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November 14: Today on TownHall Sue Schade, Principal at StarBridge Advisors speaks with Eric Rogers, Chief Information Officer at Hebrew SeniorLife. They discuss Hebrew SeniorLife’s patient and family-centered approach to elder care. Eric discusses the importance of building strong relationships with family members who act as proxies in care decisions, the role of the innovative MEDITECH Expanse family and patient portal, and the strategies for successfully onboarding patients and families onto various technologies. He also underlines the challenges and strategies of managing patients as they transition through different settings, acuity levels, and stages of life within a diverse care environment. Lastly, Eric provides a forward-looking perspective on the future of patient and family engagement, underlining the significance of harnessing technology, AI, telemedicine, and groundbreaking research for revolutionizing elder care.

Learn more from Eric Rogers on the foundational elements needed to deliver quality senior care across a continuum and what the future of elder care looks like.

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Today on This Week Health.

Someone could be in our independent living environment, need a hip replacement. Have their hip replacement done. They're going to be in our inpatient rehab. They might get discharged to home health. then they're back to their regular outpatient primary care provider.

That could have been five different systems in our old model. It is one system now. So that has been a sea change for us.

Welcome to Town Hall, a show hosted by leaders on the front lines with interviews of people making things happen in healthcare with technology. My name is Bill Russell, the creator of This Week Health, a set of channels and events dedicated to keeping health IT staff current and engaged.

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Now, on to our show.

Hello, I'm Sue Shade, Principal at Starbridge Advisors and one of the hosts for the Town Hall Show at This Week Health. Today, my guest is Eric Rogers, Chief Information Officer at Hebrew Senior Life. I'm looking forward to hearing what he and his team are focused on with EHR integration and the continuum of care for elders, as well as development of their patient and family portal.

Welcome, Eric.

Thank you, Sue. Thank you very much. Yeah, I'm happy to be here. Thank you.

Great. I look forward to our conversations. So let's start by having you briefly introduce yourself and tell us about Hebrew Senior Life. Certainly.

Yes. I am the chief information officer, as you mentioned, at Hebrew Senior Life.

I also serve as the chief information security officer. Hebrew Senior Life is the largest nonprofit senior care, senior housing services in New England. We have eight facilities in the greater Boston area. We provide senior housing, senior healthcare, of course. And we actually have a very well known Institute for Aging Research, or Marcus Institute for Aging Research, here in our headquarters in Roslindale, with 28 scientists on board.

And we are the only senior care organization with a Harvard Medical School affiliation.

gReat. And how about a little bit more about you and your background? Just briefly, you were telling me decades like myself?

Yes, right? Yeah, we're just talking about that. Yeah, boy, over three decades in healthcare IT now, exclusively healthcare IT.

Most of it acute care. That was also private sector. I ran a consulting line for an organization for a while and landed here in post acute care, which To my surprise, it was a lot more progressive and a lot more to learn than I had ever realized. I've been quite happy with the evolution.

That's great, and it's great to hear that you consider it more progressive. I'm sure we'll get into that with some of what we want to cover today. So, your organization, Hebrew Senior Life, is unique in that your patients often have extended stays of several years, not days. They depend on family to support them as proxies in their care decisions.

So how important is it for you to build relationships with those family members, and what are some of your strategies for success?

Sure, so it's interesting, not just days, not just years, oftentimes decades again, as a full service provider and a continuum, we start all the way back in if you may, if you will, in independent living and then as a patient moves or a resident in that case moves through the continuum there's assisted living and so on.

So, our strategy, early and often, we like to get the family members involved. They very often are involved in independent living. But certainly by the time anyone progresses to assisted living, the family is involved in that care. We recruit family members, so it's again, it's an active process.

How do we do that? Well, they're invited to participate in many forums. They're invited to participate in the programming we run. Again, there's a lot of programming we run here. Family members are invited. And boy, the second anyone enters our inpatient environment, right up front and center, we're getting that healthcare proxy.

And that family member truly is part of the care plan.

That's great. And I understand that you have taken things a step further from the typical patient advisory councils to have a family advisory council. Can you talk a little bit about that and what benefits you've seen from the family advisory council?

cErtainly. Yes, our chief nursing officer chairs the Family Advisory Council. It's made up, of course, family members of patients Within our healthcare system, it is largely clinically focused, but I have on many occasions had the opportunity to both present And listen within that forum.

So there's a highly engaged team of family members. I presented on, many aspects of digital transformation. We can also use that forum. I use that forum as a conduit for communication for things. year ago, October, we went live whole house with a new EHR, the Meditech Expanse platform.

So that environment was great to communicate the changes that will be coming and then solicit feedback. And certainly very topically was a great forum for me to talk about in recruit for the patient and family portal.

That's great. Let's talk some more about the patient and family portal. How does it differ from a traditional portal in an acute setting?

And what role have you had in working with Meditech to develop that solution for Hebrew senior life?

Yeah, so first of all as you notice, we call it the patient and family portal, so family is front and center. Once again, there's that continuing theme. It is very important. We have the family members involved, so it was important that we got their input for the development of this patient family portal, so it is being custom developed.

It has the bones, of course, of a traditional patient portal, but as way back in the contracting phase with Meditech, you know, I was talking to many of their executives, their sales team, of course, And something we wanted in there was really a focus on that portal. So post acute care, unlike acute care, it can be a little bit slow on the rollout of patient portals.

We didn't have things like meaningful use to drive and fund those initiatives. So it's allowed us to have a more focused involvement in a lengthened time frame to further develop product. So Meditech has been a great partner in this process. So, again family centric with the involvement in the participation of care.

We have a first, to my knowledge of its kind, a calendar view of not just clinical appointments, but social appointments. The social isolation is just tremendously detrimental to the senior care community. So, our programming is very important at this organization. And the seniors participation in that programming is very important.

It's kind of a broadening of the social determinants of health, if you will. So, very important, Meditech developed with us. The capturing of the social and programming attendance. So we're talking healthcare appointments. We're talking attendance at piano recitals. And so forth, so we have involved our very collaborative with the acute care team in the life enhancement team.

And so we have the social determinants of health in there, which is very progressive and then building off of that. We're building into their what I call roles based security, if you will, to use some common vernacular. And what that allows is, again, this isn't just patient centric.

With the family centric aspect, we can take that healthcare proxy, they become an administrator themselves. They see the full breadth of what's going on in the portal as we traditionally envision it. But there's also the ability to allow other family members. Just get involved in more of the social aspects of their loved ones they can monitor maybe not the deep, clinical aspects, lab results and so forth, but more, is mom going to the hairdresser?

I know it's very important for mom to go to the hairdresser. What? She isn't hitting her appointments? Let me call up CIS and find out what's going on there. So it really allows for that bi directional care of our patients and further, integrates the family member into that care plan.

That's great.

I don't have personal experience and The elder care in my own family but, I hear stories from so many colleagues and friends that go through some difficult times. So what you're describing about the patient family portal how they're able to access it and address some of those issues is really great.

I'm sure it's been very beneficial to the families. Let's talk about just how you onboard your patients and families and using these technologies and what kind of trends you're seeing at this point. I think there's probably an assumption that elders may be behind and not so tech savvy, but that's changing.

let's hear how you're approaching the onboarding.

Yeah, sure. Well, as I mentioned earlier early and often, we like to recruit our patients and family members in. So it goes, if, if they've entered our system Through housing, we're getting involved with technology there.

Technology perfuses into our housing environments. We have healthcare coaches and goal setting coaches, wellness coaches that are using technology. Themes of right care at the right place, right time, all technologically available systems behind that. But the recruiting, that family advisory council that we spoke of has been very important.

I think folks are much more invested in technology when up front they're contributing to its development. as brutal as it was, particularly for our organization, the elder population, certainly drove technology. I had Zoom in house for years. COVID hit and Zoom became the mechanism for our telehealth, for doing family meetings, you know, cross country without any problems at all.

We also were doing things like programming. So I talked about isolation and how harmful it is for the elderly. We took programming and broadcast it into their rooms. A life enhancement person could have been there with a laptop or an iPad and programming in the room. We use technology for rehabilitation.

We are, we're very progressive here, very innovative. We chase a lot of grants and art, for example. We had a program called Art on the Brain that was Delivered out through an iPad through life enhancement where we were getting that therapy out to the patient's beds in households.

So, I think, by utilizing technology, by demonstrating how progressive we can be with it, Also very important to, cultivate that within our workforce. We have a lot of workforce training programs. Whereas many organizations don't necessarily have technology going all the way to front lines, like certified nursing assistants.

We do.   📍 📍   📍 We'll get back to our show in just a minute. With Meditech Expanse, you'll have all the tools that you need to keep people at the center of care. Engage your patients, reduce clinician burnout, explore innovative care delivery models, and leverage precision medicine and advanced decision support to make informed decisions.

CY Expanse quickly ascended the class rankings to become one of healthcare's top overall software suites. Visit ehr. meditech. com to learn more. And now, back to our show. 📍  Super. I love some of the examples that you're giving in terms of the innovation and how progressive the organization is. And you mentioned COVID, and certainly that was a huge test for all healthcare providers. Particularly in the senior community. So, moving on. We often hear the terms person centered care and whole person care.

And we know the importance of managing patients health and chronic conditions in and out of various care settings. And this is true in the acute care environment too. But, You, with elder care, it's unique in that patients are oftentimes with you for several years, you said earlier, decades, and their acuity needs are constantly changing or progressing.

So how do you effectively manage their care as they pass between those different care settings, acuity levels, and different stages of life?

Yeah, thanks for asking. It is challenging, to say the least. We have a very broad offering. I talked about independent living We have our outpatient clinics, we have assisted living, we have acute rehab, we have acute step down unit, we have long term chronic care hospital, home health hospice.

So really our own little flavor of cradle to grave in the senior world, if you will. It was extremely challenging when I came to Hebrew Senior Life about 11 years ago. Many disparate systems in that model, electronically speaking. Our clinical workforce was great. They're highly collaborative, highly integrated care model.

However, there were so many... Disparate systems that, that, transfer of communication was horrible in our own ecosystem. Nevermind with our healthcare partners downtown. So, early on, and it was a long ride, and we just went live a year ago. We now have Expanse electronic health electronic health record.

So, it has been excellent from our outpatient clinics that are in our independent living facilities, all the way through hospice. It is one electronic medical record right now. So that has been extremely important. You know, Sometimes I'll provide this anecdote of very common here.

Someone could be in our independent living environment, need a hip replacement. Their doctor in the outpatient clinic advises them of that need. go downtown to have their hip replacement done. They come back. They're going to be in our inpatient rehab. They might get discharged to home health. then they're back to their regular outpatient primary care provider.

That could have been five different systems in our old model. It is one system now. And of course, that record just flows throughout and certainly enabling us to build off interoperability with our partners downtown also. So that has been a sea change for us.

Okay, so let's talk a little bit more about that.

I was 1 of those partners downtown as you say, when I was in CIO at Brigham and Women's Hospital, which is now on EPIC. know there's many community hospitals in the region that are on Meditech. So if An elder is hospitalized in a hospital hip replacement that has EPIC. How is that Meditech Expanse working?

Well, we have work to do in that space. Again, we've been live, we've been in optimization mode. Our focus is on the portal right now. Currently interoperability is more of access into the other Partner systems where we have Meditech that's of course easier, but we have work to go. That's next year's goals to truly bring up interoperability in a much more automated fashion.

If the patient is at a community hospital, that's got Meditech and then back in the Hebrew senior life system, how is that interoperability working?

Yeah, once again, we have trust in sharing. Opportunities with those partner hospitals. Right now, it's more view only access. We are building the foundation to move to that, more CCDA driven interoperability.

Next year's goals. Yeah, you're getting ahead of us.

I'm getting ahead of you. Okay, maybe we need to talk again next year. So as we look at new care models like virtual nursing, hospital at home, new technologies like AI uh, telemedicine, not really new anymore. It's really table stakes and more patient facing apps.

Where do you see the future of patient and family engagement heading? And what are you looking forward to the most there?

Right, so I'm very excited about the portal that we're rolling out. It's in pilot mode now, and we continue to enhance and improve that. That integration through the portal is going to be excellent.

I know that the, enhanced contribution we get from the family members will be very important. AI is becoming increasingly more advanced. Nothing necessarily brand new there. We've been doing natural language processing for quite a while now. What we are excited about is, the enhanced large language models and what that will bring to clinical decision making. tHe business and clinical analytics, I'm very excited to bring that to Hebrew Senior Life. We need to have much better. Data driven decision making in that regard. Also, don't always look exclusively externally. Internally, as I mentioned, we have our Marcus Institute for Aging Research. It is great to have 28 scientists downstairs.

Several of them are professors at Harvard Medical School. They are in the top 10 percent of the National Institute of Health funded organizations. So, there's a lot of great technology coming out of there that I collaborate with that department. We just recently had our annual meeting. Our scientists presented on things like brain stimulation to improve gait and balance amongst elders, particularly with Parkinson's.

There's some groundbreaking research showing that just Improved sleeping environments and temperature specifically is very important to a senior's cognition and well being. So we're integrating wearables into that regard. I look forward to bringing more and more of that into the electronic health record and in working with Meditech and other partners to do things like that.

So we are we're a living lab here. So we, we truly are, restless innovators. Folks don't often think of elder care as restless innovation. And we truly, one of our taglines is lead the field of aging. So we are constantly innovative and do embrace new technologies.

I mentioned earlier, it's also important to cultivate our workforce in that regard, right at the front lines with our CNAs. Digital literacy programs, up to and including upon graduation, you can get a laptop. So I think by starting, at the front lines, in engaging our workforce through collaboration, through multidisciplinary committees, so that, again, they're stakeholders in the technology that's being developed and being rolled out.

So they're, they're along for the ride, as opposed to having to be, forced to come along for the ride. I think that's important. But, There's a whole new frontier coming, and it's coming fast, and we're, you know, we're at the tip of the spear in many regards, as leaders with our research organization, serving over 000, seniors directly every day, many more thousands indirectly through our research and education is a very important component of what we're doing, so we're happy to also be, not just the recipients of technology, but driving technology.

That's great. And it, and I think it does give a little different spin on elder care than what we might assume or expect. So, thanks for sharing all that. I like the restless innovator. So, is there anything else that you want to highlight before we close

today? bOy, yeah. I hope that I've conveyed that, senior care is exciting.

The world of senior care, I had shared with you earlier, 30 years in healthcare IT, and most of it was acute care. I came here and was rather surprised to learn how much opportunity there was, and not just opportunity, but actually, you know, reward in implementing these new systems and a receptiveness to doing it.

I would encourage others to look at senior care. It is certainly going to be more demanding and more necessary in the future. Baby boomers are aging every day. The, you know, retirement plus age of our population is growing every day. So, Senior Care will continue to draw more talented individuals and and I invite them.

I saw your, podcast with Kara Babichiko a couple months ago. I know she echoes that, that sentiment. So, there's some good leadership out there in the Senior Care world and I invite others to join.

Absolutely, and I was thinking about that interview with Kara. You knew Kara from when she was in the Boston market, right?

Yeah, we, right, our paths crossed often. And in fact, I uh, I took the position here for someone that was a colleague of hers also.

Okay, great. Well, this has been enlightening for me, and I'm sure for those who will be listening to this. So, thank you so much, Eric for all this information and a little bit of inspiration as well.

Thank you.

Thank you, Sue. I really appreciate the opportunity. Thank you very much.

  📍 I love this show. I love hearing what workers and leaders on the front lines are doing.

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Thanks for listening. That's all for now.


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