The care requirements for skilled nursing facilities continue to expand. Hospitals are increasingly only expected to treat a condition that is severely acute. Once this is done, patients are then taken to a facility where their care is more cost-effective.
This has resulted in skilled nursing facilities providing care for patients who are increasingly more frail and can require complicated care. The number of patients having over eight comorbidities in skilled nursing facilities has increased to more than 86 percent over the past few years. Patients having significant or a serious illness has increased over 44 percent.
Skilled nursing facilities often have paraprofessionals as a significant part of their staff. This includes registered nurses who will supervise nursing assistants. The doctors who serve a skilled nursing facility are often located off-site. These physicians may visit the facility weekly or biweekly as well as be available for telephone consultations when necessary. This is a staffing model that creates a challenging situation for a paraprofessional medical staff. These individuals become responsible for the outcomes of patients. The care required by fragile patients is often very complicated. It requires skills that are beyond the licensing limits of a paraprofessional staff. This often creates a situation where patients are regularly taken to emergency rooms of hospitals for care and assessment. This causes stress for the skilled nursing facility staff as well as the patient and hospital.
This technology has shown tremendous potential for decreasing issues associated with skilled nursing and emergency department issues. It utilizes a computer with a camera. This makes it possible to provide a live interaction between a patient or nursing assistant at a skilled nursing facility and a nurse or physician who is off-site. When it has been utilized in different situations, this technology was able to significantly decrease unnecessary patient transportation to emergency rooms at hospitals and more.
The reason many skilled nursing facilities do not have telemedicine is the perceived costs associated with purchasing the software and equipment. Many people working in the industry believe having an iPad next to a patient’s bedside with Vsee or Zoom on it is enough to provide the necessary help. A facility must also deal with various operational issues. It must have doctors and nurses willing to make themselves available to use telemedicine. The skilled nursing facility would also be required to properly document the interaction between the patient and healthcare professional. It has been suggested telemedicine may work best with physicians or nurses who are on after-hours coverage. In the long run, it will be a cost-effective tool to decrease unnecessary patient transportations and increase a patient’s access to healthcare professionals.
Telemedicine technology makes it possible for a physician to assess a patient’s situation from their home or any other location. It would make it possible for the physician to visit a skilled nursing facility if necessary to provide a patient with a specific treatment. A patient would only need to go to the emergency room at a hospital when necessary. This would significantly decrease unnecessary hospital and physician visits. Telemedicine has the potential to significantly decrease the cost of care while increasing the amount of care provided to patients.
When a skilled nursing facility is ready to use telemedicine, there are certain things it must take into consideration. The senior leadership must be convinced of the benefits to the facility associated with using telemedicine. They will then become advocates for using it. The support of senior leadership will promote the training required as well as to encourage its use and more.
This is often the most challenging barrier to overcome. It is common for the staff at a skilled nursing facility to resist change or have anxiety when it comes to using new technology. The software utilized in telemedicine is not complicated. Complying with HIPAA requirements while using telemedicine may take some time to learn. Most staff resistance can be overcome with dedicated training designed to help eliminate worries and anxiety. Once a staff learns the benefits of telemedicine; they prefer using it.
One of the first steps to implementation of telemedicine is for the senior leadership of a nursing facility to set goals that are achievable. Data should be captured to measure the goals. Making certain the clinical team is completely dedicated to using the technology and are aware of the goals is essential. Clarify if they have separate goals. The selection of hardware should be done with input from nurses, physicians as well as senior leadership. The nursing facility needs to develop policies regarding telemedicine and make them part of their current policies. Make certain step-by-step details are provided that work in conjunction with a nursing facility’s current operational process. The goal is to make it non-disruptive to the current operational and clinical process. A training program needs to be developed involving hands-on training for staff. Staff needs to be made aware of the goals and provided with necessary support tools. The effort needs to be focused on eliminating staff fears and showing them the benefits of using the new technology. There should be a trial period with some carefully selected situations. The results of the trial will show what adjustment need to be made to the procedures and processes. An event celebrating the full implementation of telemedicine could create excitement and interest in the many aspects of it.
Once the implementation of telemedicine is complete, it will be important to measure its activity. This can be done weekly as well as monthly and quarterly. The number of telemedicine visits that happen as well as any situations that makes it possible to avoid an unnecessary emergency room visit needs to be analyzed. Goals will need to be evaluated. Senior leadership will want to know if the goals are being met. Staff personnel should be asked about their perceptions of using telemedicine. This information can be used to make important adjustments to training, tasks or procedures that seem necessary. Training needs to continue. Once the staff is successful at using telemedicine; its other uses may be able to be utilized. This could include visits by medical specialists, monitoring patients remotely as well as family visits and more.
The world of skilled nursing facilities is quickly changing. Many are choosing to experience the benefits associated with using telemedicine. It has proven to successfully manage emergency room visit rates and improve patient care. Most nursing facilities are implementing telemedicine as a way to remain competitive in the market. It is now a key part of success in the industry.