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TechnologyAdvice Buyer's Guide to Long-Term Care SoftwareUpdated: Dec. 13th, 2018
Long-term care (LTC) software offers solutions for the workflows, administration, tracking, data, and myriad problems associated with managing long-term care patients, facilities, staff, and regulatory procedures.
The long-term care industry is undergoing rapid growth at a time that the greater healthcare market is shifting to curtail increasing costs. Long-term care, palliative care, end-of-life care,** home health care, hospice** — call it what you will, according to the U.S. Dept. of Health and Human Services (HHS), 70 percent of people turning age 65 can expect to use some form of long-term care during their lives.1 The U.S., in particular, faces issues with the aging Baby Boomer generation. The 65-and-older population jumped 15.1 percent between 2000–20102, and 14 percent of the U.S. population — or 44.2 million persons — are now age 65 or older.3
The Long-Term Care Software Market
It’s not just the U.S. population that is aging. The United Nations estimates that 21.1 percent of the global population will be 60 or older by 2050 — more than two billion by current estimates.4 It’s no surprise that the global long-term care software market is forecast to grow from $1.02 billion in 2013 to more than $2 billion by 2019.5 North America holds the largest share of the marketplace, with Japan, China, India, and Latin America also seeing rapid growth. Continued economic expansion in these regions is expected to increase the demand for both long-term care facilities and long-term care software.5
Long-Term Care Software Vendors
Unlike the greater medical software market, there aren’t many current vendors of LTC software. This will surely change as the market continues to grow. Also, as is the case with most commercial software applications, vendors are increasingly offering cloud-based LTC systems. Many facilities with existing platforms could see numerous benefits by switching from an on-premise to a web-based or Software-as-a-Service (SaaS) solution, including reduced infrastructure costs, reduced need for IT support, mobile device support, and anytime/anywhere access.
Comparing Long-Term Care Software
There are a number of factors to consider when comparing long-term care software. The LTC market is highly specialized. With the exception of larger vendors, most systems are designed for a single care delivery model. Software designed to administer, track, and care for a large, on-site patient population at a nursing home, a continuing care retirement community, or an assisted living facility will be very different from systems designed for home health services such as in-home skilled nursing or hospice care. Some larger facilities even require functionality approaching that of a full enterprise resource planning (ERP) system to manage building, staff, and equipment. Before you can begin the process of selecting a LTC software vendor, you’ll need to answer the following four questions:There are a number of factors to consider when comparing long-term care software. The LTC market is highly specialized. With the exception of larger vendors, most systems are designed for a single care delivery model. Software designed to administer, track, and care for a large, on-site patient population at a nursing home, a continuing care retirement community, or an assisted living facility will be very different from systems designed for home health services such as in-home skilled nursing or hospice care. Some larger facilities even require functionality approaching that of a full enterprise resource planning (ERP) system to manage building, staff, and equipment. Before you can begin the process of selecting a LTC software vendor, you’ll need to answer the following four questions:
- What sort of long-term care or services do you provide?
- Do you require a full electronic medical records system?
- What sort of regulatory or reporting requirements do you have?
- Do you want a Software-as-a-Service (SaaS) solution, or would you prefer an on-premise deployment?
Once you’ve answered the above questions, it’s time to figure out which of the main subcategories of long-term care software will best fit your requirements.
Long-Term Care Software Categories
Since long-term care software is highly specialized, subdividing the market into general categories is difficult but necessary when attempting to make a purchase decision. The best method of segmentation is typically by intended end users:
- Nursing homes / CCRCs / Skilled nursing facilities (SNFs)
- Assisted living facilities (ALFs) / Independent living facilities (ILFs)
Home health agencies / Hospice
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Long-Term Care Software for Nursing Homes / CCRCs / SNFs
Nursing homes, CCRCs, skilled nursing facilities, and similar care delivery environments require numerous software systems to manage resident health. These include clinical systems such as electronic medical records (EMR), electronic medication administration records (eMAR) and electronic treatment administration records (eTAR), financial management and billing software for managing insurance claims, self-pay, and resident accounts, and software for reporting the minimum data set at Medicare/Medicaid-certified facilities. Some vendors offer all of these features in a single system, but the majority offer individual modules for different areas of care. These include:
- Point-of-Care: Interface for CNAs and other users to track resident care and health, such as activities of daily living, dehydration risk, skin issues, food intake, weight management, etc.
- Clinical / Charting: Full electronic medical records to document procedures and progress notes, input orders, and send/receive care summaries and transition of care documents.
- Minimum Data Set (MDS): For Medicare or Medicaid-certified retirement/nursing communities, the management and reporting of the MDS assessments for each resident are electronically tracked and usually integrated with the point-of-care and charting solutions.
- Medications Management: Full eMAR and eTAR, may also include barcode support for scanning of medications, drug-drug and drug-allergy interaction checks, and electronic prescribing. This system may or may not be included as part of a point-of-care or clinical module.
- Patient Scheduling: Scheduling, tracking, and management of resident visits with staff physicians, or at external facilities.
- Financials / Billing: Most long-term care software offers functionality similar to medical billing software for managing the billing and coding of patient appointments at internal or external facilities. These modules also usually offer a solution for managing resident accounts, including collections of monthly or annual resident fees, and sometimes also full accounting and management of residents’ finances.
- Marketing: Last but not least, many newer systems can track leads, manage email marketing lists and blasts, create status reports for next-of-kin, and also help with the management and tracking of referrals and/or pre-admissions.
Long-Term Care Software for Assisted / Independent Living
While assisted and independent living facilities have many similarities to nursing homes, CCRCs, or SNFs — they all generally have large populations, bill similar entities, and manage similar workflows — ALFs (and especially ILFs) may not need the full spectrum of clinical functionality required by their cousin facilities. Long-term care software for ALFs and ILFs typically offer all of the functionality outlined above. ALFs and ILFs however aren’t certified by Medicare/Medicaid, and aren’t always responsible for managing residents’ care. That means most of these facilities don’t need an EMR or MDS system, though most vendors do offer it if required. Also, some ALFs may deploy a medications management or point-of-care system, depending upon the needs of their resident population.
Long-Term Care Software for Home Health Care
Software systems for home health care delivery require some of the same functionality as systems for facility-based long-term care — charting, eMAR, notes, orders, etc. — as well as tracking and task management features like electronic visit verification (EVV), GPS tracking, and more. Also, unlike systems for ALFs/ILFs or other facility-based care models, mobile access is absolutely essential for home health care workers. The majority of these systems are cloud-based, and offer either a mobile-optimized web interface or a native mobile application for iPad or Android tablets and smartphones. The functionality they offer, while similar to the above software categories, has features specific to home health workflows and reporting requirements:
- Point-of-Care: the point-of-care solution is the clinical interface offered by long-term care software for home health. It assists with the management and tracking of progress notes, health maintenance, the Outcome and Assessment Information Set (OASIS), Outcome-Based Quality Improvement (OBQI) reporting, Home Health Resource Group (HHRG) scoring, completion of HFCA/CMS Form 485, etc. Most systems also offer HL7 interfaces for communicating with other medical software systems, electronic signatures, secure internal messaging, medications management, and more.
- Scheduling: electronically manage and track mobile workers’ and patients’ appointments. Some systems also offer an online scheduling portal for appointment requests, cancellations, etc.
- Billing / Accounting: electronically bill insurance and self-pay patients, offer electronic claim scrubbing and CMS-1500 completion/submission, electronic remittance notice (ERN) posting, multi-payer support, request for anticipated payment (RAP) submissions, case mix calculators. Some software vendors also offer full billing and coding services for an additional fee or percentage of total receipts. Accounting functions usually include payroll, inventory management, and budgeting/forecasting.
- Marketing: manage patient relationships with CRM-like functions, including wait-list management, donor management for nonprofit organizations, track referrals, etc.
Long-Term Care Software Case Study
Company: Allegan County Medical Care Facility6
Allegan County Medical Care Facility (ACMCF), located in Allegan, Mich., was one of the first long-term care organizations to begin using PowerChart LTC — Cerner’s electronic health record (EHR) for long-term care.
Kim Turcott, the assistant administrator at ACMCF, shared the journey her organization went through when implementing PowerChart LTC. According to Kim, the leadership group at ACMCF is a small, close-knit, and flexible team. They acknowledged the risk of being the first to try a new solution, and their decision to partner with Cerner was based on several factors. The main reason was six years of positive experiences using Cerner CareTracker, a point-of-care solution for tracking activities of daily living, along with dehydration risk, skin problems, poor intake, behavioral concerns, weight gain/loss, and more. Additionally, PowerChart LTC is built from the same foundational EHR platform used by several of Allegan’s hospital referral partners.
“If we spend less time doing med pass, less time doing documentation, and more time with residents, that’s what it’s all about.” – Kim Turcott, Assistant Administrator ACMCF
Shortly after implementing the solution ACMCF bebgan seeing improvements. Initial comments from the care team included remarks about how thin the admission packet had become, and how excited they were to send legible order sheets out of PowerChart LTC directly to the pharmacy. The MDS staff reported saving time because each resident’s demographic information flowed all the way from the registration system to the MDS.
- Allegan eliminated nearly all of the 96 pages of forms they were using prior to PowerChart LTC.
- Hours that were previously spent managing paperwork were redirected into time spent with residents.
- Overtime was decreased.
- Regulatory compliance is no longer a primary concern.
- Allegan is pioneering efforts to connect directly with their hospital referral partners, which also use Cerner solutions.
“It’s been really great for us to be able to go into a room and do the charting right there with the resident there. We’ve already seen a decrease in overtime. In the first week we saw people who had previously been working late start to get out on time.” Kim Turcott, Assistant Administrator ACMCF.
Other Market-Leading Long-Term Care Options
While Cerner’s long-term care software offerings were a great fit for ACMCF, your organization may have different needs. Solutions from different vendors will offer similar functionality, but may subtract or add features depending on which sort of care delivery setting the system is designed to serve. Depending on whether or not you’d like an integrated suite of applications or a standalone solution for one or more functions, the following vendors may offer a better solution for your needs:
Choosing a Long-Term Care Solution
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If you’d like to learn more about any of the long-term care software solutions outlined in this guide, we’d love to talk. Call one of our in-house Technology Advisors for a no-cost, no-obligation consultation today, or if you’d prefer, use the Product Selection Tool on our site to filter your results and get a custom recommendation based on your deployment preference, desired features, and more.
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- “Who Needs Care?” LongTermCare.gov. Accessed May 12, 2015. http://longtermcare.gov/the-basics/who-needs-care/
- Brandon, Emily. “65-and-Older Population Soars.” U.S. News Money. Last modified Jan. 9, 2012. http://money.usnews.com/money/retirement/articles/2012/01/09/65-and-older-population-soars
- “United States Data” The World Bank. Accessed May 12, 2015. http://data.worldbank.org/country/united-states
- United Nations, Department of Economic and Social Affairs, Population Division (2013). “World Population Ageing 2013.” ST/ESA/SER.A/348.
- “Long-term Care Software Market by Product, Mode of Delivery, and End User - 2019.” Markets and Markets. Published Nov. 2014. Accessed May 12, 2015. http://www.marketsandmarkets.com/Market-Reports/long-term-care-software-market-2959239.html
- “Allegan County: Reducing Paper, Refocusing on Patients.” Cerner Extended Care. Accessed May 15, 2015. http://www.cerner.com/uploadedFiles/Content/Solutions/Homecare_Professionals/Long-Term_Care/Allegan-case-study.pdf