Providers in cyberspace.

Facilities go on-line to buy goods, bring in new business

FOR PETER KRESS, THE VISIONARY DIRECtor of information systems at ACTS Retirement-Life Communities, Internet technology is "the future." Three years ago, ACTS, a not-for-profit chain of CCRCs based in West Point, Pennsylvania, began investing heavily in an "intranet"--an Internet-based network designed for information processing within a company or organization. Today, more than 500 employees in its far-flung communities are connected through a proprietary system that affords them quick, documented communication via e-mail and facilitates document distribution.

But for ACTS, this is just the beginning. The chain's long-term strategy is to move many tasks now done on the network to the intranet in order to take advantage of the Internet's common user interface and an infrastructure capable of providing limitless access to applications and information.

And because ACTs wants information to be "where people are working, rather than the other way around," says Kress, the company is developing the capability to deploy up to a thousand portable devices that will ultimately access the company's intranet. The company has already begun testing several network-based, hand-held devices. One can track and bill therapy time by scanning a resident's bar-coded bracelet. Another wand device can inventory and bill medical supplies; when supplies are dispensed to residents, the device automatically generates the charges. Having software do most of the data entry allows staff to spend more time providing direct care to residents, Kress says.

Down the road, ACTS hopes to equip its maintenance staff with portable devices that will allow them to access parts information and maintenance cycles, as well as order parts online.

Providers are also using intranets as a convenient, cost-effective way to disseminate information such as company manuals and policies, phone lists, procedures, and training materials. Sun Healthcare Group, Inc. has gone one better. With 600-plus facilities and more than 60,000 employees, the Albuquerque, New Mexico-based chain is attempting to rein in its exorbitant training costs by combining innovative streaming video technology (digitizing video/audio capability) with its worldwide intranet. Sun's clinicians and therapists in Australia can now watch the latest training videos on mobility or speech pathology on the same system they use to access census information, survey tracking mechanisms, check out the latest copy of Sun's internal newsletter, or buy a T-shirt with the company's logo. "The savings in video production alone has been tremendous," says Web manager, Ron Nolan, adding that there are also significant savings in shipping and travel costs.

Some providers are welcoming residents into their intranet family. Isabella Geriatric Center, a 785-bed facility in New York City, plans to install intranet-linked, touch-screen kiosks in its lobby and recreation suite. Residents and family members will be able to access the kiosks to get directions, check out the latest happenings on the events calendar, get a list of services and clubs, and access corporate and financial information.

Presbyterian Homes and Services, a Princeton, New Jersey-based, not-for-profit health care system, is developing a CCRC called Stonebridge with many features modeled after the hospitality industry. Presbyterian plans to install kiosks in common areas and provide Internet/intranet links to each resident's room or apartment, accessible by personal computer and WebTV. Residents will be able to pay their monthly bills, view their finances, and pre-select meals via the intranet.

ACTS already provides intranet access to residents with computers. A resident can, for example, go online to report a maintenance problem.

Other companies are setting up their own Web sites. A recent survey of long term care facilities conducted by OMNNI Associates, an Appleton, Wisconsin-based architecture firm, found that close to one quarter of respondents have Web sites. Of those respondents that did not have them, about 40 percent planned to go online next year.

Brian Tydrich, Web manager for Brookfield, Wisconsin-based Alterra, the nation's largest assisted living provider, thinks they're making a mistake. "We get a lot of requests for information off our Web site," he says. Alterra, which has been on-line since the first of the year, receives several hundred "hits," or user sessions, per week, Tydrich says.

Web sites are a highly affordable marketing tool. But people need a reason to visit them. Mark Braunstein, president of Patient Care Technology, an Atlanta-based technology-consulting firm, suggests that providers ask themselves: "What are people in my community interested in, so that my Web site could be of service?"

Alterra recently began posting health care articles on its Web site. And New York City-based Isabella Geriatric Center will use its soon-to-go-live Web site as part of its community outreach program, offering educational information, an events calendar for its 50-Plus Club, and more.

Braunstein cautions providers against buying into the idea without a business strategy. "A Web site is no different from a billboard on a street no one drives down. It needs to be promoted," says Braunstein.

The Alliance Continuing Care Network, an affiliation of 21 providers in metropolitan New York, launched a Web site in June. It not only provides links to each of its member facilities' sites, but also to numerous informational healthcare sites, such as HCFA, managed care organizations, and federal and state healthcare associations, as well as consumer sites and sites dedicated to Alzheimer's, diabetes, and diseases common among the elderly. "We wanted to design a site that is helpful to anyone looking for skilled nursing or continuing care placement for themselves or a family member," says Alliance healthcare consultant, Kerri Hennelly. "We also wanted to provide a central resource for people needing information about a particular disease or diagnosis."

Purchase.com

On-line purchasing is gradually becoming commonplace as well. ACTS currently purchases its office supplies via the Internet. Eventually, says Kress, the company will also purchase drugs and culinary items that way.

Jack Dile, assistant director of food-service at Masonic Homes, a 1300-resident CCRC in Elizabethtown, Pennsylvania, orders specialty foods and certain produce items on-line, as well as posting openings for foodservice jobs, locating recipes, and staying abreast of the latest health regulations in foodservice.

And, in what may prove to be the future of pharmaceutical ordering, there are systems linking institutional pharmacies with their customers via the Internet or the facility's intranet. This means providers can have immediate, real-time access to their residents' drug profiles to initiate new/refill orders, review status of existing orders, and resolve filling problems: No more wasted time playing telephone tag or being put on hold. Other benefits offered by such systems include automatic completion of the drug-related section of the MDS, access to drug clinical information to check for possible side effects and contraindications, and reduction of error opportunities in verbal, over-the-phone exchanges.

The most innovative technologies will probably continue to be developed outside long term care. The University of Michigan is testing an online drug-compliance aid that uses a commercial Internet paging system. The university has contracted with a messaging firm to send regular medication reminders and other messages to independent patients' portable pagers, reminding them to clean inhalers, record medication use, and so on. "Use of the pagers appeared to boost compliance substantially in the five patients studied," writes David Buerger in the March 1999 issue of Consultant Pharmacist.

As consumers continue to demand more choices in levels of care, lifestyle amenities, and independence-boosting aids, technology will inevitably play an ever-increasing role in long term care. Meanwhile, some providers are already discovering how technology can help them operate better and more efficiently and offer more consumer-focused care.