Understanding advancements and what steps to take in IT planning
by Terrie O’Hanlon

Pressure—although uncomfortable in the moment—shapes progress. It creates diamonds out of coal and transforms semiconductors into technology marvels. In health care, pressure to prove outcomes, contain costs and increase patient satisfaction (while serving a growing aging population) is fueling IT evolution and investment. It’s also fueling confusion among providers looking to future-proof their organizations. Putting IT solutions in the context of the pressures they alleviate can help prioritize investments and manage expectations.

Pressure to Serve Patients

The pressure to serve patients in the most economic settings is fueling opportunities for telemedicine (the use of remote technologies placed in a home or other non-acute care setting for clinical evaluation, diagnosis, consultation and treatment), telehealth (remote health status monitoring for compliance, wellness and education) and mobile health care technology. Managing patient care plans across a variety of caregivers not confined to the four walls of a single facility necessitates mobile-enabled automation built on best practices and evidence-based protocols. Mobile care teams need anytime, anywhere access to care plans, schedules and other information. Mobile cloud-based solutions deliver this capability cost-effectively and securely, and can also collect data from home medical equipment and monitoring devices to track compliance and trigger alerts when intervention is needed. Mobile apps that engage consumers in managing their health will accelerate data collection and tracking, and facilitate better care coordination. Juniper Research’s September 2013 Mobile Health and Fitness Report forecasts that by 2018, 96 million people will use app-enabled mobile health and fitness hardware devices, up from 15 million in 2013. Post-acute care providers will leverage mobile technologies to access evidence-based content at the 
patient’s bedside to provide the appropriate care, capture new data and modify care plans according to circumstances. Patients will increasingly use online portals to communicate with care givers. For example, patients with diabetes will use home-based devices that measure blood levels and automatically transmit that information to providers.

Pressure to Avoid Readmissions

Avoiding hospital readmissions and associated financial penalties is intensifying a focus on patient compliance with discharge instructions and recommended therapy. For HME providers, automating orders and communication between physicians to ensure home equipment meets the patient’s lifestyle needs, and automating resupply are worthy investments. For example, recommending lightweight, portable equipment for active patients who need oxygen during the day improves the likelihood of compliance with treatment protocols because use of the equipment doesn’t interfere with the patient’s daily activities. Automating oxygen resupply further advances compliance, as does automating data capture from home medical equipment and triggering alerts to care givers when behaviors don’t align with care plans. Equipping referring physicians with detailed analysis on how patients achieve and maintain compliance not only 
reduces the risk of readmission and additional diseases, but also helps physicians improve care and strengthens referral relationships. Also for home health care providers, monitoring and treating patients with conditions prone to higher rates for readmission is key to keeping readmission rates down. An example is a recent study of home health care agencies that followed the Depression CAREPATH protocol, 
developed by Weill Cornell Medical College, and were able to show reduction in depression symptoms by 60 percent and reduction in re-hospitalization by 40 percent versus patients not treated with the protocol. These types of quality outcomes can help home health providers demonstrate their value to the hospitals in their community.

Pressure to Remove Friction

Post-acute care providers who can’t interoperate—meaning smoothly and electronically exchange data, documents and tasks across all of a patient’s care givers—simply won’t survive over the long term. Systematic and uniform data capture, reporting and analysis is a must-have that manual systems can’t deliver. Data aggregation and data access are fundamental technology changes required to improve patient outcomes, streamline productivity and reduce costs. Including post-acute care in interoperability strategies enables health care organizations to connect critical patient information across all care settings to reveal more detailed patient pictures for more specific treatment plans and improved patient care. Technology that frees documents, clinical images, diagnostic images and information from silos so that it can be easily captured, stored and exchanged among systems and care givers is at the center of health care transformation. Web-based, software-as-a-service (SaaS) solutions excel at communicating with multiple and disparate systems and data warehouses that are essential to collaborative care.

Pressure to Prove Value

As health care shifts from a volume-based model to a value-based model, more care is being provided outside the four walls of a hospital or doctor’s office, expanding the scope and relevance of post-acute care. Providers must go beyond delivering quality care at reasonable costs; they need to irrefutably demonstrate that they are. Benchmarking agencies against best practices and others providing similar services is becoming increasingly important. Agencies are using this data to market their services to accountable care organizations (ACOs) and physician groups, and to see their performance in a larger context that reveals where they need to improve. Public reporting of outcomes through services such as Home Health Compare for home health agencies, and soon, a comparison for hospice organizations with the new mandated Hospice Item Set reporting, enable consumers to exercise their right to make their own informed post-acute care choices rather than simply accept recommendations from physicians or acute care personnel. This evolution heightens the need for post-acute care agencies to leverage software systems that monitor and empirically prove outcomes.

Three Steps for Providers

To ensure ongoing viability as health care industry pressures mount, post-acute care providers must invest in technology that helps them prove they are efficient, high-performing and able to easily 
interoperate with providers across the care continuum. 1. Identify current challenges. In collaborating across post-acute care settings and with acute and ambulatory providers, where is the friction? Where is the ball dropped? Where are costs too high? 2. Do a reality check on change. Understand that some challenges will involve technology, and some will involve culture. Consider hiring a consultant to help you through both. 3. Embrace pressures as opportunities. There is a Chinese proverb that observes, “When the winds of change blow, some build walls while others build windmills.” Those who invest in technologies that harness data, workflows, document exchange, mobile access and other elements to create more seamless and accountable care across settings will not only survive, but thrive as the winds of health care change continue to blow.