Posted: September 20th, 2022

Assignment Content Question 1: In this week’s short assignment, in at least 250 words: After reading chapter 19, what do you think are some challenges to be faced in the near future? Alternatively, you can answer using points/bullets instead of an

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Assignment Content

Question 1:

In this week’s short assignment, in at least 250 words:

After reading chapter 19, what do you think are  some  challenges to be faced in the near future? 

Alternatively, you can answer using points/bullets instead of an esay.

Please remember to cite and reference your sources using the APA format.

Course Materials: Pratt. J. Long-Term Care- Managing Across the Continuum. 4th edition. Jones and Bartlett ISBN: 978-1-284-05459-0. 

Chapter 19
Into the Future:
Trends To Watch

Learning Objectives
Understand the forces that have brought the long-term care system to its current state
Identify ways in which the challenges have been met and to what degree
Identify challenges that have not been met

Learning Objectives (continued)
4. Identify changes that have been brought on by the solutions to earlier challenges
5. Identify the trends that will affect the long-term care system in the future

Challenges Met
Consumer desire for higher quality of life has led to new, innovative forms of care
Integration has improved effectiveness and efficiency of care
Consumers now have much more say
in their care
Culture change movement has grown

New Challenges Created
by Old Solutions
Desire for cost-effectiveness helped create managed care with improved efficiency, but it created quality and service complaints
Integration improved services and efficiency; some providers haven’t survived
New, consumer-friendly services have created additional demand

Challenges Not Met
System is still reimbursement-driven
Accessibility is not universal
System is highly fragmented and
“user-unfriendly”
The number of elderly is growing faster than the system’s ability to meet their needs

Trends to Watch
Changing consumer demographics
The aging of society
Increase in chronic conditions
Greater cultural and ethnic diversity
A consumer-driven system
Focus on quality and outcomes
Quality of care
Patient safety
Quality of life

More Trends to Watch
Changes in the workforce
Growth in demand
Aging of the workforce
Staff shortages
Blending of professional roles
Changes in organization and delivery
Toward a seamless system of care
Consumer-directed care
Technological advances

Even More Trends to Watch
More and better clinical applications
Innovative delivery methods
Special care units
Informal caregivers
New organizational relationships
Among providers
Between providers and payers
Institutional to noninstitutional care
Efficiency

Still More Trends to Watch
Changes in financing and reimbursement
Increase in overall healthcare spending
Decrease in employer-sponsored insurance
Public payers continue to struggle
Providers continue to struggle
Innovative financing
Public/private partnerships

Still More Trends to Watch
Ethical dilemmas
Life-and-death issues
Allocation of resources
Regulation
Health system reform

Summary
The long-term care system is constantly changing, and each change – even if in one small segment – is soon felt throughout the system. These changes will continue and will present both challenges and opportunities for all involved.

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Long-Term Care: Managing Across the Continuum, Fourth Edition
John R. Pratt

  • CHAPTER NINETEEN: INTO THE FUTURE: TRENDS TO WATCH
  • CHAPTER HIGHLIGHTS
  • Introduction – the field of long-term care has gone through, and is still experiencing, a time of

    great change.

     Some challenges have been met, at least in part.

     The desire of consumers to receive care in the most appropriate setting and the desire

    for a high quality of life have led to development of more and better alternative

    services.

     Institutional care providers have done much to make their facilities more homelike

    and conducive to a high quality of life.

     Integrated health services and networks have affected how care is delivered, the cost

    of delivering it, and the way it is used by consumers.

     There has been progress in allowing consumers to have more say in their

    care.

     We have also seen a move toward “culture change – supporting the creation of

    environments where residents and their caregivers are able to express choice and

    practice self-determination in meaningful ways at every level of daily life.

     Some of the solutions created new challenges.

     As government and private corporations began to experience health care expenses

    beyond their ability to cover, they found relief in the form of managed care.

     The rise of managed care presented the long-term care system with other problems:

     Providers have had to pay much more attention to cost-effectiveness while trying

    to maintain high quality.

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     They have had to face complaints that managed care organizations (MCOs) put

    cost savings ahead of choice or quality.

     Integration of services has been a positive step overall, but it has been fatal for some

    providers.

     Creation of new services has created additional demand.

     Other challenges of the recent past still show little, if any, resolution.

     The long-term care system is still essentially reimbursement driven.

     The services received depend somewhat on the reimbursement available.

     There is still more demand for service than there is money to pay for it.

     Access to and availability of long-term care services continue to be areas of

    shortcoming.

     Services are not distributed equitably for a variety of reasons.

  • Future Directions – where the system is likely going and why.
  •  Changing Consumer Demographics – the demographics of long-term care consumers

    have been changing faster than the system has been able to adjust.

     The Aging of Society

     The growth in the number of elderly will be a driving influence on the system for

    years to come.

     The number of elderly (65+) is projected to mushroom to 70 million by the

    year 2030 – nearly twice what it is today.

     The group who are 85 and older will increase by at least four fold.

     They are living longer for a number of reasons and will continue to do so.

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     The longer life is due, in large part, to the improved quality of the medical care

    they have received.

     Many of the diseases that killed people as children or as young adults have

    been effectively eradicated.

     Two of the greatest killers in recent years – heart disease and cancer – have

    declined.

     Longer life can also be attributed to changes in people’s lifestyles.

     A third reason for the growth in numbers of elderly is the aging of the baby

    boomers

     Their impact over the next couple of decades will be more significant than any

    other population cohort seen to date.

     They are more likely to be open to better education about the system and

    learning how to use it wisely.

     The impact of the aging of society on long-term care, will be twofold.

     It will extend the time over which the elderly will require long-term care

    services.

     The elderly will continue to use acute care services, but not significantly more

    than at present.

     The need for acute services will simply come at a later age.

     Long-term care may be needed for many years.

     Increase in Chronic Conditions

     There will be an increase in chronic conditions as society ages.

     By 2030 half the population will have one or more chronic conditions.

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     The number of people with chronic conditions increases dramatically with age.

     There will be an increase in “new” diseases – actually, existing diseases with new

    prominence: Alzheimer’s disease, macular degeneration, osteoarthritis,

    osteoporosis, dementia, cardiovascular disease, and diabetes.

     Greater Cultural/Ethnic Diversity – long-term care consumers are also changing in

    terms of their cultural, racial and ethnic backgrounds.

     They bring with them different languages, cultural practices, and some unfamiliar

    diseases.

     Cultural diversity is also bringing a need for providers to be more sensitive to

    different cultural practices.

     Diseases that have been largely eradicated in the U.S., such as polio and tuberculosis,

    have begun to appear as people emigrated from other parts of the world.

     A Consumer-Driven System – the most important descriptor of the future health care

    system is that it will be a system that is consumer-driven.

     Consumers of tomorrow will demand more choice in both the care they receive and in

    how their dollars are spent.

     Consumers of tomorrow will be better educated and informed than those of the recent

    past.

     They will be better able to make choices.

     They will have more disposable income. Because they will be more conscious that

    they are paying for their care, either directly or indirectly, consumers will want the

    ability to shop around.

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     People who have adapted their lifestyles over the course of many years will want to

    continue those lifestyles as much as possible in their later years.

     They will look for care that is flexible and adaptable to their particular lifestyles, even

    extending to alternative medicine and self-care.

     Providers and payers will need to accommodate their desires.

    Focus on Quality and Outcomes – consumers of long-term care are learning how to judge

    quality as it pertains to them and will continue to as they become better informed. They will

    judge the system and its providers by how they are affected.

     Quality – Quality concerns fall into three distinct but related categories:

     Quality of Care – consumers are concerned about the quality of care they receive.

     Studies have shown that quality of care is not equitable across the U.S.

     The ongoing media hype focusing on examples of poor care raises concerns.

     The frequent number of lawsuits in the news, and concerns about the effects of

    cost-cutting cause consumers to have their doubts about quality of care.

     Patient Safety – patient safety will assume new prominence, both in acute care and in

    long-term care.

     As consumers learn to demand more of a role in their care, they will become less

    and less forgiving of clinical errors or lapses in care.

     Payers will continue to insist on fewer errors.

     Providers have more tools to work with, such as technology which can help them

    collect and manage relevant information to avoid errors.

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     The government has taken several steps to ensure safety, including requiring that

    all skilled nursing facilities have sprinklers as part of their fire prevention and

    control systems.

     A new concern for long-term care – at least newly realized – has come about

    because of the damage caused in recent years by hurricanes such as Katrina and

    Rita.

     Quality of Life – Quality of life will assume a high priority with tomorrow’s long-

    term care consumers.

     They want care that is either provided in their homes or in surroundings and in a

    manner that is as close to home as possible.

     Institutional providers have responded with amenities such as ala carte menus,

    home-like living settings, and flexible treatment regimens.

     Other adaptations include more flexible outpatient care, and remote monitoring

    and safety call systems that allow more of them to actually stay in their homes.

     Consumers want more control of their lives and are willing to look around until

    they find it.

    Outcomes – Payers and regulators are beginning to understand outcomes measurement and

    will rely on it more in the future.

     They have previously focused primarily on process and structure, not outcomes. Both

    government regulators and private accreditation agencies are moving toward outcomes-

    based quality measurement systems

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     They will gradually move from judging how care is delivered to assessing it based on

    what it accomplishes.

    Changes in the Workforce – The long-term care workforce will change dramatically in the

    future. The trends to watch in relation to the workforce are:

     Growth in Demand – Health care (including long-term care) is already one of the largest

    and fastest-growing occupations.

     Aging of the Workforce – The workforce is getting older, paralleling the aging of society

    in general.

     Many of them are baby boomers since that is the largest age cohort we have.

     The post-baby boomers are a smaller group, providing fewer people for the

    workforce.

     Staff Shortages – we are facing a serious shortage of staff to care for the growing number

    of elderly needing care.

     Blending of Professional Roles – If the kind of changes in organization and delivery that

    are foreseen here are going to be accomplished there will have to be some breaking down

    of the artificial barriers created by health care professionals.

     This means moving from the traditional medical model toward more of a holistic

    model of care.

    Changes in the Organization & Delivery of Long-Term Care – There will be many changes in

    the way long-term care is organized and delivered in the future. No single delivery system is

    likely to emerge as the one best system

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     Toward a Seamless System of Care – There is already significant movement toward a

    more seamless system of care.

     Increased demand and strain on resources that are already stretched to the

    breaking point will continue to emphasize efficiency.

     The demands of consumers for more choices in the types of care available to them

    will lead to a continuum that is more user-friendly, reducing much of the

    fragmentation and confusion that exists today.

     One of the most important elements of a seamless system of care is the melding of

    what are now essentially separate systems of health care and social support

    services.

     The degree to which the system of care becomes seamless will depend on

    advances in technology

     Consumer-Directed Care – consumers of the various forms of long-term care will

    expect to direct their own care as much as possible.

     A 2008 Medicaid rule permits Medicaid recipients to self–direct their own health

    care and supportive services.

     New Living/Housing Options – , long-term care providers have made significant

    strides toward meeting the needs of consumers for convenient, homelike living

    situations.

     Cohousing

     Small house design

     Sustainable Design Practices

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     Improved and Enhanced Amenities

    Technological Advances – perhaps the most significant and unpredictable factor in determining

    the shape of health care in the future will be the continued explosion in technology.

     Providers may find it difficult to keep up with the rapid changes in technology,

     Technology will also dominate how the health care system is organized and managed.

     Consumers will need to be provided with information accessible through technology.

     Future consumers are familiar with the use of technology.

    More & Better Clinical Applications – over the next decade or two, there will be new clinical

    procedures that we cannot even begin to imagine today.

    Innovative Delivery Methods – coming decades will see a continuation and escalation of the

    changes that have occurred lately in how care is delivered.

     . New forms of care, changes in assessment methods and care planning, and efforts to

    become more consumer oriented have all improved the lot of the consumer of long-term

    care.

     Special Care Units – there will be an increase in special care units designed to treat

    people needing highly specialized care.

     Informal Caregivers – the long-term care system will (finally) find ways to make

    better use of informal caregivers.

    New Organizational Relationships – in trying to secure their share of a particular market, long-

    term care providers will find many new and innovative ways to deliver care.

     Among Providers – integrated care systems will dominate because they will have the

    ability to provide more of the seamless system of

    care

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     There will be a move toward “niche” marketing.

     Providers of different types and levels of long-term care services will get together

    to meet consumer needs.

     There will be more internal organization along the lines of strategic business

    units.

     Between Providers and Payers – providers will find new ways to work more closely in

    partnerships with payers.

     Both care management and case management will continue to grow.

     Institutional to Non-Institutional Care – the shift that has been taking place from

    institutional to community-based or noninstitutional care will continue.

     Efficiency – we will see delivery methods that are more efficient—that are more

    responsive to the needs of consumers—without significant loss of quality.

     Providers will utilize technology to increase efficiency.

     These changes will not take place easily if not properly supported by regulators

    and payers, especially the federal government.

    Changes in Financing & Reimbursement – the critical role financing plays in the delivery of

    long-term care will not only continue, but will intensify.

     Overall Spending on Health Care Increasing – both public and private reimbursement

    sources will find it difficult to keep up.

     Decrease in Employer-Sponsored Insurance – employers are also trying to reduce

    costs, particularly in the recent economic situation.

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     Public Payers Continue to Struggle – government payment sources are also finding it

    difficult to survive.

     Medicare is threatened with insolvency.

     Medicaid is one of the largest costs for state governments.

     They will continue to use managed care.

     Providers Continue to Struggle – due in part to the difficulties their most significant

    payer sources are having.

     Innovative Financing – the future will also bring innovations in health care financing.

     The current trend toward capitation and other prepaid group contracts will continue

    and grow.

     Prospective payment will become the dominant form of payment for long-term care

    providers.

     We can expect a significant expansion of pay-for-performance initiatives

     Public/Private Partnerships – the key to future financing of the health care system may

    well be public-private partnerships.

    Ethical Dilemmas – both the number and scope of ethical issues that will arise and need to be

    resolved will increase.

     Life and Death Issues – clinical advances have created additional issues concerning life

    and death.

     We can extend life much longer than before

     The issues involve:

     Balancing extended life with quality of life

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     Balancing needs of consumers and providers (not making providers provide care

    not in keeping with their own beliefs)

     As providers join integrated health systems, there may be a clash in values.

     Allocation of Resources

     Shortage of resources increases the difficulty of allocating them fairly

     That may involve having to provide services that are not financially viable in order to

    meet the needs of consumers.

     The Affordable Care Act calls for greatly extending coverage.

  • Regulation – will definitely increase.
  •  Regulation of Quality

     Regulation of cost

  • Health System Reform – the fragmented system needs reform, primarily financing reform.
  •  Government Involvement

     How much or how little?

     Most Americans want government to pay more, but do not want them to run health

    care

     The Obama administration achieved passage of the Affordable Care Act (ACA).

    Only time will tell how it work out.

    © 2015 Jones and Bartlett Publishers, LLC 12

      CHAPTER NINETEEN: INTO THE FUTURE: TRENDS TO WATCH

      CHAPTER HIGHLIGHTS

    • Introduction – the field of long-term care has gone through, and is still experiencing, a time of great change.
    • Future Directions – where the system is likely going and why.

    • Changing Consumer Demographics – the demographics of long-term care consumers have been changing faster than the system has been able to adjust.
    • The Aging of Society

      The growth in the number of elderly will be a driving influence on the system for years to come.

      Increase in Chronic Conditions

      Greater Cultural/Ethnic Diversity – long-term care consumers are also changing in terms of their cultural, racial and ethnic backgrounds.

      A Consumer-Driven System – the most important descriptor of the future health care system is that it will be a system that is consumer-driven.

    • Focus on Quality and Outcomes – consumers of long-term care are learning how to judge quality as it pertains to them and will continue to as they become better informed. They will judge the system and its providers by how they are affected.
    • Quality – Quality concerns fall into three distinct but related categories:

      Quality of Care – consumers are concerned about the quality of care they receive.

      Studies have shown that quality of care is not equitable across the U.S.

      Patient Safety – patient safety will assume new prominence, both in acute care and in long-term care.

      Quality of Life – Quality of life will assume a high priority with tomorrow’s long-term care consumers.

      Outcomes – Payers and regulators are beginning to understand outcomes measurement and will rely on it more in the future.

      They have previously focused primarily on process and structure, not outcomes. Both government regulators and private accreditation agencies are moving toward outcomes-based quality measurement systems

      They will gradually move from judging how care is delivered to assessing it based on what it accomplishes.

    • Changes in the Workforce – The long-term care workforce will change dramatically in the future. The trends to watch in relation to the workforce are:
    • Growth in Demand – Health care (including long-term care) is already one of the largest and fastest-growing occupations.

      Aging of the Workforce – The workforce is getting older, paralleling the aging of society in general.

      Many of them are baby boomers since that is the largest age cohort we have.

      The post-baby boomers are a smaller group, providing fewer people for the workforce.

      Staff Shortages – we are facing a serious shortage of staff to care for the growing number of elderly needing care.

      Blending of Professional Roles – If the kind of changes in organization and delivery that are foreseen here are going to be accomplished there will have to be some breaking down of the artificial barriers created by health care professionals.

      This means moving from the traditional medical model toward more of a holistic model of care.

    • Changes in the Organization & Delivery of Long-Term Care – There will be many changes in the way long-term care is organized and delivered in the future. No single delivery system is likely to emerge as the one best system
    • Toward a Seamless System of Care – There is already significant movement toward a more seamless system of care.

      Consumer-Directed Care – consumers of the various forms of long-term care will expect to direct their own care as much as possible.

    • Technological Advances – perhaps the most significant and unpredictable factor in determining the shape of health care in the future will be the continued explosion in technology.
    • More & Better Clinical Applications – over the next decade or two, there will be new clinical procedures that we cannot even begin to imagine today.
    • Innovative Delivery Methods – coming decades will see a continuation and escalation of the changes that have occurred lately in how care is delivered.
    • Special Care Units – there will be an increase in special care units designed to treat people needing highly specialized care.

      Informal Caregivers – the long-term care system will (finally) find ways to make better use of informal caregivers.

      Among Providers – integrated care systems will dominate because they will have the ability to provide more of the seamless system of care

      Between Providers and Payers – providers will find new ways to work more closely in partnerships with payers.

      Institutional to Non-Institutional Care – the shift that has been taking place from institutional to community-based or noninstitutional care will continue.

      Efficiency – we will see delivery methods that are more efficient—that are more responsive to the needs of consumers—without significant loss of quality.

    • Changes in Financing & Reimbursement – the critical role financing plays in the delivery of long-term care will not only continue, but will intensify.
    • Overall Spending on Health Care Increasing – both public and private reimbursement sources will find it difficult to keep up.

      Decrease in Employer-Sponsored Insurance – employers are also trying to reduce costs, particularly in the recent economic situation.

      Public Payers Continue to Struggle – government payment sources are also finding it difficult to survive.

      Providers Continue to Struggle – due in part to the difficulties their most significant payer sources are having.

      Innovative Financing – the future will also bring innovations in health care financing.

      Public/Private Partnerships – the key to future financing of the health care system may well be public-private partnerships.

    • Ethical Dilemmas – both the number and scope of ethical issues that will arise and need to be resolved will increase.
    • Life and Death Issues – clinical advances have created additional issues concerning life and death.

      Allocation of Resources

      Regulation – will definitely increase.

      Health System Reform – the fragmented system needs reform, primarily financing reform.

    Long-Term Care: Managing Across the Continuum, Fourth Edition
    John R. Pratt

  • CHAPTER SEVENTEEN: TECHNOLOGY IN LONG-TERM CARE
  • CHAPTER HIGHLIGHTS
  • Introduction
  •  Technology is becoming ever more important to long-term care.

     The ways in which technology can be used in long-term care fall into two broad

    categories: applied technology and information technology (IT).

    Applied Technology – technology has much to offer in maintaining or improving a person’s

    functional independence. In several ways, including:

     Artificial Functioning – devices to provide assistance from wheelchairs to robots.

     Emergency Notification –panic buttons to notify when help is needed.

     Telemedicine – remote monitoring of a consumer’s condition, conferencing among

    health care professionals, and consultation with specialists.

    Information Technology – the application of certain types of technology to the collection and

    use of information.

     Includes data input, data management, and data output

     Categories of computerized information applications:

     Clinical Applications:

     Admission, Assessment, and Care Planning

     Consumer Safety

     Record Keeping

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     Quality Measurement

  • Administrative Applications:
  •  Staffing

     Financial Management

  • Strategic Support Applications
  •  Planning

     Operational Decision Making

     Performance Measurement

     Marketing

  • Networking Applications:
  •  Involvement in integrated health systems

     Coordination of information

     Patient scheduling

     Managed care contracting

  • Systemwide Applications:
  •  Electronic Health Records

     Automated patient records

     Personal health records

     Quality Measurement and Improvement

     OSCAR

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     RAI/MDS

     OASIS

     Consumer Information and Education

  • Privacy Concerns and the HIPAA
  •  One of the two major purposes of the Health Insurance Portability and Accountability

    Act (HIPAA) is to protect the privacy of consumers’ health information.

     HIPAA creates a set of national standards governing such electronic transfers to protect

    the privacy and confidentiality of consumers. These standards cover the following areas.

     Access to medical records.

     Notice of privacy practices

     Limits on use of personal medical information

     Prohibition on marketing

     Confidential communications

     Complaints.

  • Cyber Security
  •  All entities relying on computer systems must today be concerned about cyber security.

     Loss of either personal or organizational information could greatly disrupt the ability to

    provide high-quality care.

  • Benefits of IT
  •  Benefits for the Long-Term Care System

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     Allows care providers in long-term care, acute care and home-based settings to

    efficiently collect, manage and share vital information about their clients’ medical

    histories and care regimens.

     Sharing of best clinical practices, the use of clinical guidelines and quality

    measurement tools.

     More timely and accurate exchange of financial information saves money and avoids

    waste.

     The ability to improve research into both clinical and administrative methods.

     Increased ability to provide consumers with the information they need to make care-

    related decisions.

     Benefits for Providers

     IT can help them operate more efficiently and effectively.

     It produces cost savings by avoiding duplication and waste and allows them to

    optimize their resources.

     Benefits for Consumers

     Consumers receive more and better services.

     . IT can empower individuals in long-term care facilities and their families – helping

    to reduce isolation among seniors and caregivers.

     . Consumers living at home benefit by being able to access information about

    providers, services, and eligibility using the Internet.

  • Barriers to Use of IT
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     Lack of Commitment – if it is to work effectively, providers must commit to really

    using it.

     Lack of Understanding – that commitment must be based on a full understanding of

    what IT can do and not do.

     Financial Investment – making use of IT is not inexpensive (but the outlay is worth it).

     Need to Upgrade Old Technology – most providers getting into or maximizing use of

    IT must scrap their old systems or invest in a significant upgrade.

     Changing Operational Systems – operational systems must change, not just technology,

    if it is to be successful.

     Obtaining IT Expertise – most providers will need outside assistance.

    Options for Acquiring IT – providers have several options available to them when they decide

    to acquire new IT or upgrade existing systems:

     Developing an entirely in-house system.

     Purchasing software for its own hardware (PCs, data entry terminals, etc.).

     Outsourcing the entire system development and maintenance to a contract firm.

    Guidelines for Selecting an IT Vendor

     Analyze the business requirements

     Conduct Vendor search

     Request for Proposal (RFP) Development

     Proposal evaluation and vendor selection

     Contract negotiation strategies

    © 2015 Jones and Bartlett Publishers, LLC 5

    Long-Term Care: Managing Across the Continuum, Fourth Edition
    John R. Pratt

    © 2015 Jones and Bartlett Publishers, LLC 6

      CHAPTER SEVENTEEN: TECHNOLOGY IN LONG-TERM CARE

      CHAPTER HIGHLIGHTS

      Introduction

    • Applied Technology – technology has much to offer in maintaining or improving a person’s functional independence. In several ways, including:
    • Artificial Functioning – devices to provide assistance from wheelchairs to robots.

      Emergency Notification –panic buttons to notify when help is needed.

      Telemedicine – remote monitoring of a consumer’s condition, conferencing among health care professionals, and consultation with specialists.

    • Information Technology – the application of certain types of technology to the collection and use of information.
    • Clinical Applications:

      Admission, Assessment, and Care Planning

      Consumer Safety

      Record Keeping

      Quality Measurement

      Administrative Applications:

      Staffing

      Financial Management

      Strategic Support Applications

      Planning

      Operational Decision Making

      Performance Measurement

      Marketing

      Networking Applications:

      Systemwide Applications:

      Quality Measurement and Improvement

      OSCAR 

      RAI/MDS

      OASIS 

      Consumer Information and Education

      Privacy Concerns and the HIPAA

      Cyber Security

      Benefits of IT

      Benefits for the Long-Term Care System

      Benefits for Providers

      Benefits for Consumers

      Barriers to Use of IT

      Lack of Commitment – if it is to work effectively, providers must commit to really using it.

      Lack of Understanding – that commitment must be based on a full understanding of what IT can do and not do.

      Financial Investment – making use of IT is not inexpensive (but the outlay is worth it).

      Need to Upgrade Old Technology – most providers getting into or maximizing use of IT must scrap their old systems or invest in a significant upgrade.

      Changing Operational Systems – operational systems must change, not just technology, if it is to be successful.

      Obtaining IT Expertise – most providers will need outside assistance.

    • Options for Acquiring IT – providers have several options available to them when they decide to acquire new IT or upgrade existing systems:
    • Guidelines for Selecting an IT Vendor

    Long-Term Care: Managing Across the Continuum, Fourth Edition
    John R. Pratt

  • CHAPTER SEVENTEEN: TECHNOLOGY IN LONG-TERM CARE
  • CHAPTER HIGHLIGHTS
  • Introduction
  •  Technology is becoming ever more important to long-term care.

     The ways in which technology can be used in long-term care fall into two broad

    categories: applied technology and information technology (IT).

    Applied Technology – technology has much to offer in maintaining or improving a person’s

    functional independence. In several ways, including:

     Artificial Functioning – devices to provide assistance from wheelchairs to robots.

     Emergency Notification –panic buttons to notify when help is needed.

     Telemedicine – remote monitoring of a consumer’s condition, conferencing among

    health care professionals, and consultation with specialists.

    Information Technology – the application of certain types of technology to the collection and

    use of information.

     Includes data input, data management, and data output

     Categories of computerized information applications:

     Clinical Applications:

     Admission, Assessment, and Care Planning

     Consumer Safety

     Record Keeping

    © 2015 Jones and Bartlett Publishers, LLC 1

    Long-Term Care: Managing Across the Continuum, Fourth Edition
    John R. Pratt

     Quality Measurement

  • Administrative Applications:
  •  Staffing

     Financial Management

  • Strategic Support Applications
  •  Planning

     Operational Decision Making

     Performance Measurement

     Marketing

  • Networking Applications:
  •  Involvement in integrated health systems

     Coordination of information

     Patient scheduling

     Managed care contracting

  • Systemwide Applications:
  •  Electronic Health Records

     Automated patient records

     Personal health records

     Quality Measurement and Improvement

     OSCAR

    © 2015 Jones and Bartlett Publishers, LLC 2

    Long-Term Care: Managing Across the Continuum, Fourth Edition
    John R. Pratt

     RAI/MDS

     OASIS

     Consumer Information and Education

  • Privacy Concerns and the HIPAA
  •  One of the two major purposes of the Health Insurance Portability and Accountability

    Act (HIPAA) is to protect the privacy of consumers’ health information.

     HIPAA creates a set of national standards governing such electronic transfers to protect

    the privacy and confidentiality of consumers. These standards cover the following areas.

     Access to medical records.

     Notice of privacy practices

     Limits on use of personal medical information

     Prohibition on marketing

     Confidential communications

     Complaints.

  • Cyber Security
  •  All entities relying on computer systems must today be concerned about cyber security.

     Loss of either personal or organizational information could greatly disrupt the ability to

    provide high-quality care.

  • Benefits of IT
  •  Benefits for the Long-Term Care System

    © 2015 Jones and Bartlett Publishers, LLC 3

    Long-Term Care: Managing Across the Continuum, Fourth Edition
    John R. Pratt

     Allows care providers in long-term care, acute care and home-based settings to

    efficiently collect, manage and share vital information about their clients’ medical

    histories and care regimens.

     Sharing of best clinical practices, the use of clinical guidelines and quality

    measurement tools.

     More timely and accurate exchange of financial information saves money and avoids

    waste.

     The ability to improve research into both clinical and administrative methods.

     Increased ability to provide consumers with the information they need to make care-

    related decisions.

     Benefits for Providers

     IT can help them operate more efficiently and effectively.

     It produces cost savings by avoiding duplication and waste and allows them to

    optimize their resources.

     Benefits for Consumers

     Consumers receive more and better services.

     . IT can empower individuals in long-term care facilities and their families – helping

    to reduce isolation among seniors and caregivers.

     . Consumers living at home benefit by being able to access information about

    providers, services, and eligibility using the Internet.

  • Barriers to Use of IT
  • © 2015 Jones and Bartlett Publishers, LLC 4

    Long-Term Care: Managing Across the Continuum, Fourth Edition
    John R. Pratt

     Lack of Commitment – if it is to work effectively, providers must commit to really

    using it.

     Lack of Understanding – that commitment must be based on a full understanding of

    what IT can do and not do.

     Financial Investment – making use of IT is not inexpensive (but the outlay is worth it).

     Need to Upgrade Old Technology – most providers getting into or maximizing use of

    IT must scrap their old systems or invest in a significant upgrade.

     Changing Operational Systems – operational systems must change, not just technology,

    if it is to be successful.

     Obtaining IT Expertise – most providers will need outside assistance.

    Options for Acquiring IT – providers have several options available to them when they decide

    to acquire new IT or upgrade existing systems:

     Developing an entirely in-house system.

     Purchasing software for its own hardware (PCs, data entry terminals, etc.).

     Outsourcing the entire system development and maintenance to a contract firm.

    Guidelines for Selecting an IT Vendor

     Analyze the business requirements

     Conduct Vendor search

     Request for Proposal (RFP) Development

     Proposal evaluation and vendor selection

     Contract negotiation strategies

    © 2015 Jones and Bartlett Publishers, LLC 5

    Long-Term Care: Managing Across the Continuum, Fourth Edition
    John R. Pratt

    © 2015 Jones and Bartlett Publishers, LLC 6

      CHAPTER SEVENTEEN: TECHNOLOGY IN LONG-TERM CARE

      CHAPTER HIGHLIGHTS

      Introduction

    • Applied Technology – technology has much to offer in maintaining or improving a person’s functional independence. In several ways, including:
    • Artificial Functioning – devices to provide assistance from wheelchairs to robots.

      Emergency Notification –panic buttons to notify when help is needed.

      Telemedicine – remote monitoring of a consumer’s condition, conferencing among health care professionals, and consultation with specialists.

    • Information Technology – the application of certain types of technology to the collection and use of information.
    • Clinical Applications:

      Admission, Assessment, and Care Planning

      Consumer Safety

      Record Keeping

      Quality Measurement

      Administrative Applications:

      Staffing

      Financial Management

      Strategic Support Applications

      Planning

      Operational Decision Making

      Performance Measurement

      Marketing

      Networking Applications:

      Systemwide Applications:

      Quality Measurement and Improvement

      OSCAR 

      RAI/MDS

      OASIS 

      Consumer Information and Education

      Privacy Concerns and the HIPAA

      Cyber Security

      Benefits of IT

      Benefits for the Long-Term Care System

      Benefits for Providers

      Benefits for Consumers

      Barriers to Use of IT

      Lack of Commitment – if it is to work effectively, providers must commit to really using it.

      Lack of Understanding – that commitment must be based on a full understanding of what IT can do and not do.

      Financial Investment – making use of IT is not inexpensive (but the outlay is worth it).

      Need to Upgrade Old Technology – most providers getting into or maximizing use of IT must scrap their old systems or invest in a significant upgrade.

      Changing Operational Systems – operational systems must change, not just technology, if it is to be successful.

      Obtaining IT Expertise – most providers will need outside assistance.

    • Options for Acquiring IT – providers have several options available to them when they decide to acquire new IT or upgrade existing systems:
    • Guidelines for Selecting an IT Vendor

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