Posted by Ken Accardi on Wed, Nov 30, 2011 @ 03:43 PM
Here's a novel idea from Dublin Ireland where home care nurses are deployed, via bicycle to evaluate an elderly person's need for hospitalization. The full story, from the site Acorbat.org is pretty short and included here:
Home Care and a Bicycle
The Mater hospital in Dublin recently launched an original project: a health care system of male nurses with bicycle transport in order to provide Home Care services, for the elderly. This a winning formula, both in financial and human terms, which could inspire other hospitals to do the same.
When medical personnel call the hospital for a patient seeking admission, the nurse gets on a bicycle to go to the patients home. The nurse is charged to evaluate the appropriateness of a possible admission to hospital and, if that does not prove necessary, the nurse is entitled to practise the relevant patient care directly in the home.
To avoid the stress of hospital admission for the patient
One of the major advantages of this system is that the elderly do not unnecessarily suffer both the stress of a hospital stay and the trip to the hospital. These home visits by a nurse on a bicycle make it possible, in many cases to avoid the hospital admission of the patient! The financial advantage is the second benefit, because a nurse on a bicycle makes it possible to avoid many of the costs associated with hospital admission.
For Me, this is a fantastic example showing that it's possible to reduce hospitalizations and reduce the cost of healthcare delivery.
Can home health partner with health care payers or managed care providers to reduce admissions? Why not?
Ankota provides software to improve the delivery of care outside the hospital. Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care. To learn more, please visit www.ankota.com or contact Ankota
Posted by Ken Accardi on Tue, Nov 29, 2011 @ 07:36 AM
Our goal at Ankota is to improve the delivery of healthcare. We think everyday about how healthcare should be reformed, and we focus on the areas where we know we can make an impact. We are convinced that the solution is to focus on the most expensive patients and to proactively manage and coordinate their care, keeping them at home. But today's post is very special because it comes from a home health nurse who validates our vision.. We're pleased to introduce Beth Kennedy, a home health nurse in northern Virginia. Here's Beth's view...
The question on everyone's mind is how to do we lower healthcare costs while still providing optimal care to our patients? If someone could solve this problem we could all sleep better at
night. That being said, it appears that the healthcare industry continues to spiral out of control. I say this as a healthcare professional. I am a nurse who works in home healthcare. My goal is to assist patients in coordinating their medical needs after discharge from the hospital. This can be quite an overwhelming task because it can range from physical needs to medication discrepancies to social and economic issues and also the need or lack of medical supplies and equipment such as wheel chairs or walkers or gauze/bandages.
Collaboration in the release of a patient to home care is a critical component. Even though it is a critical component, it almost always lacking in details and results in incomplete discharge orders and unclear instructions for home health management of the patient. The end result? The patient does not get the adequate care he/she needs and his/her condition continues to depreciate in the home and he/she ends up back at the doctors office and usually admitted back into the hospital. From a monetary perspective, this costs the healthcare industry a lot of money. And if it was just one patient, swallowing the money would not be too difficult, but this happens every day all around the country to thousands of patients.
One idea on how to fix this disastrous chain of events is to streamline discharge care. Even though hospitals function as separate units, this is a country-wide issue. Proposing a standard federal policy of discharge (or at least state) is a step in the right direction. There should be specific steps that are always taken prior to discharging a patient from a hospital setting: meeting with family members or primary caregivers to discuss discharge process, assessment of home environment prior to discharge (for safety issues), review of medications that need to be taken once discharged (and a way to make sure patient has access to this medication), home health service assigned to patient by hospital staff so that a planning meeting can be established and the home health nurse is in communication with hospital staff (mainly doctor and nurse that discharged patient).
Some hospitals have case managers that are responsible for discharge planning. Most do their best to ensure a positive discharge, but hospitals are super busy and staff is overworked. Their only goal is to "get the patient out the door." They are not seeing the big picture --- that we should be trying to keep the patient out for good and prevent a readmission.
Hospital administrators need to hand down the information to case managers, nurses and doctors that the overall goal of the hospital is to prevent readmission. More time and energy needs to be focused on coordinating outside care and collaborating with family members, obtaining proper medications and explaining the process of taking care of a patient in the home.
Without this necessary process being done, patients will continue to decline in the home and wind up readmitted to the hospital and also continuing to waste thousands of dollars for readmittance to the hospital.
Communication and education are two of the most important parts of the patient-discharge process. Healthcare professionals are too busy to have these much-needed conversations with patients and their families. But we are seeing, the end result, is that the lack of communication and education is causing readmission to hospitals and strains on the economy.
Ankota provides software to improve the delivery of care outside the hospital. Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care. To learn more, please visit www.ankota.com or contact Ankota
Posted by Marc Ottinger on Wed, Nov 23, 2011 @ 07:47 AM
In caring for the elderly, knowing how to work with Alzheimer’s and Dementia patients is essential! We've blogged about this in the past based on a very special meeting with the "The Alzheimer's Whisperer" Dr. Verna Carson Benner (see providing better Alzheimer’s care).
Today's post was inspired by a new article in the Huffington Post that discusses a few tips that can really assist in the home care of Dementia patients.
Making a Connection with Someone with Dementia
In many cases, a person with dementia simply needs something to connect to their past memories. Try some of the following to engage with them:
- Old photo albums – pictures of people and locations they recognize
- Music – songs that are special to them or that they will remember and associate
- Smells – for example, if your patient used to garden, introduce roses to the environment
Trying to force someone with dementia into a situation that they're not comfortable with can lead to a bad outcome. Instead, try to engage them and give them freedom of choice. Recognize that obstinacy is a symptom of dementia. Rather than argue, wait five minutes to try again and use one of the tips above, like singing a song with them. After the pause, they are likely to not remember being opposed to the event.
Communicating with Family Members:
Remember that the family doesn’t always understand how dementia affects their loved one. Some situations may arise in which you need to respond delicately and non-defensively..
- Keep notes on the care that you provide. If a family member or loved one says something like "My mom didn't get her bath today" or "My dad said that the caregiver didn't give him any breakfast", give them the details of the care provided, and gently remind them that mom or dad may not always remember their care.
- If the loved one is upset that their family member or friend doesn’t remember them or respond to them, suggest that they employ the ‘five minute rule’ and tell them to try again and to use one of the memory triggers listed above.
Maintaining Dignity
It's important to help someone with dementia avoid feeling useless. Keep a routine that includes tasks that they can achieve. Having them confidently perform a task like folding towels can improve their self-esteem. For more about providing dementia care and to find more best practices for your agency, see the full article tips for Dementia care, online at Huffington Post.
Ankota provides software to improve the delivery of care outside the hospital. Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care. To learn more, please visit www.ankota.com or contact Ankota
Posted by Ken Accardi on Tue, Nov 22, 2011 @ 10:54 AM
Starting Ankota has been a great adventure and we're now at an exciting time in the company where we're bringing on new customers frequently, while still sticking to our goal of learning from each customer, improving our products as a result and delighting customers in the process. One thing that greatly helped us to grow was to learn from excellent mentors along the way, and we've tried to share what we've learned on this blog. Today's post is inspired by a few of those mentors, Ginny Kenyon, from Kenyon Home Care Consulting, and Pat Drea, from Visiting Angels. Ginny has been doing an excellent series on starting a home care business that you can read here. We've done two prior posts based on things we learned from Pat including this one about maximizing the value of your Private Duty Home Care Software.
Today's post is inspired by a post by Pat on Ginny's blog entitled New Rules for the New Private Duty Home Care Economy. As always, our goal here is to give you an introduction to the great content and if we whet your appetitie, we encourage you to check out the full post. Here are some of the key points:
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You need to "Make “disciplined reinvention” your mantra" so that you are always adjusting to new searching and buying habits.
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"Become experts at lead conversion". A lot of your early efforts in the business are likely about "building a funnel" and then you're winning your share of the deals. Now is time to focus on conversion and increasing your share.
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Next advice "Establish marketing and networking as core functions of your office operations". Ankota has recently integrated Customer Relationship Management functionality into our software so that you can better organize and track your referral sources and prospects. Please contact us to learn more.
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"Refine your private duty home care operations for maximum efficiency". This is a topic where we've blogged about Pat's best practices in the past.
Once again, we encourage you to read the complete post here.
We try not to advertise in our blog, but there are so many of the best practices above that Ankota can help you with and we'd love to do so. Click below to set up a meeting or a demo.
Ankota provides software to improve the delivery of care outside the hospital. Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care. To learn more, please visit www.ankota.com or contact Ankota
Posted by Marc Ottinger on Mon, Nov 21, 2011 @ 10:51 AM
Steve Jobs, the inspirational leader of Apple Computer recently passed away but left an
incredible legacy. I first remember seeing Apple Computers in the 1980s, but recently Apple has really captured the hearts and minds of technology users with the Mac, the iPad, the iPhone, The new iPhone 4S (the one that responds to vioce commands) and even the iPod and iTunes store which have revolutionized the way people buy music.
Ankota developed our home care software to run on the Mac and the iPad
Ankota began developing our products in November of 2008 and from day one we knew that we needed to run on the web, support both Mac and PC, and use what the web brings to enable coordination of care. This is what inspired us to make sure that we run on the Mac, and many of our clients are using the software on their iPhone and iPad.
Why doesn't your home care software run on the iPad or the Mac?
In general, software is developed to work in the best environments available at the time it is released, and software companies need to rearchitect the software every several years to keep up. A lot of the software in home care was developed when the best technology was called "client/server software". Client/Server software is installed on a local PC in an office. As such, it can only be run in the office, it requires the user to do backups and upgrades, and its performance often slows down over time.
Today, the best practice is to develop software, including home care software and most other types of software, that runs on the web in a model called cloud computing or software-as-a-service (SaaS). In this model, a smaller number of shared computers on the web can serve more customers and give them faster performance. Plus the software company provides the backups, improvements and new features for you as they evolve. Plus they add and upgrade hardware over time to improve performance. There are risks in this model as well. For example, you need internet access to use your software.
As recently as 5 years ago, this new model was considered too risky, but now it has become the norm in software, including in financial services and in healthcare.
We advise people to look at what you're able to do with consumer electronics and expect your business software to be 1 to 2 years behind. Most of you have likely been getting your email and paying your bills on the web for the last several years. So it's time that your software can do the same.
Ankota provides software to improve the delivery of care outside the hospital. Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care. To learn more, please visit www.ankota.com or contact Ankota
Posted by Marc Ottinger on Thu, Nov 17, 2011 @ 03:18 PM
Renowned spiritual leader Billy Graham spent his life career inspiring people to live lives of grace, faith and charity. Now, at the age of 93, Rev. Graham is inspiring us in the final stages of life. His new book, "
Nearing Home: Life, Faith, and Finishing Well" addresses the process of growing old and approaching the end of life and doing so gracefully and with an eye toward God.
In a recent article in
USA Today, Graham discussed why he chose to write this book at this stage in his life.
"No one prepares you for loneliness, for pain, for the grief of losing your soul mate, he now writes. When his wife, Ruth, died in June 2007, he was stunned that she died before he did. He had never envisioned his life without her.
Graham says he wanted the book to be the handbook he never had — spiritual, pragmatic
and fearless." (Read the entire article here.)
Graham has Parkinson's disease and is confined to a walker or wheelchair. He also has macular degeneration and can no longer read. He dictated "Nearing Home" to staff members. Yet he continues to live out his life to the fullest, still taking advantage of opportunities to minister to his global congregation. This time, Graham's words encourage seniors to turn to scripture for wisdom in how to proceed in the twilight of their lives.
While many people have written books before about dying and growing old, few have the same clout with generations of people across the country, across imaginary boundaries of income or race as the Rev. Graham.
Through Graham's experiences and his decades of devotion to people's spiritual well-being, "Nearing Home" can bring comfort and hope to anyone facing their own end of life or those who care for the elderly. We can all take away several lessons in patience, compassion and grace from Graham's work.
Ankota provides software to improve the delivery of care outside the hospital. Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care. To learn more, please visit www.ankota.com or contact Ankota
Posted by Will Hicklen on Wed, Nov 16, 2011 @ 11:13 AM
You may have heard about the rapidly growing Home Care dentistry industry, with businesses such as our friends at PrevMed and The Homecare Dentist becoming vitally important to overall health and contributing to reductions in healthcare costs. There are reasons that businesses like these are growing and thriving, and emerging as a vital component of the healthcare continuum. If your Home Care agency is not coordinating with other services like this today, you’re missing out on a huge opportunity to improve the lives of your clients. If you are part of a health system looking to improve the lives of patient populations and you are not considering oral health in your overall plan, you should consider integrating it into your plan now.
First, consider the fact that oral health plays an indisputable role in overall systemic health. Regularly maintained oral health contributes to fewer ER visits and hospital admissions for the elderly, and improves outcomes for those with the most prevalent chronic diseases:
- Five of the six most prevalent chronic diseases are linked to periodontal disease.
- 89% of those 80 or older have advanced periodontal disease, according to the CDC.
- Reduction in ER admissions: In the elderly, bacteria that originate in the mouth cause needless ER visits and hospital admissions, commonly costing tens of thousands of dollars per episode. Simple preventative care can eliminate many of these admissions.
- Potential impact on chronic disease management: In diabetics of all ages, for example, a Cigna study showed that patients who received an initial treatment for gum disease with subsequent maintenance had lower overall healthcare costs than those who did not receive regular maintenance. Savings averaged 24% in the study, or $2483 per patient per year. Cigna is so convinced by the results that they now reimburse members with certain chronic conditions for out of pocket expenses incurred for their oral care. Read more here PrevMed
What is the opportunity for Home Care? Simple: Medical and Non-Medical Home Care is increasingly becoming a Care Coordination business. Programs like Geriatric Care Management (GCM), Patient Centered Medical Home (PCMH) and others require the services and coordination of multiple providers to deliver a comprehensive, well planned set of services that should result in improved outcomes and reduced overall costs. Clearly, oral care must be integrated into the overall care plan, particularly for the elderly and others who may have difficulty getting to the dentist on their own.
If you are not already, consider partnering with businesses in your area that provide oral care services like PrevMed (for clients living in facilities) and The Homecare Dentist (for home-based dental services). Particularly for Private Care agencies, there is a revenue opportunity for coordinating these services with your overall care. You'll be providing a more valuable service to your clients, who will be grateful for their improved health and dignity.
Ankota's Xchange Care Coordination Portal provides an excellent platform to coordinate Home Care and Dental services like those in this article. Ankota's Healthcare Delivery Management (HDM) technology also helps individual providers to reduce costs and grow their businesses more efficiently, including Home Health and Home Care, Physical Therapy, HME, Infusion, and more.
Posted by Ken Accardi on Tue, Nov 15, 2011 @ 01:40 PM
Sobering statistics show that falls resulting in injury can be the beginning of the end for seniors--not only of independence, but also their lives. Among the dangerous consequences of falling, hip fractures sustained in a fall are tragically common among seniors.
Shockingly, injuries resulting from falls kill tens of thousands of seniors each year. Falls affect
nearly 1 in 3 seniors annually--about 300,000 seniors will suffer a quality-of-life threatening incident this year.
It follows that preventing falls from happening is key in extending the lives of seniors.
Importantly, fall prevention also preserves quality of life. Home care is a major factor in keeping seniors attended, functional, significantly safer, and able to live the independent lives they deserve.
Home Care can extend their clients' lives by preventing falls.
Previous coverage on the Ankota blog explores this topic and its relation to your agency. Find it here.
The blog post shares a simple yet crucial piece of advice: when shopping for Home Care, look for an agency's record in fall prevention as a true measure of quality care.
A new article in AARP magazine makes the case compellingly clear. The article lays out the numbers, which are not at all encouraging. Yet it also provides a comprehensive list of measures to take to significantly reduce this all too common threat to the quality of life for seniors.
"The Deadliest Break" gives an example of a 91-year-old woman who was able not only to survive, but also to thrive after her fall resulting in hip fracture.
Unfortunately, it goes on to explain, she is in a select minority of seniors who are able to resume activities of daily living unassisted after such an incident.
Does aging itself necessitate a resigned attitude toward inevitable decline of one's own abilities and capacities? The article explores an insidious bias, while giving clear directives for restoration and renewal. It shows how to overcome a prevalent notion--that recovery from hip fracture or other fall-related injuries will not result in fully restored vigor.
Why are falls resulting in hip fractures particularly deadly to seniors? The article looks at co-morbidity factors affecting this population, plus takes on other damaging factors, including "the vanishing" of continuing care at a crucial juncture--care which could restore an injury sufferer to previous levels of functionality in daily life.
The article is followed by a list of definite measures--some perhaps surprising--to bolster a senior's chance of preventing an incident.
Naturally, prevention is paramount. Yet early treatment, thorough rehabilitation, and continuing care at the right time are the simple yet uncommon measures to improve the situation for seniors and those who care for them.
Find the full article here: "The Deadliest Break."
What is your agency doing to prevent falls? Please share your best practices in the comments. If you have a great story to share, we want to hear it. Be sure to contact us and we'll feature the best in our blog.
Ankota provides software to improve the delivery of care outside the hospital. Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care. To learn more, please visit www.ankota.com or contact Ankota
Posted by Will Hicklen on Fri, Nov 11, 2011 @ 12:20 PM
This one will be a quickie. Every one of us wastes time every day and if you're like me, you may occassionally get frustrated when you realize that some of the important things did not get done. Volumes have been written on the topic of time management, but I tend to like the "quick lessons" that you can absorb and put to use...QUICKLY.
I share this summary below of tips on prioritizing tasks to you from a more detailed article in CBS Money Watch.
- People currently paying you. When a current client emails, respond right away. And initiate a lot more emails to paying clients.
- People who used to pay you. Past customers should get plenty of attention.
- People who say nice things. Responding to a compliment with a "thank you" takes seconds. If someone says something nice, make sure they hear back from you right away.
- People who say not-so-nice things. Take a little longer to respond so you reply thoughtfully. No one is always right -- and that includes you and me.
- People who ask good questions. Most people like to help people when they can. Almost never do those exchanges result in actual business, but that's okay.
As my fellow Ankotians will tell you, I'm fond of reminding our entire team to focus on W.I.N. -- "WHAT'S IMPORTANT NOW." Recognize that what's important isn't always what is urgent, and managing the difference can be a challenge. Too often, we respond to what feels most urgent. Looking at your list of items, quickly rate them by which are IMPORTANT and which are URGENT-- and be honest with your assessment. The ones that are BOTH IMPORTANT and URGENT deserve your immediate attention. The rest, well, those are the things that you can address next.
Posted by Marc Ottinger on Thu, Nov 10, 2011 @ 11:36 AM
We regularly find inspiration from Julianne Haydel, an accomplished home health consultant. We previously blogged about her
advocacy of therapy management in our posting entitled
Home Care Prediction: 2011 will be the Year of Therapy and we enjoy receiving her email updates.
Julianne recently blogged about how caregivers can set better, more realistic and more humane goals for their patients that honor their lives as fully realized adults and members of society. She tells us of her friend Bill and his father, who is a patient. But Julianne reminds us that Bill's father was not a patient first.
"He has had a long life filled with stories of success and failure, love and loss, happiness and sadness just like the rest of us. I don’t think it would surprise him to
find out that he is approaching the end of his life. And that man – not the patient – could probably give a flying flip about his A1c or serum potassium level." Read Julianne's full post here.
Through this simple photo and recounting of the sum of a patient's life, we are reminded that setting goals for health has so little to do with numbers, charts and serum levels. Setting goals for health has everything, though, to do with living life and enjoying life to its fullest. What this looks like for each individual is different based on that person's life experiences.
When entering into any kind of patient relationships, caregivers will better accomplish their goal of assisting a patient if they stop to recognize who the person is and was before they became "the patient." These are people who want to heal, who want to see their families and who don't want to be defined by the parameters of their illness or injury.
It is this approach to goal setting with a patient that honors the dignity of a life well lived. Thanks, Julianne, for this humble reminder that therapy is about the person, not the patient.
Ankota provides software to improve the delivery of care outside the hospital. Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care. To learn more, please visit www.ankota.com or contact Ankota
Posted by Marc Ottinger on Mon, Nov 07, 2011 @ 09:48 AM
The Health Care Reform debate rages unabated even as costs for employers, insurers and individuals spiral up and up. In the current climate of health care in America, patient outcomes from one of the costliest health care delivery systems in the world are dismal--and worsening.
As a society, we are sicker, and more expensively sick than ever before.
It seems obvious that the number one priority of health care reform should be to provide better care at lower cost. Yet somehow, despite advanced technology and massive investment in health care delivery--not to mention widespread demand for improvement at every level--we find a deteriorating situation whose costs are felt far and wide.
Atul Gawande, Ankota's author of the year for 2010, wrote an inspiring article in the New
Yorker magazine recently, a medical report called "The Hot Spotters." In it, Gawande presents cogent arguments for a simple, human, rational yet revolutionary approach to the complicated problems in health care.
Solid research and rich documentation make a compelling case for an approach based on care coordination. Close examination of numerous examples show clearly that when care is focused on the highest cost patients, outcomes are improved and costs drop dramatically.
Gawande asks, "Can we lower medical costs by giving the neediest patients better care?" He then goes on to give profiles of providers and professionals whose protocols substantiate his proposed (and, encouragingly resounding) "Yes" answer.
We meet Dr. Jeffrey Brenner, a Camden, New Jersey physician whose dedication and devotion sparked a movement to map and target "super-utilizers" of medical services. Brenner set out to find what was going so badly, tragically wrong. What was causing such massive waste with costly, ineffectual treatment that had some patients in a revolving door of ER visits?
Details of what happened and how it all began for Brenner's revolutionary approach take the reader on a fascinating journey through the mean streets of Camden, drilling down into root causes of out-of-control health care costs, to arrive at some simple truths about people, medicine, and our current health care system.
Exploring the new and growing field of "medical intelligence" provides insight into off-site data analysis aimed at controlling costs for companies that provide medical insurance to their employees. Since patient privacy rights prevent analysis of employee's personal health spending, the requirement is for pattern analysis based on companies' health care payment records as a whole. This enterprise is designed to provide its clients--among them the government of Dubai--with ways to reduce spending.
The work of physician Nathan Gunn, employed with leading medical intelligence company Verisk, yields insight into the "sweet spots of preventive care."
Radical measures taken by Atlantic City's biggest employer pools--the casino worker's
union and its hospital AtlantiCare Medical Center--have resulted in marked improvement in patient outcomes with the care coordination approach of targeting the neediest cases with a level of support that pays for itself in measurable cost drops, while delivering superior care.
Details of independent economic corroboration of value increase with lowered expense (in the range of 40% drops) are given, with specifics on how the Special Care Clinic in Atlantic City did it. Gawande explores scale and sustainability in depth.
Gawande looks closely at the impediments to progress, among them the fact that "one man's cost is another man's income" and the status quo can prove paralyzing to even the best of plans.
Though the path to a more perfect system is by no means strewn with rose petals, hope abounds, expansion awaits.
Find the full article
here
How can your home care agency reduce cost of patient care by focusing on patients with the highest needs? Share your own stories in the comments.
Ankota provides software to improve the delivery of care outside the hospital. Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care. To learn more, please visit www.ankota.com or contact Ankota