As technology platforms flood the nursing home market, operators are having a hard time tuning out the noise to focus on what will actually move the needle when it comes to quality care and workforce efficiency.

No one seems to have cracked the code yet when it comes to using AI, robotics, and other tech platforms, said Efriam Weinfeld, COO for ALIYA Healthcare. He argued that it’s difficult to quantify the return on tech when there are so many other factors at play. But designing tech around the needs of users in a nursing home, involving them in the creation process and getting feedback on what type of tech platforms are making their lives easier, are all important steps in making such platforms more useful.

In other words, tech platforms have to be tailored to the specific needs of the nursing home workforce. And yet, this simple principle is absent from the many tech tools that are currently out there.

A major pitfall of these tech options is that they are too complicated, and add more hurdles for staff to jump through instead of freeing them up to be by the bedside.

“Less of more and more of use [is needed],” said Weinfeld, “Are we adding more layers or are we making our team better and more efficient at what they’re doing? Right now, I don’t see something that is paradigm shifting.”

Prominent technologies being used or tested in the nursing home space include electronic health record (EHR) optimization, remote patient monitoring, and of course all things artificial intelligence (AI), along with automation and machine learning, according to Brickyard Healthcare Chief Clinical Officer Lisa Chubb and Weinfeld, who both spoke about the promises and pitfalls of tech platforms during Skilled Nursing News’ Clinical Conference last month.

Swing and a miss

Brickyard piloted a few tech platforms that claimed to improve predictability for falls, but the uptake among staff wasn’t there as they didn’t find value in it, Chubb said. It was more akin to “alarm fatigue,” she said, a health care phrase referring to staff becoming desensitized to safety alerts, leading to the possibility of missed alarms or delayed responses.

AI in managed care is the perfect example of tech that doesn’t exactly work as intended, Weinfeld said. While good in concept, it draws the sector further away from person-centered care, he said.

“There has to be empathy in health care, with technology. Until we figure it out, abandon AI that’s determining how much care and therapy a person is getting in a facility,” said Weinfeld.

Even as the sector sees AI used in managed care – with much notoriety – Chubb expects there to be even more AI of all different types that is going to be part of risk-based strategies. 

“It’s going to put our sector in a more forward facing, proactive care model of care,” said Chubb. Automation and platforms focused on interoperability will be huge, she added.

Indiana-based Brickyard operates 23 nursing homes across that state.

What’s working?

Brickyard, meanwhile, has been using AI in electronic health records to summarize data in one spot, enhancing nurse-physician communication.

MDS scrubbers and survey tools have been useful too, Chubb said.

Moreover, Brickyard is working out the kinks in remote nurse support, and figuring out what can be done remotely and what needs to be done in the building. The operator is continuing to build teams of remote support nurses and regional nurses that go into the buildings.

And use of tech platforms has led to reduced rehospitalization rates by 10%. Brickyard used a multifaceted approach to curbing rehospitalizations by adding remote patient monitoring and predictive analytics – risk assessment tools that are all different depending on if it’s the EHR or medical provider.

Still, while Brickyard was able to measure the improvement in its rehospitalizations rate, the organization was unable to pin the success to any one tool or process.

“When it comes to ROI, especially clinically, it’s soft ROI. It’s going to be quality of care and regulatory outcomes, a decrease in rehospitalizations,” said Chubb.

As for ALIYA, it has focused on AI to determine gaps in documentation, with a sidebar popping up for staff to fix the gaps when documenting clinical care, Weinfeld said.

The operator is relatively new to the skilled nursing sector, being founded about two years ago, and operates 13 properties across Illinois.

ALIYA’s choice of tech is based on bedside needs, and what can improve bedside care. That being said, it was hard to pinpoint when tech was improving a certain metric, Weinfeld said.

“How do you determine return on investment and actual effectiveness when there are so many other factors? It’s hard to separate what actually contributed to, say, a decrease in falls. It could be remote patient monitoring, or because the patient mix changed,” he said.

Or, it could simply be the right person, the right systems and protocols, and the right workflows around a certain incident, Weinfeld said.