Hospice Hope

by | Jul 10, 2025 | Admin, CMS, Hospice, Outcomes, Regulatory

by Peggy Rattarree, Principle Product Manager, Curantis Solutions

Hospice HOPE

The importance of documenting symptom impact for patient-centered care

In hospice care, the focus isn’t just on treating symptoms; it’s on improving the quality of life for patients and their families. This is where Hospice HOPE takes center stage, emphasizing the importance of documenting symptom impact to deliver truly patient-centered care. By understanding how symptoms affect each patient’s physical, emotional, and psychosocial well-being, hospice teams can provide care that aligns with their unique needs and goals.

What is hospice HOPE?

Hospice HOPE stands for Hospice Outcomes and Patient Evaluation. It’s a philosophy that places the patient’s comfort, dignity, and goals at the forefront of care delivery. Documenting symptom impact is a critical part of this approach because it provides a detailed understanding of how symptoms affect the patient’s overall quality of life.

In hospice care, every patient’s journey is unique. By actively tracking and documenting symptom impact, care providers can move beyond generic treatments and embrace a truly individualized approach that prioritizes what matters most to the patient.

Why documenting symptom impact matters?

Moves us to patient-centered care

Documenting symptom impact allows hospice teams to focus on what truly matters to the patient. Instead of simply addressing symptoms like pain, nausea, or fatigue in isolation, it provides a holistic view of how these symptoms affect the patient’s daily life. For example:

  • Pain
    • How does it limit mobility or the ability to participate in meaningful activities?
  • Fatigue
    • Is it preventing patients from spending time with loved ones?
  • Nausea
    • Is it reducing their ability to eat or enjoy meals?
Curantis Solutions Hospice HOPE

By asking these questions and recording the answers, hospice providers can better tailor interventions to manage not just symptom management but the overall patient experience.

Improves communication across the care team

In hospice care, communication is everything. Documenting symptom impact ensures that every member of the interdisciplinary team (IDT), from nurses and physicians to social workers and chaplains, has access to the same comprehensive information.

This documentation:

  • Creates a shared understanding of the patient’s condition
  • Helps align the team’s goals with the patient’s priorities
  • Reduces duplication of efforts and enhances care coordination

When everyone is on the same page, patients and families receive more seamless, cohesive care.

Hospice HOPE Communication

Supports compliance and quality standards

Regulatory bodies like CMS (Centers for Medicare & Medicaid Services) require hospices to document and monitor patient symptoms to ensure care quality. But beyond compliance, tracking symptom impact demonstrates a commitment to continuous improvement.

Documenting symptom impact allows hospices to:

  • Identify trends and gaps in care
  • Measure the effectiveness of interventions
  • Use data to advocate for better resources or innovations in care delivery

Empowers families and caregivers

When symptom impact is documented, families and caregivers gain a clearer understanding of their loved one’s condition. This transparency fosters trust and collaboration between the hospice team and the family, ensuring everyone is working toward the same goals.

For example, a caregiver might better understand why a loved one sleeps more during the day or avoids certain foods. These insights can help families feel more prepared and supported during a challenging time.

Final Thoughts

With CMS rolling out Hospice HOPE, documenting symptom impact is no longer optional. It’s the standard for compassionate, high-quality care. This shift helps hospice organizations go beyond symptom control and into whole-person care that honors each patient’s life journey.

This is part one in a two-part series on Hospice HOPE. Check back next week for part two.

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Peggy Rattarree Curantis Solutions Hospice HOPE
Peggy Rattarree Curantis Solutions Hospice HOPE

Peggy is an IT professional with over 30 years’ experience. She has defined and developed software products in industries such as grocery management, financial services, and reporting and analytics. In her 2.5 years with Curantis, Peggy has helped to shape the definition and delivery of the application. She brings a passion for agility and has been integral in transitioning Curantis to an environment of delivery on cadence, release on demand.

Peggy has a Bachelor of Music degree from University of North Texas.

©2025 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in the Curantis Solutions blog and is reprinted here with permission. For more information or to request permission to print, please contact Curantis Solutions.

Alliance Statement on House Passage of Reconciliation Bill

by | Jul 3, 2025 | Advocacy, Breaking News, Partner News, Regulatory

FOR IMMEDIATE RELEASE

Contact:                                                       Elyssa Katz
571-281-0220
communications@allianceforcareathome.org

Medicaid Provisions Threaten Home and Community-Based Services for Millions of Vulnerable Americans

Alexandria, VA and Washington, DC, July 3, 2025. The National Alliance for Care at Home (the Alliance) issued the following statement today in response to the House’s passage of the “One Big Beautiful Bill Act,” also known as the Reconciliation bill, which now heads to President Trump’s desk for his signature.

“The Alliance is deeply troubled by the Medicaid provisions within the One Big Beautiful Bill Act, which has passed both chambers of Congress and now awaits President Trump’s signature,” said Alliance CEO Dr. Steve Landers. “These provisions—including work requirements, reduced provider taxes, and new cost-sharing mandates—prioritize short-sighted budget savings over the health and wellbeing of our most vulnerable citizens who rely on home and community-based services (HCBS).”

Dr. Steve Landers

CEO, The National Alliance for Care at Home

The Alliance Advocates for Care at Home

The home care community advocated throughout the legislative process for Congress to mitigate these harmful Medicaid provisions. The legislation will reduce state provider tax rates, cutting funding that states rely on to support HCBS programs. New work requirements and mandatory cost-sharing will also create administrative burdens for both providers and beneficiaries, likely resulting in coverage losses that extend beyond those directly targeted by these policies. Further, new limits on home equity for long-term care recipients will force older adults to sell their homes, leading to unnecessary institutionalization.

Continued Advocacy

“As these Medicaid provisions become law, the Alliance will work tirelessly to monitor their implementation and advocate for the protection of Medicaid enrollees, families, and providers nationwide,” said Dr. Landers. “We will continue to champion the delivery of HCBS – proven services that are preferred by beneficiaries and save the system money.”

Careful Consideration Needed

Landers CEO The Alliance Reconciliation Bill

The Alliance calls on federal and state officials to implement these new requirements with careful consideration of their impact on vulnerable populations and to work collaboratively with providers to minimize disruption to essential services.

# # #

About the National Alliance for Care at Home

The National Alliance for Care at Home (the Alliance) is the leading authority in transforming care in the home. As an inclusive thought leader, advocate, educator, and convener, we serve as the unifying voice for providers and recipients of home care, home health, hospice, palliative care, and Medicaid home and community-based services throughout all stages of life. Learn more at www.AllianceForCareAtHome.org.

© 2025 The National Alliance for Care at Home. This press release originally appeared on The Alliance website and is reprinted here with permission. For additional information or to request permission to print, please see the contact information above.

Follow our continuous updates on the bill passage, what it means for Medicare and Medicaid, and how the provisions of the bill will be rolled out in our accompanying article here.

HIPAA Compliance Voice Activation

by | Jun 27, 2025 | Admin, Artificial Intelligence, Regulatory

by Curantis Solutions

HIPAA Compliance for Voice Activated Technology

HIPAA (Health Insurance Portability and Accountability Act) compliance is critical in the healthcare field, particularly regarding any technology that handles patient information, including HIPAA-compliant voice technology. Understanding the implications of HIPAA is essential for ensuring that innovations in healthcare technology do not compromise patient data privacy regulations.

Patient Privacy Protection

HIPAA enforces strict privacy protections for all patient data, including voice recordings and summaries. Voice recognition technology in healthcare must ensure that data is only accessible to authorized personnel. Any voice-activated system must adhere to HIPAA security measures for handling Protected Health Information (PHI).

Data Security Requirements

Voice-activated systems must implement safeguards to protect patient information from unauthorized access and breaches. This includes both physical and electronic security measures, such as:

Voice Activation HIPAA
  • Encryption
    • Data should be encrypted both in transit and at rest to prevent unauthorized access.
  • Access Controls
    • Systems must restrict access to only those who need to know, using multi-factor authentication and role-based permissions.
  • Audit Trails
    • Voice-activated technologies should log all access activity, tracking who accessed data, when, and what specific information was retrieved.

HIPAA Training Requirements for Voice-Activated Systems

HIPAA emphasizes the need for staff training and awareness regarding handling PHI in voice-recognition software. Training programs should cover:

  • Best Practices
    • Staff should be instructed on correct voice command usage to minimize accidental PHI disclosures in public or unsecured environments.
  • Identifying PHI
    • Employees should learn to recognize and protect sensitive patient data when interacting with voice-activated systems.

Data Minimization Principles

Under HIPAA, organizations should limit data collection to only what is necessary for specific tasks. This includes:

  • Minimal Data Handling
    • Only essential PHI should be processed and stored.
  • Anonymization Processes
    • Voice-activated systems should anonymize data when full patient identification is unnecessary, reducing security risks.

Incident Response Protocol

In the event of a data breach involving voice-activated patient summaries, organizations must follow HIPAA-compliant response steps:

  • Incident Reporting
    • Immediate breach investigation and reporting per HIPAA timelines.
  • Notification Requirements
    • Patients must be notified if their PHI has been compromised, along with steps taken to mitigate risks.

Summary

HIPAA compliance directly impacts how voice-activated patient summaries are implemented in healthcare. Ensuring compliance requires:

  • Robust data security measures
  • Thorough staff training
  • Strict vendor agreements
  • Comprehensive privacy protections

By aligning voice-activated patient summaries with HIPAA regulations, healthcare organizations can enhance patient care, safeguard sensitive information, and build trust with patients and families.

# # #

About Curantis Solutions

Curantis Solutions was founded on a desire to put hospice and palliative care first. We are dedicated to radically transforming standard electronic health records into a refreshingly simple and intuitive experience so that providers can keep their focus where it matters most – on the patients and families they serve. 

With a genuine culture of caring, we have assembled a team of highly talented individuals who are passion-driven and feel connected to their role in supporting the bigger mission of enabling high-quality end-of-life care. From forward-thinking technologists to hospice and palliative care experts, and every role in between, our team works with great integrity, accountability and responsiveness to bridge the latest technology with smart design to keep patient care at the center of what we do.

©2025 This article was originally published by Curantis Solutions and is reprinted with permission. For additional information or to request permission, contact Curantis Solutions.

Evaluating QHINs Interoperability 3

by | Jun 27, 2025 | Admin, Clinical, Regulatory

by Ben Rosen, Sr. Client Success Manager, Netsmart

Interoperability

What you need to know and how it affects you Part 3

For over two decades, tech companies and government agencies have been moving toward the goal of interoperability in healthcare technology. At long last, standards and protocols are in place—and continually being improved—to support open data exchange networks. As a result, healthcare providers, including human services, post-acute providers and specialty practices, have more opportunities to participate in alternative payment models and adapt more readily to the evolving payment landscape.

This is part three of a four-part series covering the forces that are driving interoperability, as well as the future vision of open networks, and what it all could mean to your organization. Read Part One Here; Read Part Two Here.

Interoperability in Healthcare

Evaluating QHINs for your Organization

As outlined in Part Two of this series, all Qualified Health Information Networks (QHINs) must apply and be accepted according to the baseline requirements outlined by the Trusted Exchange Framework and Common Agreement (TEFCA). While the rigorous testing and project tasks for each QHIN are the same, they may differ in services offered, geographic focus, technical capabilities, pricing and specific target markets. This blog will explore similarities and differences between QHINs, to provide insights that will arm organizations with the knowledge needed to make informed decisions about selecting a QHIN.

How to choose the right QHIN for your organization

As with any major business decision, consider what your organization is currently doing for data exchange and connectivity and how these factors are likely to change in the next 18 to 24 months:

  • The services you provide today and with whom you exchange data.
  • The communities you serve.

Prospective QHINs should have experience in serving the technology needs of the communities you serve and exhibit an understanding of how your service lines could impact the types of data transactions you use. If your strategic plan calls for expanding your services or community footprint – either organically or through partnerships with other providers – you’ll need to consider how your current needs will evolve and how that will affect your QHIN criteria.

QHIN candidates should have experience working with your electronic health record (EHR) vendor and be able to manage a smooth integration with your existing technology. Compatibility with your

EHR will help simplify implementation and further establish the network as a good fit for your organization. Integration capabilities of the QHIN should lend well to your current EHR build, such as being able to integrate the QHIN data directly to your EHR workflows.

Consider technical requirements

Each QHIN will have to build to and abide by the same standards for exchange via TEFCA. These requirements are outlined in the Common Agreement and the QHIN Technical Framework documents. Differentiation among QHINs will come from doing an analysis of your organization’s data exchange requirements and then determining how well they match up with the technical infrastructure and capabilities of the QHINs.

If your service lines require special consent practices or you do business in a state with strict data laws, it is paramount that your QHIN be technically capable of handling your most complicated information sharing needs from day one. Network 

Technology

size and geographic coverage should also factor into your decision as well as the QHIN business itself. QHINs today fall into categories such as developer platforms, data exchanges, and EHRs.

Questions to ask your QHIN short list candidates

Use the previously mentioned factors to focus on your top candidates, then it’s time to start asking about specifics:

  • Cost structure and pricing

    • QHINs may charge a per-transaction fee for their connectivity services. The specific services they can charge for are outlined by TEFCA, but the amount they can charge is not. Be sure to ask about ongoing costs and transaction fees so you can accurately project costs.

  • Additional services, such as analytics or public health reporting

    • All QHINs can provide you with connectivity for data exchange. But you should also explore each QHIN’s ability to provide reporting, analytics and other value-added services that will help you relate that data to your organizational goals.

  • Customer support and ease of onboarding

    • Ask about the onboarding process, how long it typically takes and the level of support you can expect from start to finish.

  • Plans to implement FHIR

    • QHINs will all be held to the same FHIR (Fast Healthcare Interoperability Resources) standards for exchange via TEFCA. When evaluating FHIR capabilities for QHINs, it’s important to understand what the QHIN’s strategy is around subscription services and bulk data access. This also ties into the consideration that even though a QHIN may support FHIR standards, you need to evaluate how well those pieces of information are actually integrated so you receive the information in a usable form.

  • Ongoing compliance with TEFCA and security standards

    • Technology companies must meet strict standards to become a QHIN. But you should also inquire about further monitoring and safety measures that guard against breeches of security and other concerns.

  • Total transactions and how different kinds of transactions are managed

    • Ask vendors for metrics around total transactions facilitated on their network and how they manage the different exchange types that are available via TEFCA. You also should find out ratio of errors to successes they have with their current network participants.

Final Thoughts

Due diligence is always essential whenever you choose technology. Scrutinizing all the factors outlined above for QHINs is particularly important because of the potential they will have for enhancing data sharing throughout your organization. In the final part of this blog series, we will explore actual QHIN use cases and the benefits they may offer.

Coming soon in Interoperability Part 4:QHIN implementation, use cases, and benefits.

# # #

Interoperability Ben Rosen Netsmart
Interoperability Ben Rosen Netsmart

Ben Rosen is a senior client success manager and business unit owner for the interoperability solution suite at Netsmart. With more than a decade of healthcare experience, Ben has led numerous initiatives to integrate healthcare systems and enhance data sharing across the care continuum. His dedication to advancing healthcare interoperability drives his active involvement in industry initiatives and standards organizations, where he provides insight for frameworks such as HL7 FHIR, USCDI and others. Ben holds a Bachelor of Science in kinesiology from Kansas State University and a Bachelor of Science in nursing degree from the University of Nebraska Medical Center.

©2025 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in the Netsmart blog and is reprinted here with permission. For more information or to request permission to print, please contact Netsmart.

PocketRN SYNERGY HomeCare Partner

by | Jun 20, 2025 | Partner News

FOR IMMEDIATE RELEASE

Contacts:                                       Melissa Drake
Imagine Productions
Melissa@imagineprstrategy.com
(732) 236-1569

William Leiner
PocketRN
will.leiner@pocketrn.com

PocketRN, SYNERGY HomeCare Partner for Dementia Care

This partnership will operate under CMS’s Guiding an Improved Dementia Experience (GUIDE) Model

Tempe, AZ, June 16, 2025. PocketRN, a provider of virtual nursing care, and SYNERGY HomeCare, a homecare company, announced they will form a national partnership to test the Centers for Medicare & Medicaid Services (CMS) alternative payment model designed to support people living with dementia and their family caregivers. 

SYNERGY HomeCare Speaks

“This is an exciting collaboration that amplifies and elevates the services both PocketRN and SYNERGY HomeCare bring to their clients,” said Rich Paul, chief operating officer for SYNERGY HomeCare. “As the fastest growing homecare franchise in a relatively young industry, we have a tremendous opportunity to positively impact a large number of people affected by dementia. SYNERGY HomeCare has a long history of aligning with a wide array of national partners, health plans and third-party payers to create a highly diversified referral base and extend services to a greater pool of clients. Our partnership with PocketRN is another excellent example of our ability to survey the evolving homecare landscape and find meaningful ways to deliver even more value through strategic partnerships.”

GUIDE Model

Under CMS’s Guiding an Improved Dementia Experience (GUIDE) Model, PocketRN will be one of almost 400 participants building Dementia Care Programs (DCPs) across the country, working to increase care coordination and improve access to services and supports, including respite care, for people living with dementia and their family caregivers. This partnership allows for integration of medical and non-medical care in the home.

PocketRN SYNERGY HomeCare Partnership

According to the CMS, many people with dementia do not consistently receive high-quality, coordinated care, despite its prevalence. As a result, they experience poor outcomes, including high rates of hospitalization, emergency department visits and post-acute care utilization. They also experience high rates of depression, behavioral and psychological symptoms of dementia and poor management of other co-occurring conditions.

New Approach

The GUIDE Model, which launched July 2024, is testing a new payment approach for supportive services for people living with dementia, including comprehensive, person-centered assessments and care plans; care coordination; 24/7 access to an interdisciplinary care team member or help line; and certain respite services to support family caregivers. People living with dementia and their family caregivers will have the assistance and support of a care navigator to help them access clinical and non-clinical services such as meals and transportation through community-based organizations.  

“This is an exciting collaboration that amplifies and elevates the services both PocketRN and SYNERGY HomeCare bring to their clients. Our partnership with PocketRN is [an] excellent example of our ability to survey the evolving homecare landscape and find meaningful ways to deliver even more value through strategic partnerships.”

Rich Paul

COO, SYNERGY HomeCare

Partners

SYNERGY HomeCare’s partnership with PocketRN is rooted in the fact that a significant portion of its client base has a dementia diagnosis. The company’s locations nationwide provide in-home memory care support for people living with Alzheimer’s and other forms of dementia, as well as respite care for their family caregivers.

PocketRN Speaks

“We couldn’t be more thrilled to partner with SYNERGY HomeCare to bring our revolutionary Nurse for Life model to the millions of dementia patients and families who need it most,” said PocketRN CEO Jenna Morgenstern-Gaines. “With PocketRN, patients and families get unwavering support from a dedicated, trusted nurse as they navigate the complexities of managing dementia at NO cost to them. Nurses are a critical part of the care continuum across all health fields and even more so as they provide a cohesive ‘glue’ for patients and their families throughout their dementia journey.”

Access to Care by Referral

PocketRN’s partnership with SYNERGY HomeCare to deliver the GUIDE Model will help people living with dementia and their family caregivers have access to education and support, such as training programs on best practices for caring for a loved one living with dementia. The GUIDE Model also provides respite services for certain people, enabling family caregivers to take temporary breaks from their caregiving responsibilities. 

Under this partnership, PocketRN will refer families in need of respite care to local SYNERGY HomeCare agencies. Respite is being tested under the GUIDE Model to assess its effect on helping caregivers continue to care for their loved ones at home, preventing or delaying the need for facility care. Similarly, SYNERGY HomeCare can refer their clients to PocketRN in the event they would benefit from 24/7 access to virtual clinical support.

For more information on CMS’ GUIDE Model, visit: cms.gov/priorities/innovation/innovation-models/guide. 

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About SYNERGY HomeCare

SYNERGY HomeCare is the fastest-growing national franchisor in the home care industry with over 240 franchises operating in more than 550 territories across the U.S. The company provides a broad range of non-medical in-home services including personal care, companion care, memory care and specialized care for individuals who are living with physical or developmental disabilities, chronic health conditions or recovering from illness or surgery. No matter what each person’s circumstances are, SYNERGY HomeCare steps in with effective, comforting, life-affirming care that moves people emotionally and physically forward. For more information visit SYNERGYHomeCare.com or find an in-home care location near you.

About PocketRN

PocketRN gives patients, families, and caregivers a Nurse for Life. Its mission is to close the gap between home and healthcare by: enabling nurses to care proactively and continuously at the top of their license, enabling caregivers with peace of mind and the confidence to support others, and enabling patients to access whole-person, trusted, empathetic care when and where they want it. PocketRN is the glue that holds together fragmented experiences in care so that partners, clinicians, patients, and families get back more of what they need: quality time. For more information, visit www.pocketrn.com or engage with PocketRN on LinkedIn, Facebook, and Instagram.

©2025. This press release was issued jointly by PocketRN and SYNERGY HomeCare and is reprinted with permission. For more information or to request permission to use, please see media contacts above.

AI in Home Care

by | Jun 13, 2025 | Artificial Intelligence, Home Health, Hospice

by Laurie Orlov, Founder, Aging and Health Technology Watch

The Future of AI in Home Care

New Research Report

Wed, 06/04/2025

PORT SAINT LUCIE, FL, UNITED STATES, June 4, 2025 /EINPresswire.com/ — The home care industry is facing a crisis. Driven by demographic shifts, longer life expectancy, and rising rates of chronic illness and cognitive decline, the demand for in-home personal care and home health care is surging. This will accelerate as the baby boomers age into their later years – in January, the oldest of the 76 million baby boomers will turn 80. At the same time, the care industries will face a critical shortage of all categories of care delivery, with millions of additional workers needed over the next decade. Against this backdrop, AI technology has emerged to help older adults in multiple ways. In a 2023 report, The Future of AI and Older Adults, AI was already able to produce insights about a person’s health needs and offer a chatbot to help with post-hospital care. In a subsequent 2023 report, AI and the Future of Care Work, it was apparent that AI could help generate an appropriate care plan and that an ‘AI Caregiver’ role was emerging to supplement in-person care delivery. In the 2024 report, The Future of AI in Senior Living and Care, AI was being used to analyze hospital discharge information to compare patient needs to nursing home capacity. 

Today there are many more initiatives and new possibilities for addressing multiple aspects of both private duty home care and home health operations, including assistance with recruiting and onboarding workers, using data to create and update care-related documents, and introducing AI agents that can be assigned to complete specific tasks. As current industry leaders note, AI tech is playing a role in care oversight and enabling the creating of hybrid models – an increasingly likely combination of in-person care supplemented with AI.

This report draws insights from experts across home care, home health care, plus software and device providers, and healthcare sectors to examine how AI is currently being used and suggest what lies ahead within the next five years.

The report can be found at this link: https://www.ageinplacetech.com/page/future-ai-home-care

# # #

Laurie Orlov The Future of AI in Home Care
Laurie Orlov The Future of AI in Home Care

Laurie M. Orlov, a tech industry veteran, writer, speaker, elder care advocate, is the founder of Aging and Health Technology Watch — market research, trends, blogs and reports that provide thought leadership, analysis and guidance about health and aging-related technologies and services that enable boomers and seniors to sustain and improve their quality of life. In her previous career, Laurie spent many years in the technology industry, including 9 years at analyst firm Forrester Research. She has spoken regularly and delivered keynote speeches at forums, industry consortia, conferences, and symposia, most recently on the business of technology for boomers and seniors. She advises large organizations as well as non-profits and entrepreneurs about trends and opportunities in the age-related technology market.  Her perspectives have been quoted in the Wall Street Journal, the New York Times, Vox, Senior Housing News, CNN Health, AARP Bulletin and Consumer Reports. She has a graduate certification in Geriatric Care Management from the University of Florida and a BA in Music from the University of Rochester. Laurie has provided testimony about technology at a Senate Aging Committee hearing and has consulted to AARP.  Advisory clients have included AARP, AOL, Argentum, Bose, Calix, CDW, Microsoft, Novartis, and Philips. Her reports include: The Market Overview Technology for Aging 2025, The Future of AI in Senior Living and Care, The User Experience Needs An Upgrade 2024, The Future of AI and Older and Older Adults 2023, The Future of Care Work and Older Adults 2023, The Future of Sensors and Older Adults 2022, Beyond DIY: The Future of Smart Homes and Older Adults 2021, and The Future of Wearables and Older Adults 2021. Laurie has been named one of the Women Leaders in Voice, Top 50 Influencers in Aging by Next Avenue and one of the Women leading global innovation on AgeTech. 

©2025 by Aging and Health Technology Watch. All rights reserved. This introduction and link are printed with permission from the author. For more information or to request usage rights, please contact Laurie Orlov. 

TEFCA and QHINs: Interoperability 2

by | May 29, 2025 | Admin, Clinical, Regulatory

by Ben Rosen, Sr. Client Success Manager, Netsmart

Interoperability

What you need to know and how it affects you Part 2

For over two decades, tech companies and government agencies have been moving toward the goal of interoperability in healthcare technology. At long last, standards and protocols are in place — and continually being improved — to support open data exchange networks. As a result, healthcare providers, including human services, post-acute providers, and specialty practices, have more opportunities to participate in alternative payment models and adapt more readily to the evolving payment landscape.

This is part two of a four-part series covering the forces that are driving interoperability, as well as the future vision of open networks, and what it all could mean to your organization. Read Part One Here.

Interoperability in Healthcare

The creation of TEFCA and QHINs

TEFCA (Trusted Exchange Framework and Common Agreement) is a national framework designed to enable seamless, secure sharing of health information across organizations. With respect to EHRs, this framework simplifies data exchange with other providers, payers and public health entities while enhancing compliance with interoperability requirements. TEFCA is touted as a nationwide federal and private data exchange network.

End goal

One of TEFCA’s main goals is to standardize data sharing, therefore reducing the complexity of managing multiple connections and enhancing the interoperability of your EHR with other systems nationwide.

TEFCA was created by the U.S. Department of Health and Human Services’ Assistant Secretary for Technology Policy (ASTP). The ASTP is contracting with the Recognized Coordinating Entity (RCE), The Sequoia Project. The RCE is tasked with governing and maintaining the operations of the entities who are electing to implement the TEFCA network, these entities are referred to as Qualified Health Information Networks (QHINs).

Interoperability
Interoperability TEFCA QHIN

QHINs

The certification process

QHINs are the entities that build the frameworks to allow data exchange as specified by TEFCA and facilitate the national exchange of health information. A single QHIN may represent dozens or even hundreds of healthcare providers, referred to as participants or sub-participants, across sectors (i.e., acute, human services, post-acute) public health agencies, health IT vendors and payers.

Applicants must build their TEFCA connection, which is then subjected to rigorous technology and security testing. QHIN applicants must also sign the Common Agreement that is countersigned by The Sequoia Project. These rigorous standards have a time limit: Each QHIN who applies must have their network built, tested and designated by the ASTP and RCE within 12 months of the application acceptance date. As of this writing there are eight designated QHINs and two candidate QHINs.

Benefits of participating in a QHIN

  • Streamlined Data Exchange
  • Compliance with Federal Interoperability Mandates
  • Access to Broader Patient Data
  • Improved Care Coordination

The market is already seeing regulatory rules and guidance tied directly to TEFCA. For instance, HTI 1 rule laid the groundwork for TEFCA and the HTI 2 rule is expanding on the process for designation, as well as codifying definitions and use cases to be exchanged via QHINs. Overwhelmingly, one of the biggest benefits to using a QHIN will be the increased types of data exchanged via the network.

The Same, but Different

Data exchange via TEFCA will look different than what we are used to with other nationwide networks today, such as Carequality, EHealthExchange or CommonWell. Via TEFCA, QHINs will exchange more robust types of data, referred to as Exchange Purposes, and will deal with higher volumes as a network. A few examples of these Exchange Purposes are clinical documentation (CCD-A), benefits determination data, public health research data, and even lab data, just to name a few.

Another benefit will be seamless connectivity. Other QHINs should integrate with EHRs to facilitate data exchange, acting as a hub that connects your system with other networks, providers and stakeholders.

Coming soon in Interoperability Part 3: Not all QHINs are created equal. How to choose the one that’s right for you.

# # #

Interoperability Ben Rosen Netsmart
Interoperability Ben Rosen Netsmart

Ben Rosen is a senior client success manager and business unit owner for the interoperability solution suite at Netsmart. With more than a decade of healthcare experience, Ben has led numerous initiatives to integrate healthcare systems and enhance data sharing across the care continuum. His dedication to advancing healthcare interoperability drives his active involvement in industry initiatives and standards organizations, where he provides insight for frameworks such as HL7 FHIR, USCDI and others. Ben holds a Bachelor of Science in kinesiology from Kansas State University and a Bachelor of Science in nursing degree from the University of Nebraska Medical Center.

©2025 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in the Netsmart blog and is reprinted here with permission. For more information or to request permission to print, please contact Netsmart.

Interoperability

by | May 16, 2025 | Clinical, Regulatory

by Ben Rosen, Sr. Client Success Manager, Netsmart

Interoperability

What you need to know and how it affects you

For over two decades, tech companies and government agencies have been moving toward the goal of interoperability in healthcare technology. At long last, standards and protocols are in place — and continually being improved — to support open data exchange networks. As a result, healthcare providers, including human services, post-acute providers, and specialty practices, have more opportunities to participate in alternative payment models and adapt more readily to the evolving payment landscape.

Interoperability in Healthcare

What's driving the need for change?

Government regulatory agencies, together with payers and healthcare organizations, have long recognized the need to improve care coordination among healthcare providers. Making it easier to share information via a nationwide data sharing network is a critical component of this effort.

End Game

The ultimate goal of providing access to complete, accurate patient information is to help drive down costs to providers and electronic health record (EHR) users. Through exhaustive work and years of innovation, we’re seeing the tangible outcome of this effort. Information now flows seamlessly across multiple healthcare networks. Using a concise view of the data, we can focus on broader population health initiatives that improve outcomes for chronic conditions, reduce emergency department (ED) visits, and prevent hospitalizations. The interoperability market is moving ahead at blazing speeds. Therefore, we must understand the players who are the driving forces behind the movement.

Interoperability

The Interoperability Highway

Who are the players and how do they work together?

Healthcare technology is complex. It’s not surprising, then, that getting the disparate systems to share information seamlessly and securely is a complicated process. In the last decade an increasing number of vendors, organizations, and healthcare players started working together to advance a useful interoperability market.

Some of the larger players in this space include government and regulatory agencies. To understand the role these entities play and how they coordinate with other organizations and efforts, let’s compare the process to building a national highway system.

Building an open data exchange network

  • Assistant Secretary for Technology Policy and Office of the National Coordinator for Health (ASTP/ONC): This federal agency sets the vision, rules and regulations for health information technology policy. Compare it to the Federal Highway Administration (FHWA), the federal agency that provides stewardship over the construction, maintenance, and preservation for all interstate highways.
  • Trusted Exchange Framework and Common Agreement (TEFCA): Established by the ASTP/ONC, TEFCA sets the rules for health data exchange over the network. This is similar to plans or blueprints for highway construction. This would also include engineering, construction and safety standards for the highway.
  • The Sequoia Project (RCE): The Sequoia Project is the Recognized Co-ordinating Entity (RCE) for TEFCA and is appointed by the ASTP/ONC. The Sequoia Project is a non-profit, public-private collaborative that leads the implementation project for nationwide data exchange. They approve and help regulate the TEFCA exchange, via QHINs. The Sequoia Project can be compared to a construction manager that approves contractors and oversees quality control measures to ensure standards are met.
  • Qualified Health Information Networks (QHIN)s: QHINs are data sharing networks built to operate the exchange network as outlined by TEFCA. In our analogy, QHINs are the highways, and the companies that build QHINs can be compared to the construction companies that physically build and maintain the roadways themselves.

Now that you’re familiar with the entities involved in developing the standards for interoperability and building the data exchange networks that make it a reality, we will next look at how these enhanced capabilities can impact your organization.

This is part one of a four-part series covering the forces that are driving interoperability, as well as the future vision of open networks, and what it all could mean to your organization. Check back for part 2, “How TEFCA affects your technology and what the heck is a QHIN?” coming soon.

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Interoperability Ben Rosen Netsmart
Interoperability Ben Rosen Netsmart

Ben Rosen is a senior client success manager and business unit owner for the interoperability solution suite at Netsmart. With more than a decade of healthcare experience, Ben has led numerous initiatives to integrate healthcare systems and enhance data sharing across the care continuum. His dedication to advancing healthcare interoperability drives his active involvement in industry initiatives and standards organizations, where he provides insight for frameworks such as HL7 FHIR, USCDI and others. Ben holds a Bachelor of Science in kinesiology from Kansas State University and a Bachelor of Science in nursing degree from the University of Nebraska Medical Center.

©2025 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in the Netsmart blog and is reprinted here with permission. For more information or to request permission to print, please contact Netsmart.

WellSky wins Best Home Health Solution

by | May 9, 2025 | Partner News

FOR IMMEDIATE RELEASE

Contact:                                             Emma Neal
617-401-3131
emma.neal@allisonworldwide.com

WellSky® Wins ‘Best Home Health Care Solution’ Designation in Ninth Annual MedTech Breakthrough Awards Program

Prestigious international annual awards program recognizes standout digital health and medical technology innovations and companies

OVERLAND PARK, Kan, – May 8, 2025 – WellSky, a global health and community care technology and services company, today announced that WellSky Enterprise Referral Manager has been named “Best Home Health Care Solution” in the ninth annual MedTech Breakthrough Awards program conducted by MedTech Breakthrough, an independent market intelligence organization that recognizes the top companies, technologies, and products in the global digital health and medical technology market. This is the sixth consecutive year that WellSky has been honored by MedTech Breakthrough.

Enterprise Referral Manager

The WellSky Enterprise Referral Manager solution transforms referral, intake, and customer relationship management processes for home health, hospice, and other home-based care agencies by consolidating inbound referrals originating from nearly 2,000 hospitals using WellSky CarePort solutions, e-Fax, and direct secure messaging within a single dashboard, centralizing referral activity in one place. The solution surfaces information needed to evaluate referrals, such as payer and

MedTech WellSky wins best home health care solution

insurance details, services requested, discharge date, ZIP code, and more. This allows intake staff members to spend less time clicking between solutions, enabling them to make quicker decisions and respond to referrals faster directly within their workflow.

Referral Management

“Home health and hospice agencies depend on referrals for growth but the process of managing referrals is complicated, with the data within referrals often scattered, forcing intake staff to open several documents, work in multiple systems, and piece together the information to make decisions,” said Steve Johansson, managing director, MedTech Breakthrough.

“WellSky Enterprise Referral Manager helps agencies transform referral and intake processes, putting them on a path for efficient, effective, and sustainable growth. We’re pleased to award WellSky with the ‘Best Home Health Care Solution’ for 2025.”

Steve Johansson

Managing Director, MedTech Breakthrough

Referral and Intake

WellSky Enterprise Referral Manager also supports referral task creation and assignment across intake, sales, and marketing roles, enabling intake coordinators to track the status of required pre-visit activities and begin care in a timely fashion. Additionally, the solution uses patient information received within referrals to create or update patient records within the WellSky electronic health record (EHR), helping to eliminate workflow bottlenecks, prevent duplicate EHR records, and improve intake throughput.

“An agency’s ability to quickly respond to referrals is critical to operations, affecting staffing, growth, and high-quality care delivery. Our solution improves the entire referral process with a centralized view, integrated referral data sent into the EHR, and synchronized referral activities between agency roles. We’re grateful to MedTech Breakthrough for this recognition and we’ll continue to deliver cutting-edge solutions that improve outcomes through efficiency, intelligence, and connection.”

Bill Miller

Chairman and CEO, WellSky

MedTech Breakthrough Awards Program

The MedTech Breakthrough Awards program celebrates excellence and innovation in the health and medical technology industry, recognizing the companies and solutions driving meaningful progress and improving patient care. Spanning a wide range of categories—including Telehealth, Clinical Administration, Patient Engagement, Electronic Health Records, Virtual Care, Medical Devices, Medical Data & Privacy, and beyond—the awards highlight the groundbreaking work that is transforming the healthcare landscape.

This year, the program received more than 4,500 nominations from leading companies and startups in more than 18 countries, showcasing the global impact and momentum of the digital healthcare industry today.

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About WellSky®

WellSky is one of America’s largest and most innovative healthcare technology companies leading the movement for intelligent, coordinated care. Our proven software, analytics, and services power better outcomes and lower costs for stakeholders across the health and community care continuum. In today’s value-based care environment, WellSky helps providers, payers, health systems, and community organizations scale processes, improve collaboration for growth, harness the power of data analytics, and achieve better outcomes by further connecting clinical and social care. WellSky serves more than 20,000 client sites — including the largest hospital systems, blood banks, cell therapy labs, home health and hospice franchises, post-acute providers, government agencies, and human services organizations. Informed by more than 40 years of providing software and expertise, WellSky anticipates clients’ needs and innovates relentlessly to build healthy, thriving communities. For more information, visit wellsky.com.

About MedTech Breakthrough

Part of Tech Breakthrough, a leading market intelligence and recognition platform for global technology innovation and leadership, the MedTech Breakthrough Awards program is devoted to honoring excellence and innovation in medical & health technology companies, products, services and people. The MedTech Breakthrough Awards provide a platform for public recognition around the achievements of breakthrough healthcare and medical companies and products in categories that include Patient Experience & Engagement, Health & Fitness, Medical Devices, Clinical Administration, Connected Healthcare, Medical Data, Healthcare Cybersecurity and more. Tech Breakthrough LLC does not endorse any vendor, product or service depicted in our recognition programs, and does not advise technology users to select only those vendors with award designations. Tech Breakthrough LLC recognition consists of the opinions of the Tech Breakthrough LLC organization and should not be construed as statements of fact. Tech Breakthrough LLC disclaims all warranties, expressed or implied, with respect to this recognition program, including any warranties of merchantability or fitness for a particular purpose. For more information visit MedTechBreakthrough.com.

Meaningful AI

by | Apr 24, 2025 | Admin, Artificial Intelligence, Caring for the Caregiver

by Scott Green, Care Dimensions at Netsmart

Meaningful AI in Post-Acute

Elevating Care and Efficiency with Integrated AI

Meaningful AI is more than plugging your questions into ChatGPT. It goes beyond Artificial Intelligence into Augmented Intelligence. 

After a long day of caring for patients, a home health nurse pulls into their driveway, bracing for the familiar evening grind — hours of documentation. They take a deep breath, one of relief. They’re not mentally preparing for hours at their laptop, documenting every visit, trying to recall every detail while fatigue tugs at their focus. Tonight is different.

Tonight, they step through the door, greeted by their kids clamoring to show off their school projects. Dinner is already on the table, and for the first time in weeks, they sit with their family—truly present. There’s no need to pull out the laptop after dessert, no late-night race against deadlines. Their documentation? Done. Completed during patient visits, thanks to an integrated AI workflow that not only captured essential details of their patient but also highlighted critical care needs in near real-time.

This isn’t just a glimpse of what’s possible—it’s the reality Meaningful Augmented Intelligence (AI) creates for home care & hospice providers. With AI-assisted documentation tools, caregivers are freed from after-hours work. Repetitive tasks are automated, and accurate, compliant records are captured during visits. As a result, clinicians can focus on what matters most: delivering care to their patients during the day and being present for their families at night.

Meaningful Integrated AI in Care at Home: How it Works and Why It Matters

Integrated AI doesn’t just automate tasks—it enhances every part of the care process. By embedding AI directly into existing workflows, solutions empower clinicians and administrators to work smarter, not harder. Predictive analytics, real-time documentation and automated data entry reduce repetitive tasks and administrative burden, clearing staff to focus on patient care.

Unlike generic AI tools, Meaningful AI supports clinicians at the point of care. It captures essential details during visits, highlights critical needs as they arise, and offers real-time guidance. This isn’t just about making work faster—it’s about making it more human. Integrated AI simplifies workflows and strengthens decision-making, whether it’s anticipating a patient’s end-of-life needs, identifying compliance risks, or supporting proactive billing.

The AI Trifecta

AI isn’t just about automation—it’s about Meaningful AI that directly addresses the needs of community-based providers. With our AI Trifecta, every aspect of care delivery is reimagined to optimize processes, empower staff, and simplify reimbursement.

Optimize Processes

Integrated AI helps organizations operate more efficiently by taking over time-intensive, repetitive tasks, allowing staff to focus on patient care. For example, guided assist tools integrated with clinical workflows proactively coach staff through complex tasks like completing the OASIS assessment or interdisciplinary start of care documentation.

Imagine a clinician documenting care after a patient visit. With AI-powered assistance, charting can pre-fill fields based on visit details, flag potential inconsistencies in near real-time and suggest changes to align with regulatory requirements for a supervisor to review. This reduces errors and speeds up documentation, freeing clinicians to focus on patients rather than administrative tasks.

Predictive analytics empower organizations to anticipate and address challenges early, supporting clinical benefits of Hospice Visits in the Last Days of Life (HVLDL) such as symptom management, reduced patient distress and honoring the patient’s end-of-life wishes.

Empower Staff

The backbone of any agency is its staff. Integrated AI tools relieve the pressures of excessive documentation and administrative burdens. These tools aren’t just about doing tasks faster—they help create a more sustainable work-life balance by addressing challenges like burnout and turnover.

Staff can also benefit from smart task prioritization. Meaningful AI tools can include the ability to log in and instantly see a clear list of priorities based on patient needs and compliance deadlines. This reduces time spent figuring out “what’s next” so that every action directly contributes to better patient outcomes.

Meaningful AI

Simplify Reimbursement

Some AI tools monitor claims for potential issues before submission. Imagine if your system could identify a missing modifier or mismatch in coding then flag the problem and provide actionable suggestions to correct it. This not only increases first-pass acceptance rates but also reduces the exhausting back-and-forth that often accompanies denied claims.

Beyond preventing errors, predictive tools assess patterns in denial risks and reimbursement trends, enabling organizations to adjust strategies proactively. Leaders can use these insights to negotiate better contracts or refine documentation practices, ensuring steady cash flow and financial health and upstream process improvement. This empowers organizations to invest resources where they matter most: improving patient outcomes.

About Netsmart myUnity® NX

With Meaningful AI at the heart of myUnity NX, every part of the healthcare process—from care delivery to financial health—works smarter, not harder. These innovations support not just operational efficiency but also the well-being of care teams. By embedding intelligent workflows, providers have the time and space to focus on what matters most—delivering exceptional, person-centered care. Learn more about Netsmart myUnity® NX

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Scott Green Meaningful AI
Scott Green Meaningful AI

Scott Green leads the Care Dimensions business unit at Netsmart. In his role, he leads a team focused on building out a comprehensive suite of solutions designed to support organizations as they digitize their operations beyond the EHR. Green has been with Netsmart for 10 years and has held many roles during that time including leading the Human Services business unit.

Prior to joining Netsmart, he spent 13 years with Pfizer where he focused on building relationships and clinical initiatives with Integrated Delivery Networks.

Scott holds a bachelor’s degree in industrial psychology from Kansas State University and a graduate certificate in healthcare leadership from Park University.

©2025 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared on the Netsmart blog and is reprinted here with permission. For more information or to request permission to print, please contact Netsmart.