During many discussions with Assisted Living providers across the nation I have learned that most understand the benefits of using software and share a desire to use “something”.  Naturally I ask the question, why do so many providers still rely on outdated manual systems and fail to implement software?  The reasons are complicated the answer is not.  For a long time I held some common misconceptions as to why many providers fail to make a decision and inevitably delay implementing software.  These misconceptions focus on four topics: Cost/Benefit, Access, Security and Regulatory Requirements.  Although these are important issues addressed in this article my experience has led me to a more basic conclusion.  In the absence of a regulatory mandate a facility must be aware of the benefits of using software, display the willingness to change and have the leadership to make it successful.  For facilities large and small, I consider these characteristics (however obvious) as fundamental in leveraging the benefits of any software application.

Let’s consider a hypothetical situation which eliminates my basic conclusion to change the context in which we discuss evaluating a software application.  Hypothetical - All assisted living facilities are required to implement software as a result of a regulatory change.  Most assisted living facilities have read and understood the well documented benefits of automating there systems and the staff are ready to accept this change.  Does this simply the process of evaluating and choosing a software application?  Yes, evaluating software options is now an exercise in objectively comparing the features and benefits.

I do not mean to suggest a regulatory mandate would be the only reason assisted living providers would chose to implement software as many providers have already done so based on improved quality of care, resident safety and many other reasons.  The focus of this article will be how to evaluate and chose software not explore the question of why providers choose to use software.

First I begin with a search of the Internet on “assisted living software” which displays a number of software vendors, of which, five (5) specialize in Assisted Living (I used Google & Yahoo).  My preference is to review vendors which have experience in Assisted Living and develop software for this market as a primary focus.  Those providers that wish to include more vendors can apply these concepts to as many vendors (applications) as you have time for.

Let’s take a moment to consider the misconceptions outlined above as follows:

Price – Like any business IT solution a good software vendor should be able to demonstrate how the product provides “benefits” for the “given” cost.  Simple, this is what we call a favorable cost/benefit analysis.  These benefits can directly translate into financial (savings/gain) or in the case of Assisted Living providers these benefits may be indirect and harder to quantify?  At a minimum a vendor should be able to address staff productivity, increased revenue (reduced expenses) or a combination of two or more.

Access - Technology is readily available and inexpensive to implement.  Intuitive design and software platforms have enabled users with little or no computer experience the opportunity to take advantage of the technology offered today.  Many applications offer simple interfaces with nothing more than “point and click” navigation.
 
Security – HIPAA includes a “Technical Safeguards” section which outlines the security requirements for accessing, auditing and transmitting personal health information.  These strict requirements and guidelines are an important part of selecting any software application and compliance to these regulations is recommended.

Regulatory Compliance – If assisted living providers were to wait for the final draft of the regulations affecting facilities today there would be few opportunities to get started.  I believe there should be a shared responsibility from both the vendor and the provider to communicate expectations and remain current with all regulatory changes.  The software vendor must demonstrate the capacity to make changes and understand the importance of these critical updates.  In many ways the use of software technology can facilitate implementing regulatory changes and can be viewed as an improvement over manual systems.
 
Evaluating software may sound complicated to some and our goal is to simplify the process.  I suggest breaking the evaluation down into the component parts along with exercising some common sense to reach a decision.  Remember to be consistent, ask the appropriate questions and take notes for future reference.
I have listed some specific categories along with sample question(s) you may want to consider as you review software products.  A key component to reviewing software products are “real-time” demonstrations and detailed discussions with the vendor to understand exactly how the software will work for your community.

1. Functionality / Content – Does the software meet the basic requirements you have identified?  For example:  Can you automate your existing assessments or will you have to use pre-defined assessments in the software?
2. Usability – Given the different levels of computer experience of your staff, does the software seem simple to use.  Identify how many of your staff may potentially access the program.  There is no hard and fast rule for this – you must rely on your impression and the experience of other users.
3. Platform & Requirements – There are two basic categories of software, “stand alone” programs that are installed on your network (or computer) and ASP (application service provider) software which is accessed over the internet (no software installation required).  Depending on your computer setup and access to IT support you will want to consider this carefully.  Keep in mind there has been a trend towards ASP applications which minimize up front costs and reduce the amount of ongoing maintenance.
4. Support – What is included in your support agreement?  It is important to understand not only the initial support but any ongoing support and any associated costs.  This is an important category where references from existing users are critical.
5. Training Implementation – Is there comprehensive training available?  What does the vendor offer in terms of implementation support to get started?  This can be a deciding factor in many cases as many communities do not have access to in-house staff to assist with this process.
6. Performance – How does the software perform?  I would suggest getting a reference from a current user(s) if possible.  Another facility with working experience with the application can offer tremendous insight into the pros and cons associated with working with a particular program.
7. Scalability – What are your future plans in using the software application?  Can you add users and features with the existing technology?
8. Flexibility – Has the vendor demonstrated a willingness to make changes to satisfy your unique needs?  Can they provide you with a working example of how this was accomplished for other users?
9. Security – Is the vendor HIPAA compliant?  Gain a better understanding of back-up procedures and disaster recovery plans.  These discussions can get technical, use your best judgment and determine if this meets your needs.  Remember, you can always ask for supplemental information in writing to take your time and review the response in more detail.
10. Licensing - What are the terms and associated costs?  Do you need to commit to a minimum contract (i.e. one year)?  Is the number of users limited?  Once you have identified a software application(s) consider taking advantage of any free trial offers.
11. Cost/Benefit – Ask for an explanation of the cost/benefits you can expect to gain from implementing the software?  How long does it typically take to see these benefits?