Nursing homes need an overhaul—we detail the overlooked opportunity for digital health transformation

The news: The National Academies of Science, Engineering, and Medicine released a report on the state of nursing homes in the US. It reveals the shortcomings of US nursing home operations. This is the first time the National Academies did a deep dive on the state of nursing homes since 1986.

The report identified major shortcomings plaguing nursing homes:

1. Nursing home care delivery operations are inefficient, ineffective, and unsustainable.

• Nursing home staff are underappreciated and undertrained to provide quality care.
• Despite regulations in place to improve quality care, nursing homes aren’t meeting those standards.

2. The quality of care in nursing homes is low. This puts nursing home residents at risk of poor health outcomes.

• Nursing home quality of care has gone down over the years. Only 10.5% of nursing homes had a one-star rating in 2013, but that almost doubled to 19.1% in 2019, per the CMS’ five-star quality measures system.
• To add, most nursing home residents already have chronic conditions. 71.5% have hypertension, 32% have diabetes, and 38.1% have heart disease.

3. There isn’t enough financial or operational support for nursing homes.

• Low staff salaries and benefits result in high turnover and inadequately trained staff.
• And studies found that nursing homes with higher staffing had fewer COVID-19 cases and deaths amid the pandemic.

Zooming out on the problem: The pandemic revealed just how US nursing homes were falling short of providing quality care. It highlighted inadequate staffing, poor infection control, and regulatory and oversight failures. These all led to patient harm.

Nursing home residents had disproportionately higher rates of COVID-19 infection than other demographics.

• They accounted for around 19% of all COVID-19 deaths, despite making up less than 1% of the US population, per the CDC.

Why it matters: Over 1.3 million US adults reside in 15,000+ nursing homes in the US. As the senior population grows, the demand for long-term care will also rise. Nursing homes will need to be able to effectively handle greater capacity.

Where digital health comes in: Government entities will need to allocate financial resources to make improvements. We detail three digital health investments that could offer a high ROI for nursing homes.

1. AI algorithms that detect and prevent infections before they become deadly.

• This can help reduce human error and boost care quality. For example, John Hopkins’ spinoff Bayesian Health developed an AI clinical support platform that signals when a patient becomes high-risk for clinical deterioration, sepsis, or injury.

2. Nurse staffing platforms can address the nursing shortage.

• For example, digital platforms like ShiftMed and Trusted Health source nurses and pair them with vacant positions with provider organizations. This could be extended to nursing homes.

3. Remote patient monitoring solutions can help reduce spending on staff and supplement clinical workflows.

For example, connected RPM devices like noninvasive sensors and medical grade smartwatches can help provide consistent health data and insights to nursing home staff. In turn, that can be used to provide better quality, timely care.