Recently, the president of the National Association for Home Care & Hospice (NAHC) called on all American’s to commemorate National Home Care & Hospice Month. He also stated that in the coming years, home health care is poised to play a central role in the delivery of healthcare throughout the country. Yet, the growing home health market is not without challenges. Solutions that blend innovation and mobility at the point of care can help pave the way for strong patient-caregiver interactions and support positive outcomes.
Home Health Poses Challenges: Mobile Solutions Can Improve Care Delivery
An aging population and tough new compliance and regulatory issues are posing challenges for the home healthcare segment. The unique and specific needs of the home healthcare market must play a paramount role in organizations seeking to develop mobile solutions to address these issues. Home caregivers urgently need “smart” solutions that address not only patient privacy, but also, wireless connectivity, mobile printing, security and remote data access.
There are a number of issues and trends impacting the healthcare industry that solution providers and caregivers need to keep top-of-mind:
Reimbursements/Re-admissions – Medicare reimbursement reductions and new penalties are being imposed on hospitals with high avoidable re-admissions. This increases the pressure on home health agencies to leverage technology to aid patients in following aftercare instructions, adhering to medication plans and accessing their medical information – all to better prevent costly re-admissions from occurring.
Guest post by Bettina Experton, MD, MPH, president and CEO, Humetrix.
Mobile technology core to HIT implementation, a silent revolution which took place on September 23 this year when the HIPAA omnibus rule took effect, giving Americans the right to obtain electronic copies of their health records. But how can this new right be exercised at scale to transform healthcare nationwide? How do we help patients better coordinate their care and ensure their safety by getting their health records in their own hands?
The scalable computing device of choice in the hands of many is a smartphone, now owned by more than 50 percent of the population, and for many the only computing device they use daily to access information on the Internet. Clearly, electronic access to health records would be best provided on the very mobile device most of us carry at all times, especially when navigating a complex health care system with multiple and dispersed providers.
Electronic copies of health records on CDs or flash drives are not only tools of the past, but also perpetuate the barriers and complexity most of us have to face when requesting copies of our records. Desktop and portal-only solutions are also not the optimum approach to consumer-directed health information exchange, since these cannot be available at the point of care where patients need to share their medical history in the most convenient and expedient way. Mobile is, therefore, central to health information exchange policies and new care delivery models built on patient-centered care, and should not be an afterthought or secondary implementation to dated patient portal systems.
Dr. Lucy Hornstein, solo practitioner at Valley Forge Family Practice in Phoenixville, Penn., was not a proponent of electronic health records. An active physician blogger and published writer, she spent quite a few of her words on the technology’s uselessness.
They were expensive, overly complicated and tough to use and provided little return on the investment for users. Besides, most physicians, in her opinion, only implemented them because of meaningful use and the federal incentives they received for using them.
Paper, she had long decided, was good enough for her and during the first 21 years of practice in her own practice, she had no plans to change. It was only after the loss of one of her two staff members that she soon realized that she’d have to re-hire just to maintain her practice at its current load. However, that wasn’t an option for her. Neither, she thought, was adding an EHR to handle the management of the records because other than her perception of the technology, the self-described “dinosaur” didn’t have the budget for such an endeavor. She had zero for such technology.
Even if she had a change of heart and adopted the technology, she had not seen one system that was not cumbersome, not hard to use, intuitive to maneuver and or that offered her the option to meet the needs of her small practice while running the business efficiently.
One of the greatest sources of information that depicts the changes in health IT trends across the industry landscape is from Michael Lake, healthcare technology strategist. Through his monthly reports on the state of health technology, published by his company Circle Square, he provides succinct highlights from throughout the last month. Possibly, what’s best about these reports is that they cover such a diverse segment of the ecosphere.
For example, in one of his most recent reports, the focus was the EHR vendor sphere, cloud EHRs and their importance to independent practices, the use of faxes in hospitals, vendor news and transactions and practice portal insight, among other news.
According to his most recent report, cloud-based EHRs with integrated billing are quickly becoming a key to a practice’s future success as an independent practice. In his report, he cites Black Book as ranking solutions that seamlessly integrate electronic health records (EHR), revenue cycle management (RCM) and practice management (PM). Kareo tops on the list, per KLAS.
However, most practices feel that billing and collections systems and processes need upgrading (87%) and more than 40 percent (42%) are considering an upgrade to RCM software in in the next year . Most practices (71%) are considering a combo of new software and outsourcing services for improvement.
It is no surprise many hospitals and eligible professionals are “heads down” on meaningful use Stage 2 preparations. EHR upgrades, evaluating performance against increased thresholds for carry-over objectives from Stage 1, and delving into the technical, procedural and workflow complexities of many new objectives has caught many providers off guard, particularly those for whom meeting Stage 1 was a relatively easy goal.
Two very challenging areas for Stage 2 for most eligible hospitals (EHs) and eligible professionals (EPs) are the objective “Summary of Care Record at Transitions of Care (ToC)” and those that relate to Public Health reporting.
For these objectives, it is not necessarily the performance thresholds that present the challenge, rather the EHR functional requirements, the requirements-behind-the-requirements, or the workflows that are the cause of consternation. These objectives and their unique challenges are described below:
Summary of Care Record at Transitions of Care (ToC).
This objective is challenging on two fronts. First, the population and generation of the Summary of Care Record (the “Record”), and second, the actual transmission of that document at transitions of care to intended recipients.
Kareo, a company I have come to quietly respect (the company does not sponsor this site in any way) issued the following graphic (something else I have come to really like). I’m a visual person and there’s often no better way to convey complicated information like that found in health IT and I find the following graphic filled with much telling information, and seems to beg whether small practices are served well by EHRs.
This graphic seems to speak to a bigger picture of what’s going on currently in the space. This information tells the story of how it is becoming more difficult to maintain autonomy in private practice, but not impossible. With technology, small practices can thrive. But, is there enough focus on the small practices for technology to make the difference Kareo says it can?
Kareo has skin in this game, after all, and makes its position clear: “The solution is technology, and not just one piece of software but a fully-integrated seamless package of solutions from a single vendor … most physician practices know that to remain independent they will have to make changes.
“The willingness to change is important because success may rely on seeing your practice as a business and carefully considering and evaluating your bottom line. While many physicians in practices with five providers or fewer are still hesitant to adopt an EHR, the potential benefits are indisputable.”
MGMA president’s open letter to HHS Secretary Kathleen Sebelius from Susan Turney, MD, MS, FACMPE, FACP president and CEO, that is an important summation of the current meaningful use Stage 2 situation facing physicians and caregivers:
August 21, 2013
The Honorable Kathleen Sebelius Secretary Department of Health and Human Services 200 Independence Ave., S.W.
Room 445-G Washington, DC 20201
RE: Stage 2 meaningful use EHR Incentive Program
Dear Secretary Sebelius:
The Medical Group Management Association (MGMA) writes today to share our concerns regarding the current meaningful use environment and diminished opportunity for physician practices to meet the requirements for Stage 2 of the program. If the appropriate steps are not taken, we believe physicians that have made significant investments in EHR technology and successfully completed Stage 1 requirements will be unfairly subject to negative Medicare payment adjustments. Accordingly, HHS should immediately institute an indefinite moratorium on penalties for physicians that successfully completed Stage 1 meaningful use requirements.
I can’t think of a more obvious statement than the one recently made by Impact Advisor principal Laura Kreofsky, who said recently that everyone in healthcare is going to hit a wall in a year or two and fatigue is going to settle in regarding meaningful use.
By 2015, we’re all going to be sick and tired of meaningful use.