs, including mandatory sessions covering topics like HIPAA, confidentiality, and the responsible use of technology, Almer said.

“We drill this very heavily among our staff,” he said. “But again, we have to be a little bit flexible, because recruiting and retaining staff is important.”

Steve LaForte, chief legal officer and EVP of Corporate Affairs at Cascadia Healthcare, which has 46 locations across six states, said that most employees understand how to use technology reasonably well – but monitoring that every employee is on the right device when you have a large workforce is an area operators need to put effort into.

“When you have a big workforce, [making sure] everybody is using the approved device, and that they’re not violating HIPAA on a personal device that they’ve carried over [is key],” LaForte said.

LaForte said for the most part, floor staff are prohibited from using personal devices, although there are some exceptions.

Meanwhile, Gurwin Healthcare implemented its own platform called Beekeeper to facilitate effective communication within the organization, Almer said. The platform served as a channel for important updates, policies, benefits, and general announcements aimed at keeping staff informed.

Almer noted that staff members could access Beekeeper on their cell phones for work-related purposes, blurring the lines between professional and personal use.

“We now expected not to have to necessarily question staff to ask, ‘Why are you on your phone?” he said. “Now, [they] are almost encouraged to be on [their phones] so that they’re communicating and receiving information. So that was a very, very important time of communication, on use as a Beekeeper.”

While management was tasked with monitoring these activities, the organization recognized the need to be mindful of the evolving technological landscape and maintain a balanced and flexible approach to address the unique challenges facing the industry. According to Almer, this approach proved effective, underscoring the importance of adaptability.

Almer said that the implementation of Beekeeper marked a significant shift toward interactive communication among all staff members across the Gurwin system. This change in communication dynamics led to an expectation that staff members would use their phones not only without question but, in fact, feel encouraged to do so.

“You know, when there’s a holiday celebration, and we can send out pictures to staff and thank them, that just goes a long way,” Almer said. “So it’s very, very good for good communications with our staff. And we encourage them to be utilizing it so the more we encourage the more people will be on their phones.”

Guidelines and education: safeguarding responsible tech use

As the organization grappled with a staffing crisis over the past couple of years, Almer acknowledged the need for increased flexibility for staff to use phones – even beyond Beekeeper. He recognized that the original purpose of the application, as a highly interactive platform, evolved into one primarily disseminating information to staff.

During this challenging period, Almer emphasized the importance of being a compassionate employer, understanding the difficulties faced by individuals both professionally and personally.

“That was another time to say okay, the platform we were using isn’t as interactive,” he said. “It’s more just information we provide to staff now. But we have to be a little bit more flexible because we know the labor market is tough, and individuals are also very stressed in their personal lives. Work is hard. And so if we can be a good, kind employer and be a little more flexible here, that goes a long way with our staff.”

That said, Almer said that Gurwin is constantly evaluating technology needs as they shift.

“[Staff use of technology is] evolving as all of our technology needs are,” he said. “You know, we’re all evaluating artificial intelligence and robotics. So, it’s important to always be looking at what else we can do differently.”

Mindy Shapiro, chief compliance officer at American Senior Communities, said that oftentimes, staff will use phones with good intentions, but need to be made aware of the potential risks. As an example, Shapiro shared that the well-intentioned use of videos made by staff on personal devices could lead to compromising a patient’s privacy. Videos on a day in the life of a CNA might capture a resident in the background or even in an interview, without staff getting patient consent before putting them on video call.

And this led to a policy not favored by staff.

“It happens all the time,” she said. “I’ve had our hospital partner ask me to have everyone collect cell phones and not allow them on the floor, which is not very popular for a lot of reasons.”