Software Leads to Better Care
By Alan Wechsler, Times Union, Albany, N.Y.
Jan. 21–ALBANY — When the New York Association of Homes & Services for the Aging won a grant in 1996, the money went to develop a computer program intended to help prevent falls and bedsores.
Ten years later, the result of that work is a product being used at more than 400 nursing homes around the country. And the Albany-based association — specifically, its for-profit arm, NYAHSA Services Inc. — finds itself trying to market a successful computer product despite a background more experienced in lobbying and the nursing home trade.
“We’re not a software vendor,” said Christie Teigland, director of health informatics and research, who helped develop the software. “It was a surprise to everyone that it developed into this national tool.” Nevertheless, as nursing homes around the country say they’ve helped prevent patient trauma with the software, NYAHSA Services is preparing to make a deal with a large pharmaceutical company and an insurance company to help market the program, Equip for Quality.
“Our focus here is to help the facilities care for residents,” said Kevin Murphy, executive director of NYAHSA Services. “With this product, they’re able to look into the crystal ball and care for their residents properly.” The secret to the program is modeling software not unlike programs used to predict the weather or stock prices.
The variables in this case are health criteria taken quarterly from patients, as required by the federal government.
Nursing home staff keep track of a patient’s coherence, eating habits, medications, socialization and mobility, among other indicators.
All those variables are added to the program, and used to determine the likelihood of a patient falling or suffering from pressure ulcers, otherwise known as bedsores.
The program is now being improved to look at other issues, such as pain or urinary tract infections.
Such simple problems are some of the most serious health concerns in nursing homes. Hip fractures in nursing homes are 11 times higher than in the community, and 260,000 seniors die as a result of hip fractures every year due to a downward spiral of health from the serious injury.
Even less serious fractures can have a catastrophic impact on a patient’s health, Teigland said. About three in 10 nursing home falls result in injury.
Pressure ulcers are also serious because of the risk of infection and the difficulty of healing.
Besides patient health, there are also other concerns for nursing homes: falls and bedsores are two of the leading causes of lawsuits.
Bedsores alone resulted in nearly 400,000 lawsuits against nursing homes by families of patients in 2002, according to a Harvard study. The study showed that nine out of 10 lawsuits were won or settled in the plaintiff’s favor, for an average payment of $300,000.
With Equip, nursing home staff can raise red flags and treat patients accordingly. Those at risk of bedsores can be shifted more often and examined more closely. Patients at risk of falling can be placed on mattresses directly on the floor, and given assistance more regularly than other patients.
Equip was started with a $250,000 state Department of Health grant, then enhanced through a $1.2 million U.S. Department of Health and Human Services grant in 2001. Today, the Web-based program sells for about $5,000, with profits being used to fund more research.
“It’s come a long way,” Teigland said.
Local nursing homes say they’ve had success with the program. According to data released by Teigland, the Teresian House nursing home in Albany reduced falls from 93 to 53 in a six-month period after implementing the software.
Other nursing homes say they’ve had similar success.
“I’m a big fan,” said Peter Young, administrator at The Eddy Memorial Geriatric Center in Troy. “This thing can predict. It’s a tremendously powerful tool.”
Glen Cooper, administrator at St. Peter’s Nursing and Rehabilitation Center in Albany, agreed.
“You can say it’s led to prevention,” he said. “It’s like heart attacks — we’ve made tremendous strides, but you’re never going to eliminate them.”
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