Advanced Health Institute (AHI)

Christopher has more than 15 years of hands-on experience in clinical nursing and operations. His dedication lies in long-term care, an area he has devoted his entire nursing career to. Progressing from a staff nurse to Director of Nursing, Christopher has gained a wide breadth of knowledge and skills within this particular setting.

Insights about Professional Journey and Key Experiences

I transitioned from a career in contract and administrative work to nursing because I wanted a more people-focused role. I sought a position where I could help others and feel good about my work, regardless of the challenges and difficulties I might face. When I entered nursing, I started in long-term care like many new nurses. Initially, I thought I’d move to hospitals and acute care for better pay and exciting challenges. However, I fell in love with long-term care. I appreciated the opportunity to build long-term relationships with patients and provide consistent care. My career progressed from staff nurse to charge nurse, nurse manager, assistant director of nursing, and director of nursing, with a strong understanding of MDS management.

While serving as an Assistant Director of Nursing, I connected with some individuals at Advanced Health Institute (AHI) who offered a Director of Nursing boot camp. This program covered the roles, basics, regulations, and other essential aspects of the position. I stayed in touch with them for a while, and when I decided to transition into consulting, I reached out to them again.

I've now been with AHI for about five years, and it's been a great experience. We get to go out into the community, work with various organizations, and assist them with quality improvements, quality metrics, regulatory compliance, and staffing. This job includes everything I loved about my previous role but without the HR headaches and disputes over staffing and unit assignments.

"AI systems have the potential to serve as personal assistants to streamline the process of gathering and organizing essential health information. This technology could empower individuals to make informed decisions quickly by providing instant access to all relevant data they need to provide safe and effective care"

In the past year, AHI, along with a few colleagues and myself, launched a new company called DOVAXIS. This company is doing exciting work in the artificial intelligence space, specifically for long-term care providers.

Trends and Technology Advancements Impacting Skilled Nursing Services

Undoubtedly, AI is at the forefront for me. It's only recently that AI has started entering the mainstream, with more people becoming aware of and using tools like ChatGPT. At its core, I believe healthcare now heavily relies on information access and retrieval, and having all the necessary information allows for educated decision-making to provide the right care at the right time and personalize it effectively.

Also a major issue we’re facing is the overwhelming amount of paperwork that detracts from patient care. Many medical record systems contain all the necessary information for MDS assessments or to create care plans but lack automation capabilities for extracting this data. For instance, when conducting an assessment, these systems have the patient’s diagnosis codes and medications but don’t allow for easy data extraction and integration into necessary forms. Consequently, we spend a significant amount of time searching for information that should be readily accessible. So looking ahead, I envision AI systems evolving to function like personal health unit coordinators, efficiently pulling and organizing needed information and enabling us to respond swiftly with all pertinent data at our fingertips. 

Challenges in Providing Care to Seniors Over the Next Few Years

The biggest challenge we face is staffing. CMS recently issued a staffing mandate for 3.48 hours of nursing care per patient day, which is a reasonable target. I support this idea in principle and firmly believe that more staff time leads to better outcomes. However, our current use of nurses and the way we allocate daily duties result in significant resource wastage due to inefficiencies in our processes; on top of that, the nationwide nurse shortage is a serious barrier we’ll need to overcome if we are to meet the proposed PPD requirements. If this mandate is implemented and withstands legal challenges, we will need to find ways to maximize the efficiency of our nursing staff. This will involve redeploying their time to direct care areas. We may have to consider redeploying nurses from ancillary/administrative roles to hands-on ones to meet the these new regulatory requirements.

I believe it is important to consider automating document review processes to save time and increase efficiency. For example, when dealing with admission reviews, the documents can be 100 to 150 pages long, taking 45 minutes or more to read through to determine if a patient can be safely admitted. This time-consuming process takes away valuable nursing time that could be better spent at the bedside. We're working on a system that can read through these documents, pinpointing the specific information you need. This automation saves time and allows nurses to focus more on patient care. This approach can streamline not just admissions but other processes as well.

I recall reading recently that in the last couple of years we spend between 30 and 40 percent of our time sitting and staring at screens rather than interacting with people directly. If we could reduce that screen time by even half, it could significantly improve access to the care people need.

Advice for Professionals: Key Considerations and Pitfalls

The technological landscape is evolving rapidly, and new tools and announcements are emerging constantly. Engage and experiment with these new technologies to become familiar with how they work and how to interact with them effectively. Gaining familiarity will make it easier to adapt to future innovations as these skills are transferable. Take the example of electronic medical records (EMRs). It took a federal mandate to get the healthcare industry to adopt EMRs universally. Despite this, some non-skilled nursing facilities like assisted living centers still rely on paper charts, leading to significant inefficiencies. This underscores the importance of being open to adopting new technologies.

When exploring new tools, ask plenty of questions to understand where the value lies. Many AI tools are overhyped and appear promising at first glance but often fail to deliver on those promises. It's important to try these tools before making any long-term commitments and ask critical questions about HIPAA compliance and the safety measures they implement to protect information.

For instance, tools like ChatGPT can be quite helpful, and many healthcare professionals use them. However, since ChatGPT is not HIPAA compliant, users must be cautious. They should stick to asking general questions rather than copying and pasting sensitive information like progress notes for reformatting. It's crucial to be mindful of safety and security rules, which are well-established for traditional technology. Even though AI operates on different principles, these rules are just as applicable and enforced as they are for traditional technologies that have been around for decades.