Many software company executives who provided us background for this week's feature article also gave us descriptions of features they believe must be included in order to help clinicians provide better care, easily produce better documentation, and properly discern whether to readmit or discharge after a 60-day episode. Particularly when addressing the issue of how to support the effort to document medical necessity in such a way that auditors will not question a claim, there is a surprising amount of agreement among leading vendors.
Our sincere thanks go out to Tom Peth, CEO of Thornberry Ltd., Tom Maxwell, COO of Homecare Homebase, Marie Finnegan, Director of Solution Management for Allscripts, and Chris Hester, CEO of Kinnser.
Clinical features that would help keep agencies compliant and guide them to document medical necessity.
Technology can help or hinder the rate of proper payment in the way it supports documentation. That said, we software developers could use some help from CMS and from our agency customers.
Software needs to be nimble because home health agencies are constantly chasing patients around as they may live with a son for a couple of weeks after hospital discharge, then with a daughter for another three weeks, then perhaps go back home. So caregivers are trying to schedule visits while a whole lot is going on. Software should be built around the philosophy that "Home Health happens." We put up guardrails but never interfere with the clinicians' tasks.
Software vendors add fuel to the fire when they cater to the nurseís desire to quickly "check the box" on each visitís documentation, getting the paperwork done quickly but perhaps without regard to the plan of care, patient history, next physician visit, etc. Nurses need to do these visits fast due to the cost pressures of the agencies to do more with less. If the point-of-care software program in use allows this, and a nurse doesnít take the initiative to review the plan of care, patient history, etc., this leads to insufficient documentation and take-backs that Medicare considers fraud.
We believe software companies can provide an easy to use software to allow the nurses to do more visits in a day, but we must push this information to them without requiring them to take the initiative to search for it. We can also guide them with suggestions for proper and compliant documentation to insure medical necessity is clear and that proper and appropriate interventions are set, and not forgotten, visit to visit. We software vendors can guide nurses to document properly but, ultimately, itís all about the nurses.
©2015 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan's Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. firstname.lastname@example.org