U of Missouri builds integrated EHR for long-term care

There are inpatient EMRs, ambulatory EMRs and EMRs for home health, but for some reason, we don't hear too much about EMRs for long-term care. University of Missouri researchers, representing the Sinclair School of Nursing, University Hospital, School of Medicine and College of Engineering, are trying to prove the value of EMRs and EHRs in long-term care by building a system that will integrate traditional clinical information systems with data from "passive" patient monitors to help improve nursing care coordination and reduce costs for the rapidly aging population.

In a paper published in the Journal of Gerontological Nursing, the research team report on their development of a comprehensive EHR at TigerPlace, an independent-living facility for seniors in Columbia, Mo., that's partly owned by the nursing school. "The key to continued function and independence is to identify problems (e.g., acute illness, exacerbation of chronic illness) earlier and offer timely interventions designed to improve functional decline," they write. "This kind of monitoring could be accomplished with diligent and consistent human observation; however, for the majority of older adults in the United States, this is neither feasible nor cost effective and could be viewed as undesirably intrusive.

"Technology, in the form of sensor networks, offers an alternative approach that may be more feasible, more cost effective, and less intrusive."

An unidentified commercial EHR was installed when TigerPlace opened in 2004, but users had to manually record standardized assessments, and often just skipped the process. The university built its own database to integrate data from patient monitors and sensors. "No one system met all of the needs of the interdisciplinary research and healthcare teams," the paper says. But that may be changing.

"New technologies to passively monitor older adults' health are being developed and are increasingly commercially available," Marilyn Rantz, professor in the MU Sinclair School of Nursing, says, according to Healthcare IT News. "The challenge remains to integrate clinical information systems with passive monitoring data, especially in long-term care and home health settings, in order to improve clinical decision making and ensure patient records are complete."

To learn more:
- check out this story in McKnight's Long Term Care News
- see this Healthcare IT News article
- read the full study from the Journal of Gerontological Nursing (.pdf)

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