Using Technology to Reduce Falls at Home

Seniorlink is bringing innovations into the homecare environment. The company launched 16 years ago to support families on the caregiving journey. In 2005, Seniorlink launched a pilot for its program, Caregiver Homes, to bring care teams into homes alongside family caregivers.

Today, Seniorlink is seeking innovations in the marketplace, and one of the most important areas to cover among homecare agencies is the reduction of falls among patients. To that end, Seniorlink set out to study how and why falls were happening among individuals in its Caregiver Homes program, and to reduce the number of falls that occurred.

Jay V. Patel, MBA, PharmD, clinical transformation officer at Seniorlink, provided insight into these efforts and what is in store for the future of the company.

Tell me about Seniorlink and Caregiver Homes.

Seniorlink has been around for over 15 years. Caregiver Homes is a subsidiary of the company that operates in six states. That model operates in the home of a Medicaid recipient alongside a full-time caregiver.

Vela is a platform that we developed to allow family caregivers to become more engaged with their loved one and collaborate better with their care teams.

We have been using technology for more than 15 years. Back in 2007, we started giving caregivers a platform to engage with us through a computer. Now that we are in 2017, we are using an app to engage caregivers via smartphones and tablets. Technology is our in DNA.

Why is reducing falls important?

Consumers under our care are at elevated risk for many health conditions and injuries. Fall-related injuries, especially among the elderly, are a leading cause of morbidity and mortality, and avoiding hospitalizations is obviously a desirable goal.

How did you reduce falls?

In 2012, our Caregiver Homes business conducted refresher training on the importance of identifying and documenting falls in the home.

The training helped our care teams coach family caregivers on what to look for to prevent and document falls more accurately, in a timely manner. Following this intervention, we initially saw a short-term increase in our rate of falls, but this was expected given our focus on accurate documentation.

During the past eight quarters, we have seen a steady decline in the fall rate. The decline in fall rate has nearly halved from 1.6 falls per 1000 days in 2013 to 0.83 falls per 1000 days in 2016 (year to date). This is a significant number, given the health and financial implications associated with a fall.

Can you elaborate a bit on the training course you conducted in 2012? Have you updated that training as technology has changed?

We provided training for our care teams—the nurses going into the home. How do you identify someone at risk for a fall? We taught our team best practices for fall risk assessment, and what factors to be on the look out for.

Then we turned to the family caregivers; we gave them tools and reminders. What should the caregiver look for and how can they get back to us about their loved one’s condition? The first part is the identification of the problem and the second part is documentation—here is when a fall happened and this is the reason why.

Then we ask, “Who should we follow up with? Should we refer the patient to a physical therapist because he or she is limping today?”

In the world of Vela, this process is easier, because communication becomes asynchronous. Caregivers now have easy access to the extended care team for support and information they need.

How did you gather data to show this reduction?

We collect data from our Falls Management Program directly from our caregivers, with validation from our care teams. Our care teams receive a daily note from caregivers, which often indicates if a fall has occurred. Care teams follow up with caregivers within 24 hours to validate if the fall actually occurred and capture other details about the incident. All of the incident-related data is captured in a structured format, ultimately enabling our analytics team to aggregate and analyze the data. We are also able to identify trends by geography and by care team.

Tell me more about the data you gathered. What reporting methods did you use?

In 2007, we had 6 million patient exchanges and 300,000 interviews to review. Those are good data points. For every patient we secure and every family we see, we do an initial assessment that results in 500 points of data for that patient. Each family is not a one-time contact. We track changes over time in every instance. We look at changes across the entire person over time.

Besides reporting purposes, are there other uses for this data?

“Predict the preventable” is a mantra in data analysis. As we move forward, we are using our dataset to develop a custom algorithm to predict the likelihood that a consumer will fall over specific intervals (within 30, 60, 90, 180 days, etc.). The ability to predict those who are most at risk of falling is a powerful tool in reducing falls, which in turn reduces the rate of injuries and deaths amongst those under our care.

You historically serve about 7,000 families, yet there are an estimated 66 million caregivers across the United States. Do you have plans to scale your program to reach the rest of these families?

Vela, our technology solution for caregivers, is currently being used by Caregiver Homes to enable communication, collaboration and caregiver engagement in targeted branches in Indiana and Massachusetts, with a plan to expand engagement to all caregivers within Caregiver Homes through 2017.

The Vela team is also working with national MCO and ACO partners to design and implement pilots in 2017, which will allow us to serve complex consumers beyond our Caregiver Homes program—broadening our reach and extending our marketplace knowledge.

Vela is targeting specific early pilot groups for beta testing with the intent to expand to a broader population within each of the organizations where we are conducting and planning pilots, and while the caregiver remains the end user of Vela, it will be delivered via Caregiver Homes and our partners: a B2B model, versus B2C.