Healthcare advances over the past quarter century reflect changes that occur in society, and that includes the use of Information Technology (IT) in how we manage data, documentation, and information related to our patients and their programs. As we evolve as a society, with changes based on the technological advances that are now coming fast and furious in the information age, the healthcare industry will include those capabilities in how we develop and deliver care to our clients. But computers and smart phones are not the only aspect of how IT has been integrated into our daily routine; the use of technology will be front and center as we create and refine the care models of the future.
IT has been present across the care continuum for decades; acute hospitals employ Electronic Medical Records (EMR) as a standard element of quality care production and delivery, and have so for years. Physicians perform bedside rounds with laptops in hand, making and modifying care orders with a level of efficiency previously unseen in acute care. Hospital nurses chart on wall-mounted computers positioned just outside the door of the patient room for ease and accuracy of content. In addition, IT use across the care continuum continues to expand to Skilled Nursing Facilities, physician practices, and outpatient labs and treatment centers. The expanding role of IT in Home Health creates opportunities for us to improve care programs and care experiences for patients, but along with those capabilities come aspects of clinical management that will challenge our agencies and clinicians in how we control our programming.
Many Home Health Providers currently utilize IT in their use of point of care Electronic Medical Records, managing back office items and business needs as well as patient documentation. Home Health agencies with plans to continue their care missions into the future will assuredly need to add EMR to their care episodes, and any homecare clinician currently on point of care software understands the ramifications of this change in documentation platform. But these changes in the use of EMR only reflect upon the subjective experiences of the clinical staff transitioning from paper to an IT platform. What all post-acute Providers will experience as we move forward into the care era of the future, including the progressive care models that ACOs, Care Transitions, and Post-Acute Bundling represent, is the use of IT and EMR to assure the development of evidence-based, best-practice care management.
Taking a minute to review how computers work, it is important to note that information is reduced to numerical data, and this approach also applies to management of medical record content. An important point is that this numerical data offers an objective clinical profile to other clinical care Providers, and the eventual result of this is the expectation of objective and consistent clinical responses to all potential programming scenarios. The reality is that in the future, homecare Providers will create and deliver consistent programming that will have value across the entire care landscape, and this differs from what we have delivered throughout the PPS era. Both nursing and therapy care will be affected in the Home Health world, but the connection of therapy to the financial aspect of the payment model will increase the attention on this element of the care program.
CMS acknowledges the lack of evidence-based, best practice care management in Home Health in discussions about innovative care models of the future, and they point out that both acute care Providers and MD-practices are managed along these guidelines. In the future Home Health landscape, care programs will be required to be consistent and logical in their responses to the objective assessment findings derived from the assessment. This will be the eventual role of EMR as it will apply to Home Health; consistent responses to clinical problems. Do all Home Health therapists create consistent programs that are skilled in their production and delivery? Do homecare nurses manage their care programs regarding how they respond to clinical concerns in a manner comparable to those nurses managed in the acute care world? This will be the net effect of the role of IT as healthcare evolves into the future.
Therapy staff can take advantage of the use of EMR, and how this aspect of Information Technology will affect their care practices. Many HHSM Newsletter sponsors offer progressive EMR and communication platforms for the Home Health Provider or rehab clinician that address and resolve the care challenges of today and tomorrow. Part 2 of the HHSM Newsletter will outline specific features that each of the products offers for the Home Health requirements of the future.
Arnie Cisneros, P.T., President of Home Health Strategic Management, is the most progressive speaker in homecare today. He provides coaching and consulting services to providers on a national basis (see www.homehealthstrategicmanagement.com) regarding S.U.R.C.H. and other clinical management protocols for quality outcomes.