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If one scours the agenda and vendor list, it is possible to find some acknowledgement that members of the Healthcare Information and Management Systems Society know that there is life after hospital discharge. This has not necessarily been true in the past. Here is a briefing on what we found and who we met at this year's big health IT extravaganza.
Versity is a full-performance smartphone that can be used with any of the major cell carriers. It is 12.2 mm thick, runs on Android OS 8.1 and later, weighs 204 grams and offers a list of features mobile clinicians will say were designed expressly for them.
In addition to all this, we were told by Bill Foster, Director of Business Development in Spectralink's healthcare division, Versity's app can overlay a grid on its 13MP camera. When taking photos of the same wound over time, the grid enable precise measurement comparisons even if the shot is taken from different distances and angles on successive visits.
At the end of a recent hospital stay, the elderly couple was told he would be discharged "today." Ten hours later, they called their daughter 1,000 miles away in a panic. "Something went wrong. We don't know what to do and neither do the nurses." The daughter called the hospital CEO in a fury and her parents were finally released. Why had this torture happened? The doctor forgot to sign the discharge papers.
Tragedy number two. The discharging physician recommended a brief stay in a nursing facility before the patient was safe to go home. The day before discharge, the patient was handed a typed page of local skilled nursing facilities, some crossed out, some with changed phone numbers written over the old ones. "Here you go. Just pick any one you want and see if they have an open bed."
Luis Castillo is working hard to make sure such things never happen again. The president of Ensocare Care Coordination Solutions, he works with a team of software developers and sales representatives to build and spread the word about a software system that turns a 10 hour ordeal into a 10 minute solution.
EnsoCare software gathers contact information and CMS star ratings for every SNF in the region around a hospital that has purchased and installed the system. When a discharge decision is made, the software issues an alert, via a smartphone app or a desktop portal that local SNFs can use at no charge, with a brief description of the patient's condition and care needs. Any SNF with an open bed and the capability of providing that kind of care replies through the same portal or app.
In less than 30 minutes, the patient and family are presented with a short list of SNFs that includes not only their contact information but also their geographic location, what churches and freeways are nearby, what insurances they do and do not take, etc. The patient identifies his or her top three preferences, a referral is made, and a bed is prepared.
"There is no reason at all why this solution could not be extended to home health, or even non-medical home care in the right circumstance," Castillo told us. "We just haven't tried it yet." Asked about the age-old accusations by the OIG of "pay for play" arrangements, Castillo responded, "We thought of that so we make it absolutely free to any post acute care provider that wants to receive discharge alerts." There is, he added, the option of purchasing an enhanced listing, from a logo display and sentence to a quarter-page ad, but no provider receives preferential treatment for investing in one of those options.
A number of new ventures are leveraging the new Artificial Intelligence conversation technologies such as Amazon's Echo, Google's Home, and Microsoft's Cortana device. Boston-based Orbita facilitates the development of compatible apps for these devices with its newly released platform, Orbita Voice Experience Designer. Look for software developers to release products for seniors built on this platform. President and COO Nate Treloar told us that natural conversation is a superior remote patient monitoring format than screens and buttons for the elderly. "Language is one of the first things an infant acquires and one of the last skills we lose as we age," he said.
Treloar foresees an elderly person with one or more chronic conditions, whether technically homebound or not, saying, "Alexa, I need a ride to my doctor appointment tomorrow." The Amazon AI, which has been customized with the individual's information, might say, "I will remind your daughter Jane (or I will schedule an Uber) to pick you up at 9:00 for your 9:30 appointment with Dr. Jones." The app could be programmed to remind the person to stand on her Bluetooth-enabled scale every day, take her blood pressure or nighttime medications.
Early users of the Orbita developers' platform range from assisted living facilities ("OK Google, what is today's lunch menu in the dining room?"), skilled nursing facilities ("Cortana, tell my nurse I'm feeling dizzy."), and hospital systems, including the Mayo Clinic. A demonstration of Orbita's ideas for how voice and AI might be used by home care agencies can be requested at orbita.ai/for-home-care-agencies.
Speaking of conversations with disembodied voices, take a look at Pillo. A table-top communication device, it combines remote patient monitoring with medication management. A high-resolution screen can display instructional videos, photos of pills, two-way video communication, an clock faces. The AI voice system issues medication and appointment reminders and other Alexa-like conversations. The video camera uses facial recognition so the elderly patient does not have to log in or type a password to be identified. Once identified by the camera, the unit drops the pills for this day and time into a container. Remote patient monitoring features can be accessed by adding Bluetooth vital sign monitors in the home.
We got to spend a few minutes with David Belbeck, SVP, Corporate Development, and Angelo Papatheodorou, SVP, Emerging Markets and Products, to learn about Canadian SNF software giant PointClickCare's plans for the rest of the post acute market. The question has been on the table since 2015 when PCC acquired the software solution and related assets of the home health division of Smart Data Solutions, Inc., referred to as Nobility Health, a Minneapolis startup with a customer base in the single digits at the time of the acquisition.
"We did the acquisition in order to have a solution for our long term care facility customers who asked us if we had anything for their other business, the home care agency they also owned," SVP Papatheodorou told us. "Now, we are ready to offer our home care solution more broadly, not just to existing customers." He added that he is looking to build up his professional sales staff as quickly as possible.
ClearCare CEO Geoff Nudd was seen delivering a presentation in the IBM Watson meeting room. Is there something going on between the chief of one of private duty's largest software vendors and the Jeopardy champion super computer? We will find out.
©2018 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