Last year, the Centers for Medicare and Medicaid Services announced proposed changes to the Outcome and Assessment Information Set (OASIS). Though the official interpretive guidance manual won't be finalized until November, the changes are scheduled to go into effect in January 2019.
Home health agencies must plan for these changes in advance, or risk financial penalty. Here's what every HHA should know about the proposed changes:
Proposed changes could impact reimbursements
According to CMS, the overhaul to OASIS-D would affect 33 items, resulting in the collection of 235 fewer data elements within a home health episode. The proposal may also new items to support interoperability for the IMPACT ACT. Once these changes go into effect, agencies will need to ensure that staff enter data correctly or risk missing out on reimbursements.
Failure to fill out a field – or filling it out incorrectly – could result in a denial from CMS. HHA stakeholders should consider updating their policies and practices to ensure no mistakes are made when filling out OASIS forms. Policies may include provisions for training staff members on how best to collect information relevant to OASIS-D data elements. Incomplete or inaccurate assessments could leave money on the table. HHA's can protect their financial health by preparing for these changes well in advance.
Staff may require additional training
Any time changes are made to OASIS, HHA staff members need to be trained on the new measures. This year's proposed changes are extensive, but even a small adjustment would require additional training hours to ensure full compliance.
NDoc software includes a training module to help staff members become familiar with the new fields. Because the module is built into the existing platform, staff members should have little trouble accessing and engaging with the training session. Plus, individuals can review the materials at their convenience.
Because CMS won't implement the new rules until November, it doesn't leave much time for training. HHAs that already work with NDoc software will have the advantage of possessing a pre-existing solution so they can get up and on track as soon as possible.
Compliance is a big concern
As with any new regulatory change, compliance should be top of mind for all HHA stakeholders. Not only could noncompliance put your organization at financial risk, but it could also place the company in legal peril. Again, NDoc software can help stakeholders understand what it takes to be compliant and work toward that goal.
NDoc doesn't rely on static fields, but actually uses a logic-based system for comprehensive results.
As an added failsafe, NDoc not only contains compliance alerts that ask care providers to fill in certain fields, but also performs internal checks to ensure providers actually filled them in.
Interoperability will become easier
One of the major goals of the OASIS-D overhaul is to make the interoperability of data easier than ever. Essentially, the new system will pave the way for standardization among all providers, not only those within the acute care field.
For example, if a patient gets his or her hip replaced and is discharged into rehab facility and then to a home health agency, his or her data will seamlessly transfer between electronic record keeping systems. This allows for easier patient movement throughout the continuum of care.
Award winning NDoc software can help your organization stay compliant and improve operations. HHAs should consider investing in a comprehensive solution before the Jan. 1 deadline. To learn more, schedule a free demo today.
A terminal diagnosis does not have to put an end to a patient's plans. In fact, a comprehensive approach to hospice care makes it a priority to help patients achieve practical tasks and goals during end of life.
Noting, tracking and monitoring these goals within a hospice management solution helps caregivers and patients alike to follow through on those goals which are still practical and possible.
Addressing patient goals
Hospice patients nearing end of life have a number of practical goals that they would like to achieve in the time remaining to them. As noted by the National Institute on Aging, four factors influence a patient's comfort at the end of life: physical comfort, mental and emotional needs, spiritual issues and practical tasks.
A comprehensive approach to hospice care addresses each of these areas of concern in a holistic manner because each is intertwined with the others. For instance, a hospice patient who is able to complete important practical tasks may feel better emotionally as a result.
Consider this scenario: A hospice patient worries what will become of her pet cat when she is no longer able to provide for the animal. Therefore, the patient wants to ensure there is a plan in place for her beloved pet. Caregivers and family members can work with the patient to provide for the animal in the future, thus putting the family member's mind at ease.
Hospice patients may also have goals concerning events in which they want to participate. Examples could include seeing a grandchild's dance recital or visiting with a old friend. These goals may require special assistance or coordination among caregivers. Having a systematic method of tracking goal progress can make it easier to accomplish these important end-of-life goals.
Setting family and caregiver goals
Family members and caregivers may also have their own goals regarding their loved one's end-of-life plans. In addition to wanting to spend more time with their family member, caregivers may feel the stress of their responsibilities becoming overwhelming. As noted by the Mayo Clinic, caregiver roles shift over time, which can increase stress levels.
It's important to develop related goals that allow caregivers to accomplish their own ambitions. However, caregivers may hesitate to put their own needs first. The National Cancer Association suggested that caregivers learn to recognize when they're feeling overwhelmed and have resources prepared for when they need an extra hand.
Again, a systematic approach to goal setting and tracking will not only help everyone stay on the same page regarding patient care, but also ensure caregivers stay on track with their personal objectives.
Tracking goals to create new opportunities
A robust hospice management solution allows providers, caregivers and patients to establish goals, track progress and measure success. Because patient mobility changes over the course of hospice care, goals may need to be modified over time. A tracking solution makes sure everyone is always up to date with patient and caregiver goals so that all parties can work together to bring about a desired outcome.
When this functionality is built into the broader EHR platform, it's easier for providers and caregivers to align patient goals with their current treatment plans. As with other important activities, interoperability is key. Connecting solutions into a holistic system ensures nothing slips through the cracks.
To learn more about patient goal tracking and discover the other beneficial features of our award-winning hospice management solution, schedule a conversation with one of our expert consultants today.
We recently wrote about how NDoc® protocols can help reduce hospital readmissions. In this post, we'll be looking more in-depth at how a specific set of protocols can help treat and reduce hospitalizations related to congestive heart failure (CHF).
An urgent health crisis
Heart failure is a major public health crisis in the U.S. According to the American Heart Association, 6.5 million people have the condition, and by 2030 this number is expected to rise to more than 8 million. It is the leading cause of death in the U.S.
Because of the complications often tied to HF, the condition is associated with high rehospitalization figures. In fact, according to a paper in the Journal of Cardiac Failure, the annual number of hospitalizations due to HF as a primary diagnosis has increased from 800,000 to more than 1 million over the past 25 years, and from 2.4 to 3.6 million for HF as a primary or secondary diagnosis.
Furthermore, 50 percent of HF patients are rehospitalized within just six months of discharge, the AHA has found.
These high readmission rates are bad news for providers, as the Centers for Medicare & Medicaid Services has been hiking up rehospitalization penalties. These financial punishments are causing hospitals to turn to outpatient and post-acute providers to help them decrease their readmission rates and thus avoid negative financial impacts. With the high readmission levels related to HF, providers are searching for more effective ways to help patients manage the condition.
Outpatient and post-acute care providers rise to the occasion
As a result of the increased focus on rehospitalization, outpatient and post-acute care providers have reexamined patient care processes for HF, such as discharge planning, medication reconciliation, follow-up and disease management education. While one could argue post-acute providers are using comprehensive electronic medical records systems, their systems often lack streamlined and intuitive workflows that help clinicians and administrative staff keep track of the completion of best practices for reducing HF rehospitalization. They also very often face technical roadblocks to easily sharing this information with other providers in the continuum.
Out of this need came the development of the NDoc® congestive heart failure (CHF) protocol.
Using protocols to reduce HF-related rehospitalization
The team at Thornberry recognized an opportunity to enhance their NDoc® home health EMR to better support agencies in their effort to reduce HF rehospitalization rates. The team began creating an evidence-based program that was based on three components of HF patient care:
1. Teaching: Patient education is a cornerstone of disease management, especially for HF. By sharing diet, exercise and other HF treatment methods with patients, clinicians can help to reduce readmission rates by improving patients' self-management of the condition. A program is needed that ensures clinicians cover every applicable aspect of self-care education with patients.
"Patient education is a cornerstone of disease management, especially for HF."
2. Assessment: To reduce readmission rates, clinicians must be able to accurately assess patients' conditions as HF and recommend appropriate responses. A program that detailed signs of HF would help clinicians stay organized when dealing with many patients.
3. Intervention: Clinicians need to be able to effectively recognize if and when an HF patient's treatment plan needs to be altered or updated, and this information needs to be shared with and viewable by other clinicians and providers who may also see the patient.
These three needs formed the basis of Thornberry's new embedded CHF protocols for NDoc. From there, the team developed elements, including knowledge deficit statements, standard order fields, new assessment statements, new outcomes and treatment and discharge fields that enabled staff and clinicians to more effectively assess and administer patient care to ultimately reduce readmissions due to HF.
Thornberry rolled out its CHF protocol in NDoc® to great success. One such example case was at St. Joseph's Health System, a 400-bed acute care hospital using NDoc® in its home health division. The facility saw its hospital readmission rate drop from 66.7 percent in the third quarter of 2016 to just 11.1 percent in the fourth quarter. This also is an impressive comparison to the 33.3 percent readmission rate in the last quarter of 2015.
The NDoc® CHF protocol has demonstrated it can help hospitals and the outpatient and post-acute care providers they depend on reduce readmission rates for HF patients.
This Thanksgiving, families across the country will share heartfelt words of gratitude, delicious home-cooked dinners and, hopefully, their health histories. In 2004, the U.S. Surgeon General established Thanksgiving as National Family History Day, with the goal of helping more people be aware of the health problems that may run in their families.
According to the Department of Health and Human Services, a survey found that 96 percent of Americans think that knowing their family history is important. However, just one-third of these respondents said that they have ever attempted to collect and write down this history. Thanksgiving, when extended families are gathered together, presents an opportune time to have a conversation about shared health history.
Having this dialogue is important for both patients and their providers, and home health and hospice clinicians should do their part to support their patients in learning about their health history and their possible genetic risks.
Why should providers encourage their patients to know about their family health history?
There are many serious diseases that can be passed down from generation to generation, including cancer, diabetes, heart disease and cystic fibrosis. Providers need to know whether there are certain conditions present in people's families so that they can evaluate their patients' risk for developing the same or related conditions and make more informed decisions regarding their plan of care.
For example, if a person has a family history of diabetes, their doctor can recommend that they reduce their sugar intake, more closely monitor their diet and establish an exercise regimen. As noted in the article "Chronic disease: Genes matter, but so does environment," in Scope magazine, a publication of Stanford Medicine, it's imperative that clinicians have a full understanding of both a patient's family history and their lifestyle habits in order to create custom-fit plans of care.
How can providers improve the discussion around family health history?
Home health clinicians have a number of tools at their disposal to help them support conversations about family health history with their patients.
The first is the "My Family Health Portrait" tool from the Surgeon General. Both clinicians and administrative staff can encourage their patients to use the tool to easily create a record of their family health history. Another helpful resource is TalkHealthHistory.org, which has a variety of tips and best practices for gathering and recording family health history for both patients and providers. If patients express discomfort at talking to their family members about their health histories, they can use the helpful communication tips in this guide created by the HHS.
Second, providers can put greater focus on discussing, updating and reviewing family health history information with each patient at each appointment and throughout care planning. They should use EMRs optimized for interoperability that enable clear and detailed family history information to be shared with all other providers that the patient sees.
And third, home health clinicians can use protocols that support the provision of care for patients with highly inheritable diseases, such as heart conditions. The NDoc® congestive heart failure protocol, for example, takes into account family health history to help clinicians develop plan of care that respond to patients' individual needs.
Making family health history a regular part of the conversation – at both the dinner table and in medical appointments – helps individuals take control of their health and well-being through customized strategies. When it comes to family health history, knowledge is power – and that's something we can all be grateful for this Thanksgiving.
Many things in life are better when they're tailored to our exact needs. A three-piece suit, a morning coffee, a new house, a vacation, just to name a few. Choosing items and experiences that are customized to suit our preferences not only gives us more enjoyment from them but also ensures a greater return on investment. We're happier with our purchases if we're getting exactly what we need.
The process of selecting a home health or hospice EMR vendor should be no different. But unfortunately, far too many agencies choose big-box vendors that don't have the time, energy or interest to customize the EMR experience to meet their clients' needs. These home health and hospice agencies end up unsatisfied, with money down the drain, stress on the brain and the question What went wrong? ringing through their ears.
What happened is that they chose a vendor that saw them as a service ticket and not as a valued partner. It's the difference between buying a bespoke suit and grabbing the last size left at a chain store – the only thing you're buying is disappointment and an unflattering fit.
Bespoke service for your software
Vendors that take a boutique approach to EMR implementation and maintenance are the solution. They use a focused and individual delivery strategy that prioritizes customer support and attention. They know that one size doesn't fit all, especially for something as sensitive and important as home health and hospice care. They recognize the impact their products and support can have on patient care, and they're committed to a hands-on approach that empowers home health and hospice agencies to feel confident in their investments.
Thornberry Ltd. prides itself on this approach. We have a history of building successful, lasting relationships with clients. Through the years, we've developed the strategic mindset and agility necessary for us to be able to optimize our award-winning NDoc® software for each and every one of our customers.
Superior service is in our roots – and word-of-mouth marketing and an ability to identify exactly what our customers need fueled our growth. Thornberry was created in the early '90s as a right-size alternative to the reigning EMR behemoths. Originally, we offered acute care documentation software for a community hospital in upstate New York. A nearby hospital caught wind of our services and asked us to develop a system for its home health division. The project was a success, and recognizing the need for sophisticated EMR software in this sphere, we shifted our focus from acute care to home health. We soon added hospice solutions, made our software interoperable before it became a buzzword and solidified our reputation as a dependable partner for home health and hospice agencies.
Best in KLAS four years in a row
Thornberry has developed not only an industry-leading product, but a customer-centric approach that values the needs of the client above all else. Our efforts have paid off – we were awarded the title of Best in KLAS: Software and Services in homecare for the fourth year in a row – a first for companies in our sphere. Our customers stick with us, knowing that we're committed to supporting their operations with our outstanding software and support.
So if you're tired of being treated like a number, never really knowing who you're dealing with at your big-box vendor and paying for a service that's just not the right fit, it's time to learn the Thornberry difference. Simply call us at 717-283-0980 or schedule a conversation. We'll figure out together how our NDoc® solution will work for you – just as you like it.
Imagine you're in the Talking Heads song "Once in a Lifetime." You hear David Byrne's voice singing, "And you may find yourself in a beautiful house … with a beautiful wife." And you look around and see that you really are in a beautiful house with a beautiful wife. But as the days go by, you realize you and your beautiful wife disagree on some very important things like parenting methods, politics and religion, and are just fundamentally incompatible. And while your beautiful house looks like it could be in a magazine, it doesn't have any useful features or amenities.
After this realization, "You may ask yourself, well … how did I get here?"
You got here because you valued appearances over cultural fit. It's a problem decision-makers at home health agencies face every day. They're courted by EMR vendors who have fancy products with impressive-sounding technical specs, and it all seems so perfect that they sign on the bottom line without a moment's hesitation. But these vendors don't value customer service and support the way you do, and instead of that partnership you dreamed would help your agency provide high-quality care to its patients, you're left with a vendor who falls short in a lot of ways.
Unless you want to be thrust back "into the blue again after the money's gone," as the song goes, and find yourself searching yet again for another EMR vendor to fix things, it's time to recognize the importance of selecting a firm that doesn't just have a good product, but is also a good cultural fit.
Why is cultural fit important?
You can have the technology, but if you don't have the support, those tens of thousands of dollars spent on a home health EMR have a good chance of just being money down the drain.
In a perfect world, you'd purchase an EMR, train your staff members and clinicians in half an hour (no questions or pushback, of course) and then hit the ground running and never look back. Also, winter would always look like a Norman Rockwell painting in this universe, and you'd never come across spoiler alerts for your favorite TV shows online. Unfortunately, that's just not the reality we live in. That's why you need a dependable home health EMR vendor that will be there for you when the going gets tough. You'll feel secure that your vendor will be ready to step in not just when obstacles arise, but during all the in-between time, too.
"You need an EMR vendor that will be there for you when the going gets tough."
A good cultural fit is also important because it gives you and your staff confidence in the new system. Knowing that your vendor isn't going to just sell you a software suite that might not be the right solution for your agency can help you make sure that your investment is worth it. A vendor that's a good cultural fit will provide honest feedback on what software solution is best for your agency's unique needs. And having home health decision-makers who are fully confident about the value of the new system helps get buy-in from clinicians and staff members who may ordinarily feel more hesitant.
With this support and service, you'll never have to say – or sing – "My God, what have I done?"
Want a chance to see if an EMR vendor is the right cultural fit for your home health agency? Thornberry Ltd., developer of the Best in KLAS NDoc® home health EMR solution, is hosting its 20th Annual NDoc® User Conference May 23-25 in Lancaster, Pennsylvania. The conference is a valuable opportunity for home health decision-makers interested in purchasing a new EMR to determine if Thornberry is a good cultural fit for their agencies. To learn more about the conference, contact the Thornberry team at 717-283-0980 or via email or social media.
Hospital-based home health agencies serve an important function in the continuum of care. By operating within a hospital, they can help reduce readmission rates and provide a seamless transition from one setting to another for patients that require post-acute care.
For these home health agencies to fulfill their mission, however, they need to be supported by EMRs that not only include comprehensive features and functions, but also properly prioritize interoperability.
Earning the Best in KLAS designation is yet another indicator that an EMR can be depended upon by hospital-based home health agencies. In today's healthcare landscape, a Best in KLAS EMR will be fully interoperable, supporting home health agencies with the data exchange required to effectively deal with the challenges of their important role in the health system. The Best in KLAS recognition is based on extensive interviews and conversations with clinicians and staff that have used the EMR in their daily operations, and thus hospital decision-makers looking to implement a new EMR can feel confident in their decision.
Here's why a Best in KLAS EMR is important for hospital-based home health agencies:
It helps a dynamic team function.
Technology supports high-quality healthcare, but it is the people behind the care that make all the difference. The many physicians, nurses, specialists, clinicians and other staff of a hospital need to function in harmony, and home health agencies play an important role in this care symphony.
As Pamela Duncan, Innovation Advisor for the Center for Medicare & Medicaid Innovation, noted in an article by the Alliance for Home Health Quality and Innovation, "Many hospital-based transitions models have increased utilization of nurse practitioners and physician assistants which requires home health agencies to better articulate which services they can provide to complement the work of the hospital's care team."
A Best in KLAS EMR that is optimized for interoperability helps hospital-based home health agencies achieve this stronger level of communication. A cardiovascular health specialist on one floor of the hospital can input and send a patient's health information to a clinician at the home health agency, who can then prepare a care plan for the patient. By exchanging files that are able to be accessed and read throughout the hospital, as well as by any care providers the patient sees outside the hospital, the transition of care can go more smoothly thanks to effective communication between all team members.
"Transitions of care can go more smoothly thanks to effective communication between all team members."
It supports compliance.
Though the focus is always on the care, hospitals have to be increasingly thinking about the numbers, due to ever-growing regulations from CMS. The cost of the care, the number of readmissions and length of stay are all factors receiving greater scrutiny, Home Health Care News noted. Home health agencies can have a big impact on these numbers, and that's why it's imperative that they're backed by the right software. If data on readmissions, transitions of care, test administration, appointments, and other factors are not accurately logged and compiled in one central system, then a patient can be unnecessarily readmitted, or inaccurate numbers can be submitted to CMS, which can hurt reimbursement or a hospital's rating. A Best in KLAS EMR streamlines data flows and alerts clinicians to errors, helping to support compliance.
It proves they can be a valued partner.
It all comes down to partnerships. A home health agency that has a skilled team of clinicians and staff, a proven ability to improve the welfare of their patients and a highly interoperable, cutting-edge EMR can be seen as a trusted partner in the larger hospital system, helping improve the quality of care.
Thornberry Ltd.'s NDoc EMR software received the Best in KLAS award in the Homecare segment for a record-breaking fourth year in a row – contact Thornberry today to see how their expertise can help your agency be a valued partner in healthcare.
Thornberry Ltd.'s NDoc® software solution recently received the "Best in KLAS" award for the Homecare segment for a record-breaking fourth year in a row. This exciting award from independent organization KLAS Research recognizes health IT vendors for their high customer satisfaction levels and product quality, and is based on in-depth interviews with providers.
But why is it important to have a strong KLAS rating? Here's a closer look at the value of being top of the KLAS:
It helps providers make confident purchasing decisions.
If you're a provider searching for a new health IT solution, you're likely overwhelmed by all the options available and want to be sure that the thousands of dollars you're going to invest in a new system is going to be worth it. That's where KLAS Research comes in. The organization speaks directly with thousands of customers, including decision-makers and CIOs, to learn about their experiences with vendors, and this information then helps other providers make informed decisions about where to spend their money. A strong KLAS rating sets a vendor apart from its competitors and shows that it has a track record of keeping customers happy, ultimately giving providers more confidence in selecting a new EMR.
It helps providers find specialized solutions.
In healthcare, one size does not fit all. Homecare agencies, eye and ear specialists, ambulatory health services providers – they all require different EMR systems that are specially designed to fit their unique needs. KLAS Research evaluates vendors in a wide range of healthcare sectors to help providers find the right vendor in their field. For instance, Thornberry Ltd. received the Best in KLAS award in the Homecare segment, based on its strong reviews from customers at home health and hospice agencies that found that NDoc supported their existing workflows seamlessly, instead of making things more difficult.
And while providers need an EMR tailored to their sector, many of the individuals tasked with making a purchasing decision are not familiar with the ins and outs of health IT. By being able to compare vendors, read customer feedback and access market insights compiled by KLAS, providers can learn more about areas that may be unfamiliar to them.
It shows they're a market leader
KLAS Research's mission is to improve healthcare as a whole by increasing vendor transparency. It conducts candid, in-depth conversations with providers about their vendor experiences as part of this mission. The good, the bad and the ugly all come out during these conversations, and a strong KLAS rating shows that a vendor is going above and beyond to keep its customers happy. The ratings also help keep vendors constantly improving and developing their software to keep up with current demands, such as increased interoperability and regulatory compliance. A strong KLAS rating shows that a vendor is a market leader and a trusted partner for providers.
It shows they are dedicated to customer support
Through these customer-provided evaluations, providers looking for a new EMR get a deeper understanding of vendors that goes beyond technical specs. They can learn that they value partnership and relationship-building with clients, that they provide superior implementation and training support and that they have a commitment to personal attention. By reading reviews and looking at KLAS ratings, they can also learn that a small vendor can have a competitive advantage over larger firms.
Thornberry Ltd. is honored to be recognized by KLAS for the fourth year in a row. Learn more about KLAS Research here.
When you decided to work in the home health or hospice industry, did you excitedly imagine sitting in front of a computer, entering complicated data as the hands on the clock spun? Probably not – you more likely had rewarding visions of helping people with a range of conditions recover or enjoy a better quality of life.
But while many home health and hospice clinicians and professionals are passionate about providing quality care to patients, many of them spend too much of their time plopped at a keyboard instead.
Time-consuming data entry may seem like an unavoidable sentence home health and hospice agencies face, but it doesn’t have to be that way. Let’s look at the importance of a quick intake in these care settings – and what your agency can do to make inputting data a less painful process.
If you are selecting a new EMR system for your home health or hospice agency, you may think that you’ll be able to run a modern and digitally-optimized operation right away. This feeling is just human nature – that desire to skip all the preliminary work and get right to the good stuff, like wanting to have a shiny new addition on your house without picking up a hammer. But if you signed on the dotted line for a new EMR with visions of an immediately well-oiled agency running through your head, the harsh reality is that you won’t only be setting up a new EMR, but setting up your agency for failure.
In other words, successful implementation is one of the most important aspects of adopting a new EMR system. If this set-up phase is neglected or glossed over, your home health or hospice agency will suffer. After all, without knowing how to use the new software correctly, clinicians and administrative staff are likely to throw up their hands in frustration, and as a result, they inadvertently compromise patient care amid the stress and confusion.
That’s why getting off to a good start is vital to making a new EMR system worthwhile.