AI and predictive analytic tools can help operators improve clinical care, reduce staff workloads, and identify future health issues earlier. But operators must support staff without adding complexity to their operations to make them work.
Tech partners and in-house platforms can help nursing home operators avoid unapproved technologies that could expose a facility to HIPAA concerns.
Leaders with Trilogy Health Services have built the operator’s AI technology around predictive analytics, Trilogy’s SVP and Chief Nursing Officer Rhonda Dempsey told Skilled Nursing News on stage at SNN’s ReThink conference held in Philadelphia this week. It’s a tool to help with clinical workflow, reduce burdens and help direct care staff spend more time with residents while also identifying quality issues.
Dempsey and Barbara Revelette, chief nursing officer for Louisville, Kentucky-based operator Signature HealthCARE, discussed AI in the clinical setting as part of the panel. Signature operates 69 locations across five states, while Trilogy, also based on Louisville, operates 140-plus senior living communities.
Dempsey said she prefers to find out if a medical event is about to happen, instead of realizing it has already happened. High-risk residents who Trilogy is more likely to rehospitalize wear a 24-hour monitoring device on their chest that helps anticipate their needs. The device has helped reduce hospitalizations by 60%, she said.
“We track it every week, it’s on about 300 residents right now,” said Dempsey. “When their temperature goes up two degrees above their baseline and sustains for about an hour, the nurse gets the alert, goes down and assesses the resident, and calls the practitioner.”
Without the tech, the nurses would likely get the warning when the resident has already become septic and need to go to the hospital.
Signature’s virtual sitter program
Signature also uses AI to detect early warning signs, Revelette said. The company’s team won a state grant in Tennessee to put fall-prevention technology in its facilities for and automatically document activities of daily living into its system.
“We implemented CareAI initially into four facilities. It detects movement on the residents … it has some machine learning with it, where it determines movement of the resident and notification to the staff members,” said Revelette.
Clinical teams notched an 80% decrease in falls in the buildings where fall prevention AI was implemented. The operator’s team has since expanded the tech to 20 buildings.
Revelette called the ambient monitoring system a “virtual sitter program” that can watch between eight to 10 residents virtually. These sitters can press a button and talk to the residents or staff no matter what state they’re in, if they get an alert that a resident is trying to get up.
“It’s a live person right now,” Revelette said of the sitter program. “It’s got AI and ambient monitoring built into it. Our virtual sitters sit in Louisville, Kentucky, and they may be monitoring residents in Tennessee. They’ll pick up the phone and call the nurse and say ‘Betty’s trying to get out of bed. Could you go to her room?’ We also use that for behavioral monitoring.”
Families have requested to put their loved ones on the program, especially if they recently returned from the hospital. Family members can use the monitoring system too, with conference call capabilities between the doctor, family member, sitter and resident.
Overall, there’s a lot of enhancements a year into the program, and Signature is still adding features. There’s a lot of capability there, Revelette said, that the team hasn’t tapped into yet but it’s in the works.
“I’d encourage everyone to explore AI,” said Revelette. “AI really can do a lot and decrease the burden of care from the nurse and be able to allow that stakeholder to have more time with the residents and actually take care of their needs, versus dealing with the documentation.”
AI must support caregiver needs, auditor concerns
While nurses do complain of change, they’re talking to each other and they’re hearing that these platforms work, said Dempsey. It’s a one-shot deal to get direct care staff on board as a result.
“And, it all must directly relate to what someone is doing at the facility. It has to take away tasks from the caregivers. It has to be able to enhance their work and improve quality care,” said Dempsey. “If it doesn’t work up front, nurses just walk away.”
Ensuring technology companies are partners instead of just a supplier or vendor is important because it helps leaders secure buy-in from the staff at the building, added Dempsey.
And it stops staff from coming up with their own solutions, possibly opening the built up to HIPAA violations.
“They’re going to figure out a way to use some kind of tool to help them,” said Dempsey. “If you don’t figure out a way to give them tools to make their job easier, they’re going to use technology that’s going to put your company at risk.”
When it comes to using AI for clinical documentation, Signature employs tech to figure out what’s missing and pull together dashboards in one place for review. It’s easier to pull up needed data when auditors all ask for different data components, she said.
Documentation specialists, with the help of AI, are needed to keep up with auditor demands, Revelette and Dempsey said.
“I feel like we over document just to make sure we can satisfy every possible auditor that could walk in our building,” added Dempsey. “It’s not necessarily required regulatory wise, but we want all the cushion possible built into the system so that we pass any type of audit and ensure that we have every piece covered.”
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