It has been over a decade since we first launched our electronic MAR. At the time, we had no idea that QuickMAR would grow to become the industry leader and the world’s most popular e-MAR. Because I have spent so much time working on our e-MAR, the benefits of an e-MAR are clear and obvious. It is always amazing to me that our biggest competitor is still paper. I read an article recently stating that only about 25% of the assisted living facilities in the country are even using an EHR. That just shocks me. Yet it also excites me, because it means there is still so much opportunity for our company to make a difference in the world, as we convert people to a better way of providing care.
With that background, I want to provide you with a primer on the basics of an e-MAR, and why you should adopt one right now.
What An e-MAR Can Do For You
For many caregivers, medication is the most important, most time consuming, and most stressful part of their job. It is stressful for several reasons.
• A resident’s health and wellness depend on getting the med pass correct.
• Most folks passing meds are not licensed, nor are they trained medical practitioners, yet they have been delegated a tremendous responsibility.
• Surveyors spend a tremendous amount of time focusing on meds. As a result, many of the findings and citations from survey are med related.
• For some busy med passes, it is a very hectic and harried period, trying to get a large quantity of med passed within the desired time frame.
The Typical e-MAR Med Pass
I’ll walk you through a typical QuickMAR med pass, so you can see how an e-MAR makes your life easier.
Jen, the med tech on the West Wing, is in the middle of her 8AM med pass.
In QuickMAR, she sees on a single screen all of her residents, and she can tell instantly which ones still have 8AM meds to be given, versus those who have already had their 8AM meds, or have no 8AM meds. She decides to assist Lester with his meds. She can click his photo and then is presented with an easy-to-read screen showing all of his 8AM meds.
Features of the med screen
• Our e-MAR clearly highlights the controlled drug, cuing her to look in the double-locked Narc box for the med.
• The new medication that was just prescribed two days ago is clearly indicated, which is helpful, as this is Jen’s first day back after her days off.
• She can also clearly see the med that was DC’d two days ago while she was gone, helping her stay familiar with Lester’s med pass.
• She can see that Lester’s Q6 hours PRN pain med was last given at 1:35AM this morning, so she is prepared if he asks for it.
• The QOD (every other day) drug is visible, so Jen knows it is due. Meds appear only on screen on the days they are due.
• She can see that Lester is due for his weekly weight check today.
Jen grabs Lester’s blister packs or multi-dose pouches from the med cart. She then scans the barcode for every medication.
• With each successful scan, the med is clearly checked.
• If the wrong med is scanned, the e-MAR will very clearly tell her.
• If she forgets a med, the system will very clearly tell her.
Once all the meds are picked, Jen hides the screen using the Privacy button, then goes to see Lester and assist him with the meds.
Returning to the med cart, Jen unhides the screen, then records the results with just a couple of mouse clicks.
• Exceptions, such as “resident refused,” are easily noted using a drop-down menu.
• The recorded weight is quickly added.
• For controlled meds, the system tells her how many tablets remain, helping ensure an accurate inventory.
Jen is returned to the list of her residents, and now repeats the process for the other residents. That’s the classic, basic med pass.
Just as important as what Jen did to pass the meds are the things that Jen did NOT have to do. These are some things that she didn’t have to do because she was using an AL eMAR:
• Thumb through 3-4 pages of meds to identify today’s 8AM meds,
• Figure out if the QOD drug is due today,
• Manually enter her initials on every 8AM med that was given,
• Hand write an exception,
• Write a note reminding her to reorder the PRN med she just gave,
• Refer to a separate Drug Reference book or its equivalent.
In the end, Jen can complete her busy 8AM med pass in less time, and with much greater accuracy. Some of our customers claim they’ve reduced the time to complete their busiest med passes by nearly 50%, while also reducing errors.
Other Benefits, Outside the Med Pass
I remember my days as an Administrator in an AL facility, the worry and stress associated with our surveys. We never knew the exact dates for the next survey, but we knew that we would be due so many months after our last survey. I recall the many, many hours I would spend, along with my Med Supervisor, poring over page after page of paper MARs for all our residents for the last 3-4 months, trying to spot any errors – missed meds, mainly. It was like looking for a needle in a haystack. And we could only do this during the small daily windows when the MAR binder was not required for the med pass. And I had only a single med cart to worry about. I imagine you would multiply that proportionally at facilities with multiple med carts spread across a large, multi-story building.
Medication Compliance with an e-MAR
Using an e-MAR properly will drastically reduce your concerns about the medication part of your next survey.
For one thing, forget about studying scores of MAR sheets looking for holes. QuickMAR can show you in a matter seconds any holes in your MARs for a given time period. What is more, you can run that report for your entire building, from your office, without bothering the Med Aides at the med carts. That alone should be enough for you to adopt an e-MAR.
Running that report just before an upcoming survey can be good. The best operators though take the opportunity every day to review medication issues. Using the QuickMAR dashboard, you can see in a matter of minutes everything you need to know about the medication management in your building:
• A list of all order changes to review,
• Missed meds from yesterday,
• Who has been refusing their meds,
• What PRNs have been given recently,
• Expiring med orders that need to be reordered.
Our electronic MAR can also summarize and email this information to in a daily report, if you would like.
By investing just a few minutes each day, you can always be confident about your survey readiness as it pertains to meds.
What’s keeping you or your colleagues from adopting an e-MAR? Fear of technology? Fear of the unknown? Afraid it might not be affordable? Too comfortable with paper? Whatever might be holding you back, you owe it to your residents and your caregivers to take a look. I am confident you’ll be convinced.