Kenyon Connects

Technology is all around us and the innovations we use every day were unimaginable just a few years ago. In the home healthcare industry, technology and telehealth advances clearly contribute to the universal goals of smarter solutions and better outcomes.  Part of the new industry standard, from specialty software for home health, hospice and private pay to telephony to back door portals to telehealth for physicians and family members, these remarkable tools have transformed the way we care for patients and align our business goals.

Ten years ago, the desire to adopt new technologies did not reconcile with an agency’s spreadsheet.  The high cost to implement new systems cut into overall operating expenses, and none of the costs were considered an allowable expense in Medicare cost reports.  In recent years, CMS has identified telehealth as a cost saver and more and more is encouraging agencies to invest in these new technologies.  However, even with that encouragement, CMS still does not allow the costs to be factored in as a business expense. The recent passage of the Patient Protection and Affordable Care Act signals these outdated attitudes are changing.  As I dig deeper and deeper into the legislation, there are clear indications that CMS will soon allow telehealth costs to be considered a reportable expense.  What the limits will be and how they will be declared is not yet clear, but it is a fine start.

Yet, even if the costs are not fully reportable, the value of technology cannot be ignored.  Community Home Health and Hospice (CHHH) in Longview, WA is a stellar example of what telehealth can achieve. Working with Senator Patty Murray, CHHH CEO, Greg Pang, obtained a $203,000 grant for a telehealth initiative through CMS.  With the grant in place, CHHH was able to implement the telehealth monitors that are used to track patients on a daily basis.  Monitoring allowed staff to identify changes in a patient’s health conditions early on.  If a change was identified, CHHH contacted the patient for a phone assessment and if necessary, sent a nurse to the home. From there, a dialogue was opened with the doctor and clinical adjustments were made.  For a majority of the cases, the telehealth intervention averted a potential health crisis and allowed the patient to remain at home.  During the 18-month grant period, CHHH spent a total of $206,568 on its telehealth project, just slightly more than the grant funding.  The return on investment for the government resulted in 268 deferred hospitalizations, and 172 emergency room visits were averted.  In the end, CMS’ $203,000 investment saved the federal government $2,662,044.  Definitely a win/win for all involved, especially the patients who were able to continue to live at home with their health status under control, which is the preferred outcome across all cultural and economic lines.

MultiCare Good Samaritan Home Health and Hospice in Tacoma, Washington, has a telehealth initiative that monitors CHF, COPD, end-stage cardiac, and complex multi-diagnostic patients – the patients most likely to be readmitted to the ER or hospital. On average, they have approximately ninety telehealth units in the field at any given time.  The units are taken home upon admission to the home health division.  For the end-stage cardiac patients, the units have a powerful healing effect on both the family and the patient, as everyone feels more secure knowing the unit is in place.  This sense of security breeds confidence and overall, patients and staff are better able to manage their symptoms.  Early tracking of data clearly indicates the telehealth units are reducing hospital readmits and unwarranted visits to the ER.

While this is just two examples of how telehealth is changing our industry, much more is on the way.  A key player in telehealth is Ankota, a software company.   Their work focuses on managing the delivery and coordination of care across disciplines. Additionally, their technology can schedule interactive telehealth sessions into treatment plans.  Part of a new generation of innovations, Ankota is currently working on a pilot project to improve the response and follow-up tracking on telehealth alarms.  With this new system, the on-call person is presented with a care plan based on the patient’s condition (e.g., CHF) and presents them with a checklist appropriate to their care.  The program also documents the follow-up interaction as well as steps taken (e.g., dispatching a caregiver, opening discussions with doctors, etc.).

Part of an ever-expanding telehealth horizon, in the near future, I anticipate many new innovations and greater support for technology from the federal government.  While nothing will ever replace hands-on care, the possibilities for telehealth are boundless and more and more we will see these remarkable tools taking center stage in home healthcare business success.

Category: Articles, Ginny's Blog