BALTIMORE – Transitioning from paper medical records to electronic records is challenging for providers in any healthcare setting, but what about in a facility that serves as a combination of physician office, rehabilitation center and home?

Long-term care facilities are not known as innovators in healthcare IT, but Erickson Retirement Communities of Baltimore wants to change that perception.

Erickson has been implementing an electronic medical record system in its communities since 2003. The process began with CareMEDX software from Ozark, Mo.-based HealthMEDX. Erickson uses that product in its skilled nursing and assisted living facilities, as well as home health and rehabilitation settings.

Each Erickson community – there are 20 in 11 states – has its own medical center, which utilizes GE’s Centricity EMR. Primary care physicians employed by Erickson use the software to record clinical notes and order medicines electronically.

“We want to build a comprehensive electronic health record that can import external data and link to outside specialists,” said Daniel Wilt, Erickson’s vice president of information technology. “We also want quality reporting capabilities to improve patient care, but we’re still a few years away from that.”

Long-term care facilities face hurdles in rolling out technology that would be familiar to other healthcare institutions. Training staff unfamiliar with computers was a major hurdle, Wilt said.

“Two-thirds of our user base didn’t have basic computer skills,” he revealed, noting that clinical nursing assistants (CNAs) employ laptops or tablets at the bedside to check the health status of residents. “The physicians were a bit hesitant at first, and it took a few years before the technology became second nature. Now our docs are pushing us to give them more, and the nursing staff is learning how to become more efficient with the technology.”

The rate of IT adoption in long-term care settings is slow compared to hospitals, but increasing. Wilt says that most long-term care facilities will invest a maximum of one to two percent of their budgets on healthcare IT.

“It’s so low because most of these organizations operate on thin profit margins,” Wilt explained. “Their income is primarily from Medicare.”

Peter Kress, vice president and CIO of ACTS Retirement-Life Communities in Ambler, PA., estimates that approximately 15 percent of long-term care facilities currently use EHRs and other healthcare IT tools. But those numbers are growing.

“There is a lot of interest in point-of-care devices for routine data collection,” Kress said. “Facilities are adopting touchscreen devices, handhelds, even voice-activated devices. These technologies will dramatically increase the data-flow in our organizations.”

Kress points out that the kind of medical care offered in long-term care facilities is different than in hospitals. It’s generally not acute care, but revolves around maintaining “wellness.”

“The popular definition of long-term care is too narrow,” Kress said. “It’s not just nursing home care, but is more broadly focused on health maintenance. The IT we adopt will be oriented toward coordinating care through a variety of settings.”