Getting ready for HCFA's software mandate - Health Care Financing Adminstration - Conference Call - Interview

Nursing Homes, Jan-Feb, 1994

Oatway: This sort of commitment is spreading. We have seen, in our own experience with nursing homes, a tremendous improvement in quality of care over the past five years. There is almost no comparison to where they were 15 or 20 years ago.

From all of your comments so far, it would seem that a facility needs a smooth working relationship with its software vendor to successfully computerize the MDS. What do you think it takes to develop such a relationship?

Dooner: Where we used to have a customer-vendor relationship, we now have a partnership. Not only is the vendor trying to make a profit, the vendor these days is trying to help the facility improve quality of care. An important first step toward developing that partnership is for the organization's leaders to actually visit the vendor's corporate offices and get to know the vendor's staff and work together to meet common goals and objectives.

Decker: I agree wholeheartedly with that. We realize that facilities need assistance from us in understanding their problems long before we attempt to help them develop a solution to these problems. One of our advantages at American Healthcare is that we have a sister company that owns and manages a chain of nursing homes and provides management services to the industry.

Roland: At Genesis, before any purchase is made, we develop an implementation plan with the nursing home involving all relevant disciplines. Furthermore, we ask the nursing home to designate a staff member to act as the "project manager," facilitating communication between the us and the facility. This has worked out very well.

Oatway: I agree that this approach is important, although it has to be geared differently for different-sized facilities. The larger chains may already have a Medical Information Systems department; for the smaller ones, we serve as the MIS.

Harris: As someone who visits and works with facilities on a regular basis, I see it as a basic function to make sure that everyone understands each other's expectations. They have to be alike, otherwise you'll have a rocky road. The first thing for the vendor is to understand what the customer expects and wants. For example, nurses often have concerns about getting involved with computers. They'll point out that they are not typists, and they're definitely not data entry people; they're caregivers. To get them over this "bump" in implementation, they need someone who can focus them on the end results of this effort, so that they can understand the benefits to resident care. This is one reason why a close collaboration between vendor and facility is so important. What are some future developments you foresee in the area of nursing home software?

Roland: I foresee a wide variety of experimental items appearing in the mid-90s -- handheld bedside computers, computerized medication carts, and so forth. However, we learned something when we experimented with voice recognition in the mid-1980s. We discovered that the nursing home environment is not particularly conducive to technological experimentation. Equipment costs are high, and the budgets just aren't there.