Electronic Health Reporter

By Lee Horner, CEO, Synzi. 

Visiting nurses are valued for their caring and compassionate nature.  Their valuable skillset makes a difference in the well-being of their patients and the lives of patients’ families.  However, they face unique challenges amid the coronavirus as patients and staff are concerned about receiving in-home care during this time.  Bringing healthcare to the home is no easy task.

As NAHC President William A. Dombi stated, “Home care and hospice nurses, therapists, aides, and other providers who choose to use their lives to serve our country’s aged, disabled, and dying. This noble work deserves our recognition and praise.”

Home health agencies are on the front line amid the coronavirus pandemic. A recent Home Care Association of New York State (HCA-NYS) survey found that nearly half of agencies in the survey said they have experienced patients or family members refusing entry of home care personnel. “Different states and regions are at different stages in surveillance and monitoring,” Roger Noyes, director of communications at HCA-NYS, told Home Health Care News.

“This speaks to some very important educational and outreach needs to reassure patients and to ensure that vital care can be delivered,” Noyes said. In addition to patients’ hesitation to let nurses into their homes for in-person visits, many patients are already quarantined, sheltering in place, or social distancing. And, some patients are denying service because they appreciate their nurses so much that they do not want to risk getting their nurse sick in-person. Concurrently, the nurses themselves might also be wary of conducting in-person visits as they might not have sufficient protective gear and/or fear the risk of infection.

Agencies are implementing telehealth/virtual care to preserve their patients, their staff and their limited supplies. Technology can help agencies’ staff continue what they do – provide compassionate and critical care – and “be present” with their patients as much as possible. With technology, agencies can safely continue the delivery of care during this time and quickly communicate critical updates as needed. The technology helps home healthcare agencies:

• Conduct virtual visits with patients to safely ensure continuity of care
• Send out critical COVID-19 updates and self-care tips
• Send condition-specific messages to improve ongoing adherence
• Provide virtual access to their staff which helps nurses address patients’ emerging concerns and also alleviate patients’ loneliness while being socially isolated

With virtual visits, agencies are kept abreast of the realities of the patient’s home environment and their available resources (financial, food, social, etc.). Staff can continue to monitor their patients’ day-to-day situation and individualize the care (and conversation) to the “new normal” for the at-home patient.

Why Nursing Homes are Implementing Telehealth

Facilities (such as SNFs, ALFs, and LTCFs) need to consider what additional threats may results from the coronavirus and have a plan for safely maintaining operations given staff and patient concerns. Patients (and their families) are hesitant to let visiting clinicians, nurses, and aides perform their typical in-person visits at a facility. The facility’s staff wants to telecommute and/or conduct more virtual visits with patients vs. in-person visits at this time. External healthcare providers and home care aides are also seeking to virtually engage a facility’s patients instead of being on-site and risking infection or transmission.

Nursing homes are embracing the role of telehealth as they significantly restrict visitors and nonessential personnel inside nursing homes. CMS is recommending that “in lieu of visits, facilities can consider offering alternative means of communication for people who would otherwise visit, such as virtual communications.”

Video-based virtual visits and check-in’s help:

• Staff access offsite medical directors for immediate decisions and avoid transfers
• External care team members safely check-in with their patients
• A patient’s family remain engaged in their loved one’s care
• A facility expand its services by providing convenient access to specialists
• Staff continue to engage rehab patients who have returned home

Telehealth and virtual care is being deployed at these facilities, enabling internal and external staff to ensure the continuity of care.