Healthcare at Home: The Rowan Report

by Roger McManus, MBA (who has held several positions as Director of Strategic Relationships). Second in a 5-part series.

Part 2 of 5

The difference between “Profiles” and “Pages,” as Facebook defines them, is that Personal Profiles are for non-commercial use and may only represent individual people. Corporations are not people in Facebook’s world, no matter what the Supreme Court says. This can be confusing because the two types of Facebook entries look very similar. Business “Pages” are managed by real people who must themselves have a Facebook Personal Profile but the Pages they manage are separate from their Profiles.[More difference between Profiles and Business Facebook pages are provided by the author in this article, in which he points out the many instances of use and abuse incurred by Facebook page developers. Targeted use of Facebook pages for healthcare at home businesses  is also described near the end of this article, with suggestions to accomplish productive posts.]

Though business “Pages” look similar to “Profiles,” they offer unique tools for home care agencies. You can “like” a Page to receive see updates in the News Feed of that Page regularly. The News Feed is that information in the middle of your screen when you open Facebook. Pages, however, are not like Profiles where another Facebook user must accept you in order to establish a connection. With Pages, all an individual need do is to “like” your Page and you have a relationship.

Businesses want people to “like” them because that gives them permission to send them information. Caution: Abuse the privilege and they can “unlike” you just as quickly.

These days, almost everyone has a Facebook page. All too often business owners turn their personal Facebook pages into the online representation of their business. This is a mistake for many reasons. First, it violates Facebook’s terms of service. While this may not be a major crime, Facebook can and will terminate your profile when you are discovered. This wipes out a lot of work on your part if you have put effort into building it up with your key audience.

Instead, establish a Facebook Business Page. It makes you look more professional. Using a personal profile for business makes it look as though you do npt know what you are doing. This is not the message you want to be sending to customers and potential customers. Another key reason to use a Facebook Business Page instead of putting your business on your Facebook Personal Profile is that, with a profile, you are limited to 5,000 friends. With a Facebook Business Page, you can accumulate an unlimited number of followers. They are called “fans.”

One other, sometimes humorous, side benefit of not using your Profile for your business is that a Page clearly distinguishes a business from a person. It does not give your business a birthday, for example, or a gender, which can make your business appear less than serious. Instead, a Page gives your business a category and a mission. It allows product descriptions, a list of awards, if applicable, and a founding date.

What you share on a Business Page will not show on your Personal Profile and vice versa. They are entirely independent channels. If you do not have a Page separate from your Profile, do it now. Once you create it, keep it flowing with information useful to your prospective audience.

To accomplish this, you need only to produce posts that play to the interests of an audience that likely has older parents approaching the time when they may need in-home help. You can write these yourself, re-post items written by others on Facebook or subscribe to a program that produces and personalizes home care specific content on a daily basis.

Next week:  Part 3: Facebook’s Free Tools for Agencies  (NOTE: Click here if you missed part one in this series, “Facebook as a Marketing Strategy for Home Care Agencies.”)

Roger McManus, MBA, is an online marketing consultant. He teaches businesses how to automate the solicitation of online reviews. He can be reached at rogermcmanus.com/reviewsoftware.

©2016 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. editor@homecaretechreport.com

We already know the value of healthcare at home agencies’ focusing care service delivery on patients’ as-needed risk management routines. Enough conventional care services provided to patients, so it’s thought, will avoid hospital readmissions. Not avoiding these readmissions will soon result in post-acute providers shouldering expensive penalties. Hospital readmissions are a bane, to both care providers and their patients.

Healthcare At Home Businesses and Patients Avoiding Readmissions
But are there other ways of dealing with risk management of patients that will help home healthcare agencies avoid one day being penalized for hospital readmissions? Even better, will these new ways also help patients become more independent and capable of self management at home?

There are.

There are emerging methods that involve personalized use of telehealth devices, combined with conventional treatment plans, to assist newly discharged patients live independently at home. So says Dr. Devin Doughty, a medical engineer in the UK and leader of seminal organizations such as the “Centre for Usable Home Technology.” Doughty has long been developing tools to assist discharged patients live more confidently and safely at home, a process he has dubbed “reablement.” [Ranges of reablement tools and uses are described in this article, along with a case study indicating the variations of technology levels that can be adapted to the patients’ level of need and competency. Key to these choices of tools and uses, as Dr. Doughty notes, is:  “to get each patient comfortably on track to restoring the ability to perform normal activities of daily living as needed to continue to live at home independently.” Choosing among reablement tools and processes in a personalized fashion, Doughty states: “is a way of extending service provision using technology that keeps people informed, in touch, and in control of their fears and vulnerabilities.”]

Doughty describes these restorative care services in a recent posting on a new web page, “Information for Tomorrow,” which reports on seniors’ healthcare and confidence-building needs and a range of proposed solutions. He calls them the “10 P’s of Reablement” (see Table 1)

Table 1:  The 10Ps of Reablement

Reablement Tools and Uses
Naturally, Doughty recommends selecting each patient’s reablement tools after nurses and other caregivers have assessed the person’s specific needs and capabilities, and after having provided them with conventional care and education about new routines, new dietary plans, and the importance of medication compliance.

Tools selected must be well-suited to each patient’s interests and capabilities in order to make compliance more likely. Take, for example, the case of “Mrs. Murphy,” a composite patient invented by Kevin Doughty and colleague Patrick Mulvihill.¹

This elderly woman lives with a cognitive disorder that causes her to forget both to eat regularly and to take her medications as prescribed. She is assessed by her caregivers as a high-risk patient. Reablement tools assigned to her include a monitor and alarm placed on her refrigerator so that off-site caregivers can track her eating patterns; and a wearable medication reminder/dispenser so caregivers can track her adherence to her medication plan.

More homespun but just as necessary a tool for Mrs. Murphy is the telephone, another tool for the patient to keep connected to caregivers and for caregivers to provide additional education. Familiar and easy-to-use, the telephone is a non-threatening technology that is especially useful early in the reablement process when caregiving and patient education stints are most intense as patients re-learn managing daily life routines at home.

Choosing Risk Management Tools
New reablement tools and processes tied closely with conventional care and telehealthcare services now become a bundled package of risk management tools and processes. For these to work, however, the importance of caregivers undertaking careful assessment of needs and capabilities of patients who are assigned to reablement care service delivery cannot be underestimated.

One interesting pointer that Dr. Doughty provides in his journal article is: when assessing each patient’s needs and capabilities,alternatives may be opted for as needed. The tools can be high tech, low tech, or even no tech. Doughty offers the example of a patient who is unable to walk up and down stairs. Her bedroom is upstairs; her kitchen and bathroom are downstairs.

For this patient, choices may include:

1. Install a chair lift. (high tech)
2. Install a second railing (low tech)
3. Move her bed downstairs (no tech)

The choice may or may not be obvious, but it is made in light of the goal: to get each patient comfortably on track to restoring the ability to perform normal activities of daily living as needed to continue to live at home independently. Choosing among reablement tools and processes in a personalized fashion, Doughty states: “is a way of extending service provision using technology that keeps people informed, in touch, and in control of their fears and vulnerabilities.” (See Daughty’s “Coming Home” keynote address, published on the Information for Tomorrow web site. http://www.informationfortomorrow.com/community/0316-Coming-Home.html)

Audrey Kinsella, MA, MS, is HCTR’s telemedicine reporter. She has written on home telehealthcare and new technologies for home care service delivery for 20 years, in 6 books, multiple web sites, and more than 150 published articles. Audrey can be reached at audreyk3@charter.net or 828-348-5308.

¹ Digital reablement – a personalised service to reduce admissions and readmissions to hospitals and nursing homes,” Journal of Assistive Technologies 7 (4): 228-234– http://www.emeraldinsight.com/doi/abs/10.1108/JAT-07-2013-0018?journalCode=jat

©2016 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. editor@homecaretechreport.com 

Provider News: Awards and Acquisitions

Great Lakes Great Place

According to Fortune Magazine and global research and consulting firm Great Place to Work®, “Great Lakes Caring Home Health and Hospice (Jackson. MS) is one of the 2016 Best Workplaces in Health Care in the United States. The Jackson, MI-based provider ranked number 18 on the list, based on employee assessments.

Great Lakes’ 2,600 employees were invited to comment on the reward and satisfaction they take in their jobs, the camaraderie and loyalty they experience with co-workers, and the trust and confidence they feel toward Great Lakes Caring’s leaders. As he has always done, CEO William Deary deflected the credit back to his employees to cite reasons why the company he and his wife founded in 1994 was selected for the award. He pointed out their dedication to delivering superior quality health care, their commitment to industry-leading patient and family satisfaction, and their support and respect for their fellow employees. [Details about senior executives and employees sentiments about this company’s achievements are presented in this article.

A second company covered in this article–  PromptCare®  (Clark, New Jersey)–a regional provider of specialty respiratory products and infusion therapy services– and its acquisition of Boston Home Infusion
(Stoughton, MA)  are discussed in thew detail in this article.]

“We are very pleased to have earned this acknowledgement,” Deary told Fortune. “It is the caring attitude of every one of our employees that makes the key difference in the delivery of care to each patient we are provided the honor to serve. We invest in innovation, equipment, education and technologies, however we must embrace our extraordinary staff who are committed every day to ensuring we provide value, superior quality, and patient satisfaction. Our staff is the true differentiator that creates the reputation of care and caring, which is at the heart of why we exist,” he noted.

To create the list, Great Place to Work® surveyed close to 34,500 employees at health care organizations across the United States, including hospital systems, home health and hospice care providers, national health care associations, and medical products distributors. Topping the list was Texas Health Resources, a not-for-profit hospital system with 250 locations and 18,000 employees.

Great Lakes Caring and the other winning companies were selected based on responses to Great Place to Work®’s Trust Index© employee assessment survey. Survey questions assessed co-workers’ feelings on camaraderie on the job, as well as how they felt about other workplace issues including management, communication, work-life balance, and compensation.

Great Lakes Caring, which offers home health and hospice care, believes in extending its well-being focus to both patients and employees, the magazine stated. The company offers a telecommute option used by 60

PromptCare acquires BHI
PromptCare®, a regional provider of specialty respiratory products and infusion therapy services based in New Jersey, announced last week that it has acquired Boston Home Infusion, located in Stoughton, MA. Since % of employees and provides health care coverage to part-timers who work at least 30 hours per week.

“I absolutely love my job,” said one employee. “I have freedom to treat patients in the way that I know is best, and I have the support that I need. I can really make a difference in peoples lives here.”1992, BHI has provided home infusion therapies to people in the greater Boston area.

“BHI enjoys an excellent reputation in the delivery of home infusion therapies. This acquisition offers us an ideal platform for launching our disease focused infusion programs as a complement to their current range of therapy offerings,” said PromptCare’s President and Chief Executive Officer Tom Voorhees. He added, “It is also a natural extension of our strong presence in complex respiratory and nutritional support already in this area. We believe there will be a seamless integration of the teams, providing the same excellent and dedicated service to all our patients.”

“Joining the PromptCare Companies provides a great opportunity for continuing our growth with existing and new customers. We are particularly pleased that PromptCare has the same high priority of providing exceptional patient care to improve the lives of patients in their homes as we have,” said Cheryl Terry, President of Boston Home Infusion. She added, “Their innovative cardiac care, nutritional and ventilator programs will enhance the services we provide. It’s a great fit for BHI, our employees and patients.”

About PromptCare Companies
Established in 1985 and headquartered in Clark, New Jersey, PromptCare® serves at-home pediatric and adult patients in the Mid-Atlantic and Northeastern United States. Operating from 17 local service locations, PromptCare offers advanced high-tech equipment and clinical services and is a preferred partner for management of medically complex cases.
PromptCare.net

About Boston Home Infusion
Founded in 1992, Boston Home Infusion provides in-home infusion therapy, respiratory services, enteral therapy, and durable medical equipment services for adult, pediatric and neonatal patients throughout Massachusetts, New Hampshire, Connecticut and Rhode Island.
bostonhomeinfusion.com

©2016 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. editor@homecaretechreport.com 

by Scott Herrman

Patient engagement and technology go hand-in-hand, right? It’s an elementary observation, especially given our increasingly mobile environment. As we all know, healthcare is transitioning to Value-Based Payments (VBP) in the USA and Outcome-Based Payments (OBP) in Canada, meaning reaching for the best Star Rating, increasing the quality of care for patients, and demonstrating strong patient outcomes must be at highest priority if agencies want their payback. With the new VBP/OBP environment the time has come for home care agencies to plan a way to reach clients beyond typical face-to-face encounters.

Multiple paths can be chosen for this effort, though few are as robust and comprehensive as needed to engage the patient on a regular basis and capture real-time data. There is an option, though, that resonates not only with forward-thinking agencies, but their clients as well: mobile health applications. Patient portals and/or telehealth have been more common methods to lead agencies to better client communications – but mobile health applications have moved to the forefront of patient engagement and proactive care. Let’s see how mobile health applications hold up against these two more typical patient engagement paths. [The author provides details on needs for and uses of patient portals, telehealth, and mobile health application solutions for healthcare at home patients of all ages.]

PATIENT PORTALS
In the past few years, the use of a web-based patient portal has emerged as a way to share information. Common usage is for care team, client, and a family and friend caregiver network to have access to information, keeping everyone up-to-date about a patient’s condition and plan of care.

This approach can work when there is consensus from all parties involved as to what data is to be provided by what party. However, just looking at the process is cumbersome: the client has to get online, open a browser, go to the site, log in, and free-form type their issues each day, or whenever they are instructed. Sometimes the portal has basic surveys based on their needs and/or chronic conditions to explore how they are feeling that day, but it is not robust enough for a clinician to adequately triage a situation in real-time and act accordingly. Agency caregivers need to make sure they too are keeping up with in-person observations from their last visits. While this approach is better than solely relying on caregiver notes, it lacks consistent patient engagement and real-time communication with the agency.

TELEHEALTH
Patient-reported data via telephony, remote patient monitoring, and even tele-visits help in-home care providers to increase care quality and achieve better outcomes – there’s no doubt. All of this is actionable data that providers can receive and monitor, improving their client’s health as they age.

Yes, you may be wondering, “But what about the generation that never fully immersed itself in the digital and mobile technology of this age? Are they limited by their technical disability from supplying necessary data?” Valid questions, but let me ask you in return, “Can they answer a telephone and press 1 or 2 or say ‘yes’ or ‘no’? To anyone who has an elderly influence in their lives, we know they can. These basic skills would be applied to answering basic care plan questions that can keep them healthy and provide proactive care data to the home care team. Anyone can provide additional health data if they are presented with the right tools. By sharing information with their care team they can truly be a partner in their care, directly impacting their own quality of life.

However, there are some issues with telephony, one of which I call “intrusive technology.” What if the client is not home or does not answer a scheduled call – what do we assume? Are they down for the count or are did they just not want to be interrupted? That leaves a dilemma for an agency to make the decision to send someone to check on them, or at minimum manually call back and make sure they are alive and well.

As a whole, for our current elderly generation, telehealth is a good option. It is simple for clients to understand and provides a measure of patient engagement. However, there is an option that far surpasses the practice of using telehealth alone – an option that is not just useful, but necessary for the next generation to be deemed “elderly.”

MOBILE HEALTH APPLICATION SOLUTION
We find ourselves firmly planted in today’s mobile world of applications where the Boomer/Zoomer generation lives. They know technology. They need technology. And they want a mobile application for their disease/case management. This generation, my generation, whether part of the greater care team or a client, will always use mobile devices, as will every generation that follows. From athletic fitness builders to health-conscious foodies, “there’s an app for that.” So why not have one for connected care where clients could track their own health and keep up with their care providers? Non-intrusive, proactive “nudges” that can truly impact and lower the cost of care, and allow agencies to gain advantages over their competition in home care. What if an agency provided a smart mobile app for its clients?

Think about it. In most cases, only providing the app is necessary, as most people have a smart mobile device, so upfront cost is limited. A proper home care and senior living app can streamline communication, record client-reported data, and simplify the monitoring process. Important information could be associated with each client based on his or her own personal profile, linked to their log in information. Now there is full connection to the client via the convenience of the app on a device they’re bound to use at least once a day – a non-intrusive connection where the client could at any time provide information for everything the telephony service or patient portal could ask. The mobile app would combine the two services, add more features, and ultimately result in a more robust tool for clients and agencies alike.

This app can eliminate phone calls about scheduled events (think about requesting schedule changes where the patient and staff can communicate digitally to avoid costly missed visits). Within the app, the client answers symptom-related questions. If they give a poor-health response, they are immediately provided guidance and education, from right within the app, so they have resources and answers that enable them to manage symptoms and reduce anxiety in real-time. Simultaneously, the app sends their care team an alert to show their need for potential support. Think about simple scenarios where a client may have measured a low blood glucose level and all they need is some “coaching” to get them where they need to be. They follow the guidance provided in the app to get them back on track, and their agency is alerted of their health status, allowing them to better triage the situation and potentially avoid a costly emergency room visit. This is it! Real-time reports leading to real-time assistance and fewer emergencies means higher Star Ratings, increased quality of care for patients, and strong patient outcomes.

For the client, the app has the capability to display personalized treatments and results, prescription refill information, and information about common support services. Clients will be able to maintain a healthier lifestyle because they are reminded to take their medications through alerts sent from the app. They can read educational materials, watch videos about their disease, and have resources that provide the latest news on care, all at their fingertips. They can track their health by recording their health information daily, ultimately providing the very data that keeps them from a readmission or an emergency room visit.

Maybe we will not be using this type of connectivity technology with today’s oldest generation. Providing them with a simple tool through which they can answer a small survey (telephony), or a web portal to answer basic questions, may be enough. For the fast approaching Boomer generation, though, it is a different story. They know technology. They want it. They need it. And it is available. Forward-thinking agencies will be interacting with their clients through mobile health apps, watching their Star Ratings soar, while agencies committed to legacy thinking will be stuck in a rut. Don’t be grouped with the latter. Find a platform to help your clients help you gain the advantage today by bridging the gap in care from the clinic to the home.

Scott Herrmann is the Director of Sales and Strategic Solutions for Medocity. Direct thoughts or comments about this article by writing to him at sherrmann@medocity.com. Brittany E. Zilenziger, Medocity Marketing and Business Development Team Member, contributed to this article.

©2016 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. editor@homecaretechreport.com

by Roger McManus , MBA (who has held several positions as Director of Strategic Relationships). First in a 5-part series.

Part 1 of 5

Social media marketing programs usually center on efforts to create content that attracts attention and encourages readers to share it across their social media accounts.  Wikipedia refers to social media as “electronic word of mouth” (eWOM). eWOM refers to any statement your prospects or consumers share about your business online. The giant among them is Facebook.

Facebook is the dominant social platform, used by 57 percent of American adults and 73 percent of those ages 12 to 17. More than six in ten adult users visits the site on a daily basis. Facebook references are shifting as more and more users gravitate here. [Details on Facebook’s use and its potential for healthcare at home agencies using it to attract more customers and embrace this 21st century way of making and retaining a presence for future customers are described in this short article.]

If there is an audience for your home care services anywhere among Facebook’s 1.5 billion monthly users – and it is safe to assume the vast majority of your potential clients’ or their adult children are in this number – there really is no reason for your agency not to create a Facebook Business Page.  In fact, a business without a Facebook Page faces serious disadvantages.  It can make you look out of touch and even reduce customer trust.

All you really need to do is be present.  People may not be in the right place to buy from you at the moment but, by posting regularly and sharing your knowledge, Facebook helps you be top-of-mind when they are. Regular posts establish you as an authority.

Staying in touch with family members and friends may be the primary reason the majority of people use Facebook. Inserting your business into that normal flow of communication may well be the ideal 21^st Century way to gain exposure and loyalty.

Social networking websites allow individuals to interact with one another and build relationships. When companies join these social channels, consumers can interact with them directly. That interaction can be more personal to users than traditional methods of outbound marketing and advertising.  Creating content that triggers consumers’ imagination enhances its value to the distributor.  When they pass it on to others, you could go viral.

To accomplish this, you need only to produce posts that play to the interests of an audience that likely has older parents approaching the time when they may need in-home help.  You can write these yourself, re-post items written by others on Facebook or subscribe to a program that produces and personalizes home care specific content for you. If they feed it to you daily, it is even better.

The ability Facebook offers that allows followers to “repost” comments made by others about a product being promoted is extremely powerful. By repeating the message, the user’s connections are able to see the message, multiplying its impact.  No other form of media other than traditional Word-of-Mouth is as powerful.  And, eWOM is hundreds or thousands of times more so. Because your agency information is attached to every post and re-post, this plan cannot help but drive more traffic to your agency.

Next week: Facebook:  Profiles vs. Pages

Roger McManus is an online marketing consultant. He teaches businesses how to automate the solicitation of online reviews. He can be reached at rogermcmanus.com/reviewsoftware.

©2016 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. editor@homecaretechreport.com

by Audrey Kinsella, MA, MS

Can we get comfortable treating seniors in a hands-off way? New mobile PERS systems like the one we profiled last month, (Telehealth: It’s Not Just For the Homebound Anymore) systems that allow infirm individuals to leave home but remain connected, may be hard to get used to. Longtime readers may recall a chiding I received from telehealth industry expert and first ATA president Jay Sanders, MD a couple of years ago (Keeping Seniors Independent: It All Makes Perfect Cents; An Interview With Dr. Jay Sanders). [Dr. Sanders’ views on providing new and needed care services for today’s much more informed and active senior populations are provided in this short article, as is a case study from Advanced TeleHealth Solutions (Springfield, MO)  of home telehealth use by congestive heart failure (CHF) patients assisted by a team of nurses who had first undergone specific-to-CHF-patients’-needs motivational training. ]

Dr. Sanders observed that I needed to get in touch with today’s seniors. He told me, “This is no longer the same elder population of 50 years ago,” citing examples of engaged and connected persons between ages 55 and 75, working seamlessly with technologies. He stressed, “A new senior market is demanding attention from providers of all stripes to heed its desire to age in place in their own homes. Active, healthy seniors biking and canoeing populate telehealth marketing literature, not the homebound with multiple chronic conditions.”

It is from conversations with visionaries such as Dr. Sanders that writers who cover home telehealth have begun to think differently about how telehealth and PERS vendors can meet the demand to provide services to seniors when and where needed. We only need to glance at those product brochures to see that thinking in traditional ways about today’s seniors really is out of touch.

New Ways to Deal with Today’s Seniors
Before abandoning tradition completely, however, we still have to manage health care at home Medicare beneficiaries patients, who for now are still required to be homebound in order to receive your services. Church, yes. Day-long bicycle trips, no. But just because their homebound status remains traditional, the care you provide via remote patient monitoring does not have to be.

I mentioned my new Information for Tomorrow web page last month. A featured article there describes an example of one of these new care protocols, offered by Advanced TeleHealth Solutions of Springfield, MO. (See Tools That Work) This case example indicates how nurses engage healthcare at home CHF patients with a team approach. Before scheduling 83 heart failure patients — 41 assigned to telehealth, 42 receiving care without remote monitoring — chronic care nurses were required to undertake motivational training courses. Motivational training was intended to better equip them to work with patients who were learning new ways of eating and managing routines.

As expected, both sets of patients did better than the norm, though the monitored patients did have slightly better outcomes. As a result of the motivational training, nurses kept their heart failure patients engaged in their new routines and patients learned to play a key role in their own — what was to become — lifetime, self-management routines. The patients were not “cured” of course, but they did learn to participate in and take responsibility for their own realistic goals, to be kept stable over the long term.

Next week
In the “Coming Home” section of the Information for Tomorrow site, a UK physician describes the tools and interventions he deploys to teach self-management to seniors newly discharged to home from hospitals. In the next segment of this HCTR series, we will detail Dr. Doughty’s work with technologies to keep home care patients, as he says, “…in touch and in control of their fears and vulnerabilities,” a process he calls “reablement.”

Audrey Kinsella, MA, MS, is HCTR’s telemedicine reporter. She has written on home telehealthcare and new technologies for home care service delivery for 20 years, in 6 books, multiple web sites, and more than 150 published articles. Audrey can be reached at audreyk3@charter.net or 828-348-5308.

©2016 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. editor@homecaretechreport.com

Product review by Tim Rowan, editor

“Picture this,” suggests Director of Strategic Solutions Scott Herrmann. “A joint replacement patient develops a redness around the incision. An aide notices it during a routine visit and makes a note in the app in her phone. During the next LPN visit, the aide’s note is read and the nurse makes a point of examining the incision. By this time, the redness is a full-blown infection and the patient is transported to a hospital emergency room.”

“Now, picture this instead,” he pivots to a different solution. “The same aide notices a redness on the same patient’s incision and immediately sends a message through her smartphone to the nurse case manager for this patient, ‘there is something more than just redness going on here.’ In seconds, the RN responds, ‘I’ll video in as soon as I finish this visit.’ Minutes later, through a video connection, the nurse sees the infection and takes a snapshot of it. After a quick consultation with the referring physician, which of course the aide cannot do, a medication is put in place and a trip to the ER has been avoided.”

Herrmann is the new Director of Sales and Strategic Solutions for Medocity, a Morristown, New Jersey tech company, founded by a team of physicians, that has created a patient engagement platform made up of a variety of tools to coordinate patient care among physicians, in-home care nurses, labs, pharmacies, and family. Until now, Medocity has been focused primarily on physicians who work with seniors, while quietly introducing its system to the Healthcare at Home providers to which these physicians refer patients. With the addition of home healthcare veteran Herrmann to the executive team, that effort is not quiet anymore. [Details about Medocity’s patient engagement  system to be used by healthcare at home care teams are provided in detail in this article.  Hermann also underscores the importance of this system in helping its clinician users to reach all Triple Aim goals.]

“I joined Medocity because I have been advocating a care philosophy just like theirs for years,” he told us in a recent interview from his Phoenix office. “New payment systems that will reimburse for quality outcomes will force caregivers to form a circle of care around each patient. This Medocity platform is a bridge between clinic and home and it includes patients and their entire care team. It gives home health the opportunity to be center court in the new care delivery models.”

Medocity tools
We took a close look at some of the products recently. While they are reminiscent of other patient engagement systems we have reviewed in the past, there are some interesting nuances. In addition to facilitating communication among caregivers and family, there is a remote patient monitoring component that feeds into a data analysis tool. Home healthcare nurses and other clinicians around the patient see a daily triage report that turns raw vital signs into actionable data so attention can be directed first toward patients who need it most.

A video platform enables remote visits, which for physicians are sometimes reimbursable. For healthcare at home clinicians, the video system comes in handy keeping an eye on patients between in-person visits and in emergencies such as the one described above. On the patient side, a connected tablet offers instructional videos, medication and other reminders, and social connectivity. With all of these tools, Medocity has focused on ease of use and device independence.

“Here in Arizona, people I talk to about meeting Triple Aim goals, saving money, and improving patient outcomes get it right away,” Herrmann said. “You see, I am in one of the nine states where Home Health Value Based Purchasing is already a reality. Providers are hungry for solutions and have become a test base for the other 41 states.”

He explained, and we were able to see in the care coordination tools he showed us, that the Medocity platform has the potential to address four critical issues:

• pro-active management of chronic and acute conditions through
  • clinician dashboard
  • patient medical summary
• care coordination & care continuity via
  • communication with family
  • video conferences via iPad
• reducing visits per episode without reducing care, using
  • remote patient monitoring, capturing more vital signs
  • real-time alerts with guidance for the client
  • multi-party tele-visit and secure messaging
  • messaging system to push information to patients and forward to care team members, including specialty teams
• enabling patients to manage their condition(s), with
  • multi-conferencing video meetings
  • educational videos targeting specific chronic conditions
  • patient instructions in response to alerts
  • information about community resources to review while waiting for a return phone call from a nurse

Medocity talking about Medocity
As thorough as Mr. Herrmann’s demonstration was for us, the voice of actual patients may describe the Medocity system better than we have. This YouTube video about Medocity’s iCancerHealth system will come across as more promotional than objective but we offer it because it does a good job explaining the impact the system has on real people.

“I’ve been in home healthcare a long time,” Herrmann concluded, “and I had other offers. I chose Medocity because I am convinced this is the direction technology developers should be leading in-home care providers to prepare them for the new payment models emerging from healthcare reform.”

©2016 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. editor@homecaretechreport.com