We recently passed a major milestone: our eMAR (electronic medication administration record) has been live for a year helping senior living communities across the country to pass medications to residents. With over 16.6 million medications administered using our platform, we are bearing witness to the fact that medication management in senior living is a truly herculean task.
In an assisted living community of 100 residents, there are about 1400 medications passed daily. Beyond the straightforward once daily pill, the “med pass” includes many complex medication orders, such as sliding scale insulin, steroid tapers, injectable biologics like GLP-1s, and medications with vitals parameters or atypical schedules.
Not only are the medication orders becoming increasingly complex, the sheer number of medications is rising given that older adults are moving into senior living later in life with more chronic conditions. Polypharmacy is a huge challenge; some residents have 60+ medications on their med list. Communities are storing hundreds of PRN (or “as needed”) medications, and there is a proliferation of OTC vitamins and supplements.
Now that we’ve been live with eMAR for the past year, we want to share some of our findings:
- In a typical 100-resident community:
- Residents of assisted living and memory care communities have on average 15 medications prescribed.
- 14.6% of assisted living residents have >15 medications prescribed for routine use, and 35% have >15 medications prescribed for scheduled and PRN use.
- 20% of assisted living residents and 40% of memory care residents take at least one DEA Scheduled drug.
The Operational Reality
Medication management is one of the most clinically complex aspects of assisted living and memory care operations. There is operational precision and efficiency required to ensure 1000+ medications reach the right people at the right times, every day, especially in light of the mobility of the residents moving about the community and making trips offsite. We also have to consider that some of these medications are more complicated, whether they are injections, PRN psychotropics, or specialty drugs. At the same time, communities must also store and track hundreds of medications including narcotics while balancing security with accessibility.
These demands fall heavily on med techs, whose roles are rapidly expanding. Fifty percent of the clinical leaders we surveyed with ASHA last summer reported that they are broadening med tech responsibilities to become “universal workers” — as their roles evolve to accommodate changes in the workforce, resident care needs, and clinical operations.
Looking Ahead
The days of the paper MAR are gone. Historically, the eMAR helped with the recording of medications, which was a great development. But the modern senior living community needs more. The sheer volume and complexity of the medication pass in senior living demands workflow optimization tools, clinical analytics, and business intelligence to promote medication safety and operational efficiency.
An easy-to-use interface that guides med techs to best practices and supports medication safety is just a starting point. Real-time data and intelligence generated from the medication orders and administration data must be surfaced to the med techs, nurses, and operational leaders to support ongoing oversight and improvement. Given the sheer quantity and complexity of the medications being delivered, the insights must help equip assisted living communities with the information needed to coordinate with external clinical partners to mitigate the challenges of polypharmacy and work internally to optimize the med pass for safety, efficiency, and quality.
Please reach out to let us know about changes that you’ve observed in the med pass over the years. Does the data and storyline here resonate with your experience? Let’s continue the conversation and work together to evolve the systems and operations to best support the residents.
