The long-term care (LTC) industry has not been well served by providers of information technology (IT) products and services due to the large number of undercapitalized vendors entering the market. Undercapitalization results in lack of innovation and inferior quality when compared to industries outside of long-term care.

New challenges
Historically, LTC companies viewed IT as little more than a tool needed to submit minimum data set (MDS) forms, obtain reimbursements and manage finances. IT was not a strategic component of the business. Today the needs of the LTC business are changing. IT vendors must now provide products and services that address increasing litigation, the nursing shortage and reimbursement pressures. These issues can limit a company's ability to survive and prosper.

The transition to innovative and high quality IT services has already taken place in other industries. Most industries recognize that world-class quality cannot be produced without automation. However, the LTC industry expects perfect execution and documentation from a labor source that is scarce and sometimes unskilled. Without IT solutions, those expectations are unrealistic.

IT solutions that enable facilities to produce seamless execution and documentation can provide a solid defense against the challenges facing the industry. But software developed with only necessary functionality is not enough. Professional and IT services must allow facilities to focus on their missions, rather than running data centers and networks, and fixing PCs.

To meet this mission, consumers must demand that LTC software vendors provide an appropriate level of integration. Historically, the advantages of integrated clinical and financial systems have been apparent, although many of the current "integrated systems" are little more than two disparate systems tied together. As reimbursement requirements continue to evolve, the need for real clinical and financial integration will emerge.

Growth areas
Three other areas of integration are also increasing in importance.

Decision support/executive management systems that can take data from disparate systems and produce useful, timely reports help executives be more proactive. Examples of these reports include: daily labor hours/costs per resident day, cash collection summary reports with goals, agency usage approval applications and summaries, daily census flash, clinical indicators rollup, and position control and open position reports.

Point-of-care systems. Several vendors and CMS have been experimenting with stand-alone point-of-care systems. As the benefits of these systems become clear, the best aspects of these systems will be integrated into the overall clinical/financial system. This will increase functionality at a substantially reduced cost.

System standards. Today, the LTC industry is hampered by a proliferation of incompatible systems. For example, not only is it difficult to interface systems between two vendors, it's almost impossible to exchange information to develop normative data across the industry. As the LTC software industry consolidates from over 40 vendors to just a few, standards will begin to emerge. Effects of the emerging standards will include lower costs, development of industry normative data, facilitation of an exchange of best practices, and an increase in innovation to deliver products and services that meet the real needs of the business.

Ultimately, the answers to industry challenges are IT solutions and professional services that allow facilities to focus on their missions to provide quality resident care. Leaders in the LTC industry need to demand more from their IT vendors to stimulate innovation and improve quality. The LTC software product and service providers need to step up to meet needs of the industry. Once this is done, the potential of IT will finally be realized.

Rich Giddings is COO, Achieve Healthcare Technologies, Minneapolis.