Each year, billions of dollars are spent moving residents from nursing homes to hospitals. Now, a research team at University of Missouri It studies how a common form of communication – text messaging – can be used by nursing home staff to speed up decision-making and prevent the deterioration of residents’ health that can lead to costly and traumatic hospital transfers.
To help address this costly and burdensome issue, a three-year, $1 million grant from the National Institutes of Health (NIH) will help MU researchers show how nursing home employees can securely use HIPPA-compliant texting to speed up decision-making in a way that can allow residents Safe access to care in a nursing home without the need for a painful transportation to hospital.
“Deciding whether to move a nursing home resident to a hospital may seem simple, but it is actually very complex with so many factors involved,” said Kimberly Powell, associate professor at MU Sinclair College of Nursing and principal investigator on the grant. Bedside nurses often use a fax machine or leave a voice mail to communicate with doctors or advanced practice nurses who are not in the facility. You also need to consider the preferences of the patient and their family members, and if the patient has a cognitive impairment such as dementia, which two thirds of nursing home residents have. They may be unable to express their preferences, which further complicates matters.”
Quick decision-making is crucial in these situations, Powell said, as early interventions and noting changes in the resident’s condition as quickly as possible can prevent further health complications or health deterioration that often leads to avoidable hospital transfers.
“Currently, when bed nurses send faxes or leave voicemails and wait to receive a response from physicians, social workers, specialists, therapists, registered nurses, and resident family members, by the time they receive their response, there is already a missing opportunity for early intervention and the resident should be moved to hospital because it was too late to intervene.” “Whereas through text messages, bedside nurses can contact all parties involved immediately, which speeds up the decision-making process and allows early interventions, so there is a possibility of avoiding transfer to hospital. It is an easy, convenient and low-cost solution to a serious problem.”
For the grant project, Powell will analyze the effectiveness of a HIPAA secure texting platform, Mediprocity, which was used in a previous study by nursing home staff in 16 Missouri nursing homes. That study was part of the Missouri Quality Improvement Initiative, a $35 million program funded by Medicare and Medicare that has implemented full-time advanced practice registered nurses in nursing homes in an effort to reduce avoidable hospitalizations.
By knowing what has gone well in 16 Missouri nursing homes and what can be improved, Powell’s efforts can help nursing homes across the country adopt similar technology to improve the quality of care provided to their residents.
The multidisciplinary team included nurses, doctors, social workers, specialists, therapists, and family members of nursing home residents, all of whom were included in the same text message thread.
“Our secure, HIPPA-compliant technology services focus specifically on long-term care,” said Mason Rothert, co-founder and CEO of Mediprocity, the organization that developed the technology used in the grant. “By reducing the time it takes for nursing homes, doctors, and pharmacies to communicate with each other, potential medications can be delivered to residents sooner, and interventions can be identified and taken, ultimately leading to improved health outcomes.”
NB: The scholarship was funded by the National Institute on Aging, a division of the National Institutes of Health. Collaborators include Mikhail Popescu, David Mehr, Sehun Lee and Greg Alexander.