Patient Care in the Palm of Your Hand
Product ReviewBy Kristin Rowan, Editor
For those of us who didn’t grow up with a smartphone in our pockets and every tool imaginable available on the internet, mobile apps are still a bit of a mystery and a marvel. There are 25 categories of mobile apps, including gaming, finance, education, business, dating, travel, and health. Development, testing, and execution of an app that actually works is difficult, time consuming, and expensive, so it may seem out of reach for most small businesses. Last week, we spoke with the creators of an app that not only coordinates care for your patients and families, but makes it seem like you have your own agency app.
The Story
Dr. TJ Patel, PT DPT, grew up in India, where he studied physical therapy. After landing his dream job, he started to notice a lot of patients returning to the hospital because they got an infection or just didn’t know how to care for themselves. There was no one providing care after discharge; there was no concept of home based care. Patel soon learned that if he was passionate about home-based care he needed to move to a country that had the infrastructure already built because it didn’t exist there.
Dr. Patel moved to the U.S. and received his masters in kinesiology and doctorate in physical therapy. He was working in home health within a week and did 27,000 home visits in his fifteen year tenure. During this time, Patel noticed that in healthcare, “the right hand does not talk to the left hand.” Communication was a huge pain point and Patel set out remedy that.
By combining care management, care delivery, and what the patient wants into one centralized location, it creates connectivity to all care providers for a patient. Thus, Care Coordinations was designed.
The Concept
Care Coordinations is a tech solution for an impactful experience for patients, caregivers, and families. It opens the lines of communication between the parties customized for each patient.
Patient Channels include all caregivers associated with the patient. Users both inside and outside the organization can be added to the channel. Each patient channel is a secure, private channel for all internal and external care providers. The patient channel can include smaller groups within the channel.
Care Circles include the primary agency caregiver, patients, and family members. The app allows for unlimited two-way communication that protects the personal information of the caregiver. This removes the need for the caregiver to use a personal cell phone or give the patient access to personal information like social media profiles. The two-way communication inside the app is HIPAA compliant, unlike standard text messaging.
Group Channels are non-patient specific for other members of your agency to feel connected, especially in a remote working environment. Department specific group channels for marketing, sales, or HR can also be created. Management functions allow for one-way communication to all employees, anonymous employee surveys, and read-only access to all other channels.
CAHPS Survey
The patient and family experience is captured in the CAHPS survey and impacts agency reimbursement rates. Care Coordinations includes a mock CAHPS survey for patients and families that goes out before the CAHPS survey. The agency can make any needed adjustments to the patient and family experience prior to the actual CAHPS survey, improving scores and reimbursement rates.
Additional Features
Care Coordinations integrates directly with EMRs to upload an episode of care.
Robust read-receipts allow you to see if caregivers have seen a notification inside a communication channel.
Phone and video call capability inside the app adds additional secure communication.
Remote patient monitoring is built in with integrations with more than 500 devices to monitor blood pressure, pulse ox, weight, blood sugar, and temperature.
Direct communication to the agency allows the patient or family to notify the agency in the event a caregiver does not show up for an appointment.
Similar to the user experience with Uber and Lyft, the map feature alerts the patient that the caregiver is in route and estimates time of arrival with a pictogram of a car.
Optional 24/7 functionality to allow the patient to contact the agency after hours. Your call center can input details of the call into the app for real-time updates and assist with reaching other family members in case of an emergency when calling 911 is not necessary.
Post-visit surveys are customizable and can help struggling caregivers to improve and recognize high-performing employees.
The Good, The Bad, and The…Just kidding, there’s nothing ugly
Overall, we found the Care Coordinations app to be useful and well-designed. The app is charged on a per patient basis, making it more cost effective to include multiple care providers in one patient channel for increased connectivity. The available integrations, ability to upload files and videos, HIPAA compliant communication, and familiar messaging structure all point to ease of adoption.
As we’ve noted before, many home health nurses are technology adverse and will fight against the adoption of anything new. Care Coordinations stresses the legality of HIPAA compliant communication and not using your personal cell phone as selling points for nurses. Still, we know this isn’t always enough to convince a steadfast (read stubborn) care provider. Caregiver benefits and a gamified system to track timeliness, survey results, and other metrics may add some incentives for those harder-to-convince nurses.
The Uber-like experience for the patient and family to see where the caregiver is and when they will arrive is a great feature. On the flip-side, there is no tracking of the caregiver on the agency side. With increased reports of workplace violence in home-based care, a feature that allows the caregiver to alert the agency of any change in schedule, without constant tracking of caregiver movements, would allow the caregiver and agency some peace of mind.
I found Care Coordinations to be robust and detailed. Current EMR integrations include Axxess, Kantime, and HomeCare HomeBase, all through Worldview. Direct integrations are in the works. As Care Coordinations adds features and integrations, we are bound to hear more from and about them.
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Kristin Rowan has been working at Healthcare at Home: The Rowan Report since 2008. She has a master’s degree in business administration and marketing and runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in event planning, sales, and marketing strategy. She has recently taken on the role of Editor of The Rowan Report and will add her voice to current Home Care topics as well as marketing tips for home care agencies. Connect with Kristin directly kristin@girardmarketinggroup.com or www.girardmarketinggroup.com
©2024 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in Healthcare at Home: The Rowan Report.homecaretechreport.com One copy may be printed for personal use: further reproduction by permission only. editor@homecaretechreport.com
Is the Covid Boost for Telehealth Over?
Clinicalby Tim Rowan, Editor Emeritus
In 2020, doctors flooded telehealth companies with requests for help caring for patients reluctant to leave home to come to their appointments. Following suit, many Home Health agencies that had never considered investing in home telehealth before, opened up their wallets to acquire equipment, from simple wearables to high-end, HIPAA-compliant video systems.
In addition to the need to provide care at a safe distance, many HHA leaders knew the added service would attract the attention of hospitals desperate to discharge recovering Covid victims as well as non-Covid patients. Some HHAs established relationships with hospitals they had not had before, given the chance to demonstration Home Health’s unique advantages over extended hospital stays and discharges to institutions such as SNFs that had become virtual death sentences during the height of the pandemic.
All Things Must Pass
With the introduction and widespread free availability of Covid mRNA vaccines, the death rate graph line began to tilt downward. Then came the discovery that the SARS-CoV-2 and its variants are transmitted through the air and not through unwashed surfaces. People stopped disinfecting their counter tops after unloading groceries. And they started in-person doctor visits again. Patients returned to allowing nurses into their homes.
In regions where vaccination and booster rates were high, hospitals found themselves with more and more empty beds. They took down tented treatment centers in their parking lots and sent refrigerated trailers back to trucking companies. Desperation referrals to Home Health tapered off, as did the need for virtual visits.
Isaac Newton said every action has an equal and opposite reaction. If that holds true in the healthcare business as it does in physics, the reaction to Covid easing is seen in Remote Patient Monitoring tech companies. According to Fierce Healthcare, the New York Stock Exchange told one RPM company, Amwell, formerly known as “American Well,” to raise its stock price or be delisted. Fierce added detail about the company’s woes:
“Despite decimating its workforce at the end of 2023 to cut expenses, the company still projects a 2024 loss between $160 million and $155 million amid incremental revenue growth. The company’s market cap was a stone’s throw from $6 billion at the height of its valuation, when shares were trading for more than $42 each. Amwell shares were trading at $0.72 as of market close on April 5, giving the company a current market cap of about $208.6 million.
Another market leader fared no better, Fierce Healthcare found. “Telehealth giant Teledoc, which has been in operation for 20 years, has struggled in the stock market and is facing headwinds as the virtual care market has become crowded with digital health players. Shares dropped 22 percent in February as the company missed fourth-quarter revenue estimates and offered a downbeat forecast for the rest of the year.”
Teledoc’s 15-year CEO, Jason Gorevic, resigned last week after the company reported a net loss of $220 million for 2023, following 2022’s historic loss of $13.7 billion, mostly from a write-off related to the plummeting value of its ill-advised Livongo acquisition. According to Fierce Healthcare, Teladoc shelled out $18.5 billion for the digital chronic condition management company, a record in digital health.
Gorevic’s rationale that the telehealth field has become too crowded may not be far off. Last July, Becker’s Hospital Review published an industry survey titled “280+ Telehealth Companies to Know.” The list included a half dozen names we recognized from past Home Health conferences, including Health Recovery Solutions, AMC, Vivify, and FoneMed.
Do Hospital Woes Translate Down to Home Health?
Making comparisons between telemedicine companies that focus on hospitals and physicians and those who focus on post-acute providers is hampered by the fact that few in our sector are publicly traded and do not share their numbers. UnitedHealth, which acquired Vivify in 2019 and assigned it to its Optum division, does not separately report Vivify revenue.
Health Recovery Solutions, one of the best-known names in post-acute RPM, is privately held by its founding CEO and seven investors. Its most recent influx of $800,000 occurred in January, 2022, making it impossible to determine whether it was motivated by investor confidence or the need for cash as Covid began its decline.
Analysis
This publication has promoted the advantages of remote patient monitoring for its entire 25-year existence. We have covered startups and established tech companies offering every technology from PERS to Zo monitors to automated phone calls, in-home cameras and microphones. We have followed the evolution of two-way communications and vital sign detectors from tabletop devices to tablets and smartphones. We have even tested a few robots. We have seen HHAs experience great success, and we have seen devices collecting dust on shelves.
Throughout, we have maintained that, when selected, implemented, and deployed properly, monitoring patients 24/7 instead of once or twice a week can improve patient outcomes, boost agency reputation, and, more often than not, produce a healthy ROI. The end of the latest pandemic may mean the end of demand for Remote Patient Monitoring systems, but that would be unfortunate.
Tim Rowan is a 30-year home care technology consultant who co-founded and served as Editor and principal writer of this publication for 25 years. He continues to occasionally contribute news and analysis articles under The Rowan Report’s new ownership. He also continues to work part-time as a Home Care recruiting and retention consultant. More information: RowanResources.com or Tim@RowanResources.com
©2024 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in Healthcare at Home: The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com
HIPAA: Access to Records
ClinicalBy Elizabeth E. Hogue, Esq.
A key purpose of the Health Insurance Portability and Accountability Act (HIPAA) is certainly to protect patient information. Another is to help ensure that patients have access to their health information. In fact, the Office of Civil Rights (OCR) of the U.S. Department of Health and Human Services, the primary enforcer of HIPAA, has focused on enforcement actions against providers that do not make information available to patients on a timely basis. OCR launched a right to access enforcement initiative in 2019 that is continuing.
Providers must give medical information to patients and their representatives within thirty days of requests. When they fail to do so, they may be subject to enforcement action by OCR. Following are two examples of recent enforcement actions.
OCR announced on April 1, 2024, that Essex Residential Care in New Jersey will pay a civil money penalty of $100,000 to resolve violation of HIPAA’s right of access standard. This is the 48th settlement reached under the right of access initiative. OCR received a complaint in May of 2020 from the personal representative of the estate of a patient who passed away. Following an investigation by OCR, the personal representative, who was the son of the patient, received the records in November of 2020. The provider did not contest the fine.
In another recent case, the daughter of a patient who passed away was appointed as the personal representative of her mother’s estate. She made multiple requests to Phoenix Healthcare for a copy of her mother’s medical records. She finally received the records one year after her initial request. Phoenix Healthcare initially received a civil money penalty of $250,000 for failure to provide timely access.
The provider appealed. An administrative law judge (ALJ) upheld the violation and ordered Phoenix to pay a civil money penalty of $75,000. The Departmental Appeals Board affirmed the ALJ’s decision. Then Phoenix agreed to settle for $35,000 and waived the right to further appeals. While it may seem in this case that the provider’s appeals significantly lowered its costs, it is important to note that the provider also undoubtedly expended significant resources on two appeals of OCR’s enforcement action.
Providers have placed a great deal of time and effort into the protection of healthcare information in compliance with HIPAA. Rightfully so, but providers seem to have lost sight of the fact that HIPAA is also about ensuring that patients and their representatives have timely access to their records. Now is the time for providers to conduct intensive education of staff members about HIPAA’s requirements regarding access in order to avoid enforcement actions like those described above.
©2024 Elizabeth E. Hogue, Esq. All rights reserved. No portion of this material may be reproduced in any form without the advance written permission of the author. For more information on how to get access to this or any other article, please contact The Rowan Report.
Product Review: HealthRev Partners Launches RCM Tool Velocity
Product Reviewby Kristin Rowan, Editor
Revenue Cycle Management (RCM) addresses several pain points for care at home agencies: coding errors, timely reimbursement payments, and employee workload. Available as both full-service and SaaS products, RCM automation offers higher reimbursement rates, lower overhead costs, and overall better efficiency for your agency. Not having a RCM tool leaves your agency at higher risk for nonpayment, audits, and lengthy revenue cycles that impede your ability to manage your agency’s revenue.
Last week, I had the opportunity to talk with Michael Greenlee, Founder and CEO of HealthRev Partners. Hannah Vale, Chief Strategy Officer, joined him on the call. They told me about the HealthRev Partners’ launch of their new RCM tool, Velocity.
About HealthRev Partners
HealthRev Partners offers OASIS & POC Review and Coding assistance to home health, hospice, and palliative care agencies. The partnership program starts with an initial telephone conference, followed by a live review of documentation with an OASIS expert with recommendations for accuracy and compliance. Additionally, they have a precepting partnership program to enhance clinician performance and documentation practices. The RN guided program offers OASIS documentation review and correction sessions to ensure accurate and compliant documentation. Their solutions aim to maximize reimbursements with faster turnaround and higher accuracy.
HealthRev Partners Launches Velocity
On April 1, 2024, HealthRev Partners announced the launch of a new SaaS solution for Revenue Cycle Management, Velocity. HealthRev Partners designed Velocity to transform RCM for multi-site agencies. In addition to RCM, the tool offers operational insights for optimization and growth. Velocity focuses on real-time analytics and operational efficiency by centralizing data between locations. If you have an in-house RCM team, Velocity can be a stand-alone SaaS. However, if you need it, it can also be a full-service solution with outsourced coding and RCM experts on the Velocity team.
About Velocity
According to Michael Greenlee, many agencies lack tracking of their aging accounts receivable and the status of their claims. Without these, agencies can be leaving hundreds of thousands of dollars stuck in the revenue cycle without ever getting reimbursement from the claim. Velocity works with any existing EMR to pull data from coding and billing information. The built-in quality assurance (QA) solution is automated and customizable for charting and documentation. HealthRev Partners launched Velocity to help agencies overcome some of the pain points agencies have with RCM, billing, and coding.
Features
- Productivity and Accountability Reporting: Whether using Velocity as an outsourced solution or SaaS, instantly see time-stamped productivity reports, accuracy reports, and clinician QA scoring
- Ai powered tracking: All claims in the 61-90 day and over 90 day segments are brought into the system for tracking with a follow-up reminder for each claim, payment information, and reasons for nonpayment.
- Claims forecasting: Velocity shows the current financial status of the agency, and with enough data in the system, can provide revenue forecasts simply by entering a future date into the reporting system.
- Pre-built database: All charting codes are built into the system and are searchable by keyword or phrase to reduce coding errors and increase reimbursement rates
- Platform agnostic: For many agencies, switching to a different EMR system costs more than the sticker price on the solution. With Velocity, there is no loss of data because it holds previous EMR data when you switch.
- Advanced Funding: Partners with Velocity have access to their AR funds before claims are processed, with an immediate credit line of up to $100,000, or 80% of the agencies AR.
Differentiation
Whether you need a software solution for your in-house RCM team or are looking to outsource your billing and coding to a partner, choosing the right RCM team is essential for your success. With so many RCM companies available in the market, it can be difficult to choose the right one. To choose the right RCM partner, there are a few factors to consider:
How does the solution or company match with the mission and vision I have for my agency?
HealthRev Partners has an “aspiration to develop innovative solutions that create boundless opportunities for our clients to advance their mission.”
Does the solution have the right tools for my success?
The analytics tools in Velocity can by customized to each agency’s KPIs. Velocity offers a fully supported software solution, a SaaS solution, and everything in-between to provide each agency with the level of support they need to succeed. Clinician productivity reports calculate clinician reimbursement by month. This shows which of your clinicians needs additional training and which should be recognized for their achievements, which can help to decrease your turnover rates. Velocity will custom build additional dashboards and measurements, included in the cost of the software.
Is the software solution safe for my agency and my clients?
Velocity is a HIPAA secure platform and is undergoing SOC-2 certification to protect your organization and the privacy of your patients.
Does the software partner have my best interests in mind?
Have you ever talked to someone who is so passionate about what they do that their energy is contagious? That was my experience in talking with Michael Greenlee, CEO and Founder of HealthRev Partners. Our one-hour scheduled software review meeting turned into a two hour conversation about what Velocity is designed to achieve. We also talked about how much potential it has to help home health, hospice, and palliative care agencies to survive.
Greenlee’s goal for Velocity is to have 0 claims go past 90 days for any agency they work with. They train each of their team members to meet the needs of an individual customer before they touch the account. HealthRev Partners offers “white glove service” to make good agencies great and to help partners dominate their marketplace. Michael partners with agencies he believes in as much as he believes in his own company. “We’re passionate about securing success for home health, hospice, and palliative care agencies across the nation.”
Future Considerations
Michael, Hannah, and I talked at length about what might be possible with Velocity. (So much so that Hannah asked if I was available to attend their next planning meeting.) AI capabilities are evolving and maturing at a rapid rate. Generative AI will become the standard for software solutions in care at home in short order. Michael’s passion for elevating the efficiency and prosperity of his home health, hospice, and palliative care agency partners will undoubtedly lead to even more innovation. Hannah Vale offered, “Our goal is to further enhance the sophistication of the AI. We consistently heed client feedback to creatively address their evolving requirements.”
To book a demo with HealthRev Partners, click here.
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Kristin Rowan has been working at Healthcare at Home: The Rowan Report since 2008. She has a master’s degree in business administration and marketing and runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in event planning, sales, and marketing strategy. Additionally, she has recently taken on the role of Editor of The Rowan Report and will add her voice to current Home Care topics as well as marketing tips for home care agencies. Connect with Kristin directly kristin@girardmarketinggroup.com or www.girardmarketinggroup.com
©2024 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in Healthcare at Home: The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com
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