1. Electronic Medical Records (EMRs) in a long-term and mental-health care setting Douglas A. Struyk, President and CEO Jennifer DAngelo, Director of Software Implementation

2. Christian Health Care Center

3. Our programs for the elderly and mentally ill Elder-care programs Heritage Manor Nursing Home – Post-acute Care Unit [PACU], Long-term Care Unit, Special-care Unit – 252 residents Southgate behavior-management unit – Special-care unit – 40 residents The Longview Assisted Living Residence – 95 residents Christian Health Care Adult Day Services – Wayne and Wyckoff Hillcrest Residence - 39 residents Evergreen Court - 40 affordable apartments Mental-health programs Ramapo Ridge Psychiatric Hospital - 58 beds Ramapo Ridge Partial Program – For post-acute adults Pathways partial-hospitalization program – Developmentally disabled/mentally ill adults Christian Health Care Counseling Center – Traditional outpatient

4. Unique needs of long-term care (LTC) facilities with EMR initiatives Differ from acute-care setting needs Acute-care more focused on diagnosis, treatment, and communication speed. Implementing acute care-oriented systems in LTC settings encounter limitations due to larger records and longer lengths-of-stay. LTC facilities need extensive histories and descriptive information with less treatment information and provider communication.

5. Improvements in QI/QM data, in addition to survey outcomes Reduction in errors (resident/patient safety) Improved staffing efficiency Interoperability with lab, pharmacy, rehabilitation, radiology, etc. to minimize transcription errors and streamline information Savings with third-party vendors Direct benefits of our EMR

6. Barriers surrounding implementation Financial - Christian Health Care Center invested $750,000 for hardware, software, training, and wireless set-up costs Staff - Adaptation/computer literacy - Fear/change - Time-sensitive

7. Our implementation process Three phases designed – Back-order entry, CPOE, Progress Notes – Care plans, MDS, CMS forms – Assessments, nurse instructions, CNA assignments, policy and procedure revisions Staff awareness began 12 months prior Letters sent and meetings with families Kick-off party and celebrated project Implementation begins!

8. Daily documentation totals eMAR/eTARTOTAL

9. Electronic Medical Record demonstration