Our friends at Fauquier Health Home Care Services in Virginia have been highlighted as “agency of the month” for May 2013 by the Home Health Quality Improvement campaign, a project of CMS.

Quality Coordinator Jeanelle Dawson explains their keys to success:

“At Fauquier Health Home Care Services our clinicians are dedicated to providing the highest quality of care for our patients. This means our clinicians strive to stay educated and up to date on Best Practice Interventions. The HHQI National Campaign makes this challenge easier by providing tools and BPIP’s to help educate staff. Having a dedicated knowledgeable staff helps arm our patients so they feel confident in self-management, which ultimately reflects in our hospital readmission rates.”

Congrats to the team at Fauquier for their attention and commitment to quality care!

Not to be overlooked is another significant customer achievement highlighted in the HHQI campaign. The team at Lakeland Hospice & Home Care in Minnesota has sustained improvement in oral medication rates; Home Health Compare shows that 42 percent of Lakeland’s patients get better at taking their medicines correctly, which is close to the national average of 43 percent and above the state average of 36 percent! Because med adherence can impact rehospitalization rates, Lakeland’s clinicians, therapists, and medical social workers have made a concerted effort in teaching and assessments of meds in every SN visit, as well as implementing best practices across the organization in weekly care conferences.

Read more on their achievement and get some helpful tips on medication management here (PDF).

Congrats to the team at Lakeland Hospice and Home Care for their great work in improving outcomes!

Do YOU have a story to tell about the great things happening at your organization?  Let us know in the comments!

What’s New?  “Patient Engagement”

There is a new buzzword for healthcare providers: “patient engagement.” The application of this concept to relationships between patients and providers, including discharge planners, is becoming more prevalent.  In the commentary to final regulations governing the establishment of accountable care organizations (ACO’s), for example, CMS responded to comments about the inability to control patients’ behaviors so that monies are saved, including for the benefit of participants in ACO’s. CMS responded to these comments by emphasizing that it is the responsibility of providers to “engage patients” so that patients follow their recommendations.

In 2011, the Center for Advancing Health (CFAH) published an “Engagement Behavior Framework.” Below are some of CFAH’s recommendations for patients that require involvement by providers:

-        “Ask questions when explanations or next steps are not clear and express any concerns about recommendations or care experiences.

-        Ensure that relevant medical information is conveyed between providers and institutions.

-        Negotiate a treatment plan with provider(s).

-        Learn about any newly prescribed medications and devices, including possible side effects or interactions with existing medications and devices.

-        Monitor symptoms and conditions (e.g., for diabetes – monitor glucose regularly, check feet; for depression – medical medication and/or counseling and monitor symptoms; for hypertension – measure blood pressure regularly maintain blood pressure diary), including danger signs that require urgent attention.

-        Set and act on priorities for changing behavior to optimize health and prevent disease.

-        Identify and secure services that support changing behavior to maximize health and functioning and maintain those changes over time.

-        Manage symptoms by following treatment plans, including diet, exercise and substance use agreed upon by them and their provider.

-        If diagnosed with a chronic disease, understand the condition(s), the risks and benefits of treatment options and personal behavior change(s) by seeking opportunities to improve health/disease knowledge.”

This concept of “patient engagement” is not only increasingly important to payors, but is also significant from the perspective of risk management.  When patients are non-compliant or not engaged, it is difficult to separate non-compliance from poor quality of care.  Providers must take steps to get patients engaged and to document that they have done so.  It is not enough for providers to simply throw up their hands and bemoan the fact that patients will not do what they recommend.  It is the job of professionals to utilize their expertise to engage patients in a way that will likely support compliance.

Providers have a history of concerns about non-compliance or non-adherence by patients.  The tendency has been for providers to complain that patients are non-compliant.  It is clear that a different “wind” is starting to blow now.  Providers must prepare to take on more responsibility for patient engagement, including involvement in all of the activities described above and more.

©2013 Elizabeth E. Hogue, Esq.  All rights reserved.

Consider this…

Your patient care is exemplary.  Great news!

You run a lean, efficient organization and even with rate reductions, you’re in good financial shape. Congratulations!

Your census is growing — clearly a product of your hard work and standing in the community.

You were successful in hiring a bunch of new clinicians and office staff to handle the volume. Whew – it’s hard to find good people.

They made some honest mistakes as they were getting acclimated and up to speed.  Oops.

Based on Palmetto’s new policy, any home health agency that had 100 or more RAP’s auto-cancelled in the first quarter of 2013 will have all of their RAPs suppressed and set to zero percent pay until they complete a Corrective Action Plan. In addition, warning plans are being sent to agencies with between 50-99 auto-cancelled RAP’s.

Ouch. That’s a tough pill to swallow, especially for larger agencies where 100 RAP’s might represent just 5 or 10% of their ADC, and when honest reasons such as a missing a Face-to-Face or an untimely filing of a final claim is the cause.

The punitive nature of this policy highlights why agencies need to standardize processes and best practices across their entire organization.  A couple of lax clinicians or new billers that don’t stay on top of things can cripple the cash flow of your entire organization.

READ MORE ON HOME CARE EFFICIENCY

This makes on-boarding new employees more important than ever. Do you have formal training programs or centralized departments?  Is each functional area in charge of its own new hires?

It may be wise to examine your home health software as well. Does your technology have built-in workflow and alerts to help? Here at CareAnyware, we have best practices, logic and “double checks” built in throughout the software to ensure nothing is missed.  Our customers tell us that they really appreciate the way our software helps their teams work smarter and work more efficiently every day.  Watch our short home health software demo to learn more.

What does your organization do to keep things running smoothly as you grow?

The Medicare Payment Advisory Council (MedPAC) submitted recommendations to Congress last month that would significantly impact the post-acute industry and the patients we serve. Read the full text here.

Major changes to the home health benefit would include accelerated rebasing of Medicare reimbursement rates and per-episode co-pays, asking some of the sickest and poorest Americans to shoulder the burden of our country’s healthcare cost.  Read NAHC’s response.

These proposed changes have significant flaws, but they highlight the underlying principle that MedPAC continues to repeat –the desire to pay less per patient for home-based care.    

As an industry, we should absolutely join hands in fighting these changes, but we must also accept the reality that cuts will come and that we must do everything we can to plan for them.  Every provider will need to seriously evaluate their business and implement best practices wherever possible, operating under the theme “only the strong will survive”. Every supplier and vendor, including home health software providers, must ask “how can we help our customers operate more efficiently?”

During the next 20 years, 78 million baby boomers will require medical attention and all signs point to more of that care being delivered in the home.  Organizations, suppliers and vendors must:

• streamline processes,
• eliminate inefficiencies,
• find ways to improve cash flow

These organizations will be positioned as leaders in the overall healthcare landscape. 

Technology clearly has a role to play – EMR’s, telehealth, mobile apps and more must all come together to ensure quality care at the most cost effective price. At CareAnyware, our web-based home health software has helped our customers streamline process and save thousands of dollars on administrative time and effort.  We recently launched both electronic faxing and telephony products to drive even more efficiency and cost avoidance for home health providers.  View a brief tour of the CareAnyware solution for home health.

How have you used technology to your advantage?  Have you discovered new programs or apps that you have used to save time and money?  We would love to hear about your ideas and experiences.

Transcend Hospice Marketing Group recently conducted its first national survey with family healthcare decision makers. In this complimentary webinar to be held at 1 PM EST Wednesday May 8th, they will cover their findings and you will learn how to better understand the barriers preventing people from accessing hospice.

Data indicates that 28 percent of hospice care is for duration of three days or less. To encourage earlier engagement, understanding the differences and barriers to hospice care among ethnic and age groups is crucial.

REGISTER NOW

This webinar will help you:

• Effectively gather and apply market research to identify and prioritize opportunities for increasing length of stay in your service area.
• Understand awareness and perceptual variances between ethnicities, genders and ages.
• Spark earlier admissions using marketing strategies targeted to the specific interests and preferences of different demographic groups.

About the Presenters:

Transcend Hospice Marketing Group is a leading marketing public relations firm focused solely on promoting hospices. Transcend helps hospice organizations increase ADC and LOS, which generates more revenue to fund their mission. Learn more at Hospice-Marketing.com.

Date: Wednesday, May 8th, 2013

Time: 1 PM EST

REGISTER

ATLANTA – April 24, 2013 – CareAnyware, a Brightree Company and leading provider of web-based clinical, billing, and business management software solutions for home health and hospice agencies, introduces its Spring 2013 Release for the hospice industry at the NHPCO Management and Leadership Conference, booth 203, this week.

CareAnyware’s innovations for hospice agencies include new in-patient features such as encounter entry, patient vitals capture, and ESAS symptom assessment scores that create a comprehensive solution on a single platform for hospice agencies that offer both in-patient units and home-based services.  In addition, the CareAnyware platform supplements its robust hospice workflow and reporting engine with powerful benchmarking and KPI tracking available through an interface to SHPSolutions’ Hospice product.

“CareAnyware has been great for driving efficiency and helping our clinicians in our home-based business.  The clinical content, best practices and QAPI questions are very easy to use,” said Christie Dove, EMR trainer at Hospice of the Upstate.  “Now, with the new in-patient features, we can truly serve all our patients with one system, improving our efficiency and continuity of care.”

Dave Cormack, president and CEO of Brightree, said, “Hospice organizations are challenged with maintaining the highest levels of care while controlling costs and dealing with reimbursement challenges, and our web-based technology plays a major role in balancing these needs.  We are continuing to invest heavily in both clinical and administrative capabilities to ensure our customers’ success. Organizations that have been limited by legacy software systems can benefit from our robust, modern web-based platform, which delivers new levels of ease of use and efficiency.”

CareAnyware’s new features complement its existing hospice functionality, providing hospices the first web-based system that offers full, end-to-end functionality for both in-home and facility-based patients.

At NHPCO, CareAnyware will demonstrate new and existing capabilities, including:

• Enhanced in-patient functionality, such as efficient and accurate documenting of patient encounters, capturing vitals, ESAS assessments and best-in-class MAR capabilities, allows clinicians to document directly against the care plan and reduces time spent on documenting encounters by at least 50%.
• New benchmarking, dashboards, and reports enable business owners and directors of nursing to easily access clinical and operational performance metrics and identify areas for improvement.
• Pain assessments and QAPI reporting capabilities allow organizations to more effectively manage patient care and facilitate easier compliance with all CMS standards.
• Integrated IDT functionality and HIPAA-compliant tools for iPhones and Androids improve interdisciplinary communications and cut administrative time by as much as 80% per week.
• Core hospice functionality, including hospice specific clinical content for all disciplines, hospice specific workflow engines, integrated LCD tracking and billing, and more.

For more information on CareAnyware, visit www.careanyware.com or call 866.260.4630.

About Brightree and CareAnyware

CareAnyware, a Brightree company, provides a web-based EMR software platform that delivers the clinical and operational tools needed to provide best-in-class clinical care with operational efficiency, compliance and ROI to home health and hospice organizations. With fully mobile and cloud-based tools, the CareAnyware system is easy for clinicians to learn and allows administrators to better manage their organizations. For more information, visit www.CareAnyware.com or call 866.260.4630.

Brightree is the leading provider of cloud-based software for the post-acute care industry.  Our 500 team members serve nearly 3,000 companies in the home medical equipment, home health, hospice, O&P, home infusion, and complex rehab home care segments. Brightree’s software solutions follow the natural workflow of home care providers to automate and improve how they manage their businesses. For further information, visit www.brightree.com or call 888.598.7797, ext. 5.

Brightree is a registered trademark of Brightree LLC.

As Palliative Care Need Grows, Specialists Are Scarce

In this piece from NPR, the issue of limited supply of certified palliative care specialists that account for a shortfall  of as many as 18,000 physicians focused on palliative and hospice care.  What can be done to draw more into the specialty? READ MORE

For a Hospice Pioneer, Still a Tough Call

Despite a deep and intimate knowledge of the power of hospice care at the end-of-life, a hospice pioneer delays the decision to receive care.  FULL STORY.

End-of-Life Plans, Often Not Shared or Followed

A study recently published in JAMA Internal Medicine indicated that only one-third of cases showed a match between patient preferences for EOL treatment and the care they actually received. READ MORE.

Choose Wisely Campaign Educates Older Americans About Unnecessary Treatments and Procedures

To reduce the number of commonly prescribed yet unnecessary tests and treatments, the American Board of Internal Medicine and Consumer Reports aim to educate patients and physicians.  Key takeaway: “Treat the patient, not the lab test.”  READ ON.

Do you have any news to add?  Share your organization’s good news in the comments it might end up here!

1. Get it all out in the open. It may seem like a basic place to begin, but having a conversation with a tech-resistant employee that puts both perspectives out in the open can get things started off on the right foot. Ask your employee about their hesitation. Create an environment that allows them to speak freely without fear of judgment. Giving them the chance to explain themselves will help to set the tone for moving forward.  Express why learning the new technology is important. Steer clear of clichés like “This is the way of the world now!” and instead talk about the advantages of the technology — both for the team and the individual.
2. Show them how they’ll benefit. Once you’ve explained the business advantages of using the technology, capitalize on the personal advantages. Perhaps mastering their new tablet will allow your employee to video chat with family members or download books from the library. Demonstrate how this technology isn’t only great for business.
3. Make training convenient. Your employees are more likely to be open to the idea of training with new technology if it doesn’t inconvenience them. Instead of having everyone come in on a Saturday or stay late during the week, offer “Lunch and Learn” training sessions or devote regular work hours if it suits your schedule.

We know this can be a common problem for new home health care hospice software users, and we’d love to know how you’ve handled technology reluctance in the workplace. Be sure to check out our recent post highlighting 5 YouTube videos that may help your team get more comfortable with technology.

What’s worked and what hasn’t? Share your experiences in the comments below!

1.  50 Things To Do With an iPad. For the employee that thinks their tablet can’t possibly relate to their life, here’s a video to prove them wrong. From reading scripture, to following a recipe tutorial while cooking, this video catalogs the many ways an iPad can be used in everyday life. Though this video is specific to the iPad, many of the applications used can also be found on other tablets.
2. How to Use Skype. This video was created by CDL Life, an online community designed to address the needs of truck drivers. Though the video is geared toward truck drivers, the sentiment of being away from your family and wishing to communicate might resonate with your employees. It provides a recent and step-by-step guide to installing, setting up, and making calls with Skype.  Do your aides help their patients communicate with family via Skype?
3. How To Borrow Overdrive Library E-Books on Your Nook Tablet. It might surprise your employees to learn they can download library books for free with their tablets. This tutorial deals specifically with the Nook Tablet, but similar tutorials are available for just about any tablet your employees might be using.
4. How to Download Apps from the iPad App Store. Demonstrating to your employees that “There’s an app for that!” is a great way to help them customize their new technology to their needs. Once they feel comfortable in the App Store (similar videos exist for purchasing apps in Android Marketplace), they can search for their particular interests and discover just how much their tablets can do.
5. How to Use an Android Tablet for Email Setup. This video does a step-by-step walk through on how to sync your Gmail and other email accounts to your Android tablet. Even if your employee is experienced with email, they might have difficulty transferring those skills to different technologies. Using videos to demonstrate even the most basic of tasks can help your technology resistant employees feel more comfortable.

These videos are only five among hundreds of “how-to” videos available on YouTube and other resources. Showing your employees how technology can be useful in their lives beyond work can be a useful motivational tool. How does technology enrich your daily life? What are some ways you use your tablet or smart phone?

A note from Theresa M. Forster, Vice President for Hospice Policy & Programs, National Association for Home Care & Hospice:

To comply with the Payment Year 2014 Hospice Quality Reporting Program (HQRP) requirements, providers should have entered or currently be entering their  NQF #0209 data on the data entry and submission website.

The deadline for reporting NQF #0209 data for Payment Year 2014 is April 1, 2013. In order to avoid a 2 percentage point reduction in their Annual Payment Update (APU), providers must have submitted their structural measure data by January 31, 2013 and must submit their NQF #0209 data by April 1. Providers that may have missed the structural measure deadline can still visit the data entry website, create an account, and enter their NQF #0209 data. The link to the data entry site, along with a Technical User Guide  giving step-by-step instructions on the data entry process, can be found on the Data Submission portion of the CMS HQRP website.

CareAnyware hospice software customers should use the report under Hospice menu called QAPI Patient Listing to generate the data needed for this requirement.  Need assistance?  Please feel free to reach out to the Support team at 866-260-4630, ext 205.