Like all business owners, home health, hospice, and home care owners love free stuff. Whether it be dinners with software salespeople or subscriptions to online newsletters, business owners are normally open to taking advantage of little perks or opportunities to enhance the effectiveness of their company's efforts.
Care quality and patient outcomes are enhanced when information is shared among payers, hospitals, skilled nursing facilities, home health, hospice, and home care providers. One of the tools to facilitate this patient information sharing is the Health Information Exchange. There are several HIEs around the country, some statewide, some multi-state. The goal since 2004 has been to eventually link them together so that every healthcare provider can better serve every patient.1
One of these services linking HIEs is Collective Medical, which provides a platform known as EDI over which providers and others can exchange patient information in real time. The Salt Lake City-based platform demonstrated such an elevated level of cost avoidance, its participating payers in one of the 39 states is serves decided to underwrite its fees to post-acute care providers. In New Mexico, home health, hospice, and home care agencies can participate in Collective's care coordination platform at no charge.2
Should they take the trouble to subscribe to this free HIE? An executive with the only home health agency in New Mexico that has taken advantage of this free offer says absolutely his colleagues should be using this service. We spoke to Reynold Bunzel to learn about his agency's experience with the Collective platform.
Reynold Bunzel serves as the Chief Innovation Officer of Corus Home Health and Hospice in Albuquerque. His agency has been using EDI for the last nine months. Though his team discovered its EMR could not interface with EDI, they designed a workaround and Corus began to send and receive patient information to local hospitals.
"During those initial delays, we found the EDI folks to be very pleasant to work with, he told us. "EDI's value proposition outweighs our initial effort to get it working."
That value proposition, he explained, starts with the elimination of most missed visits. "We don't know what we don't know," he said. "When we see a patient on Monday and Thursday, for example, we used to have no idea that, in the interim, the patient might have developed a fever, went to the hospital ER, and was given IV antibiotics. When we return that Thursday, our nurse would be surprised to hear about this episode."
He continued by explaining that this used to happen because patients and family find 911 easier to call in a perceived emergency. "Even when we tell them to call us first," he bemoaned, "patient habit is to use what they are familiar with. We have not had a good way to monitor a patient 24/7 because we are not a facility. We provide intermittent care, so things happen when we are not there. We want to make sure our skilled nurses and therapists, which are quite costly, are driving to homes where patients are actually there, not in the hospital. We used to have many more missed visits before EDI."
Collective Medical General Manager Kary Nulisch told us how EDI delivers these advantages. Every on-network care facility can collaborate through the Collective platform and communicate critical patient insights at the point of care through a secure connection. When a patient arrives at a hospital emergency department, EDI immediately sends that patient's history to the ED physician, by fax or text or other means that hospital has chosen.
"If the patient has a history that physician needs to know," Nulisch told us, "he or she knows it in real time, while the patient is in the ED. It might be a list of medications or co-morbidities that would inform emergency treatment. It might even be that this person is a habitual medication seeker who goes from hospital to hospital looking for unaware doctors."
If the database detects that the patient is currently under the care of a home health or home care agency, and if that agency is an EDI subscriber, EDI automatically notifies that agency that their patient has arrived at the hospital. If admitted, the post-acute care provider knows that as well. Corus Health sends ADT (admission, discharge, transfer) data to EDI three times a week.
Mr. Bunzel gave us a list of benefits that accrue to his agency as a consequence of having all this timely information.
EDI In Washington
After implementing Collective, ED care teams in Washington state saw $34 million in savings in the program's first year resulting from:
Avoiding missed visits and raising home health's image in the eyes of hospital personnel are important but Mr. Bunzel went deeper into EDI's benefits. His agency, he told us, also uses its reporting tools to improve care planning.
Mr. Bunzel summed up with a hope for the future of post-acute care. "We have positioned ourselves in home health as end of the line, the final stage of care. We need to change that. We need to see ourselves as part of a person's long-term care team, as a preferable alternative to 911."
"Ultimately, EDI helps us improves our care of every patient we serve. It gives you a window into the complexity of each patient. It also helps with coding accuracy because we know all diagnoses over different hospital admissions without having to ask the patient's physician or refer to the limited H&P from the hospital."
1 Ryan Snow — "Transitions of Care: The Biggest Challenge for Value-Based and Senior Care Efforts," 11/14/19 — https://collectivemedical.com/thought-leadership/transitions-of-care-the-biggest-challenge-for-value-based-and-senior-care-efforts
2 Zina Moukheiber — Forbes Magazine, 11/29/17 — "How Collective Medical Technologies Conquered Emergency Rooms On A Bootstrap" https://www.forbes.com/sites/zinamoukheiber/2017/11/29/how-collective-medical-technologies-conquered-emergency-rooms-on-a-bootstrap/#78ea649b6824
©2019 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. email@example.com