The Ankota Healthcare Delivery Management Blog

Patient Centered Medical Home Needs to Become More Patient Centered

Posted by Will Hicklen on Jun 26, 2013 9:20:00 AM

Patient communications is at the core of any PCMH program, and threatens to be either a limiting factor or a catalyst for its succcess. 

Stephen WIlkins photo

Steven Wilkins is the author of Mind the Gap, a blog dedicated to the communications gap between health care providers and patients who rely on them. Like the Subway term, "Mind the Gap" is a warning intended to make health care providers aware of the consequences of poor communications and how to avoid them. Steven's most recent post Patient Centered Medical Homes Need to be More Patient Centric hits on this critical issue that, if not proactively managed by providers, will assure the failure of Patient Centered Medical Home models.

As Wilkins reports, many of the early PCMH programs have demonstrated early success with measures such as hospitalization rates and total cost of care improving markedly. Even quality scores have improved under many of these programs. That's all good, right? Sure it is. However, as Wilkins explains and many of these programs have illustrated, the previous models were so bad that these early improvements may just be the easiest "low hanging fruit." Either way, eating the low hanging fruit first nakes sense. So, these early PCMH programs are probably a great start with tremendous room for improvement available. The mandate to both scale PCMH models and continuously improve them is what drives Wilkins and others like him to challenge the model even in the face of early success.

In order for the model to proliferate, achieve scale, and continue to improve, patients must feel fully engaged and respected. Traditional physician led models are very paternal, describes Wilkins. Dr. J. Hunter Young of Johns Hopkins Bloomberg School of Public Health and Ankota's Chief Medical Officer agrees, "Whether its using better techniques to ask questions of patients or to communicate information with them, health care providers have to get better. Better communication improves health, we know that," says Dr. Young, adding, "Communications with patients are not where they need to be and seem to have been ignored in PCMH models." Dr. Young goes on to explain that approaches such as the teach back method and others, while effective, are not consistently applied. Just as there are protocols for care according to disease, there needs to be protocols for communication with patients and family members that are suited to the audience and circumstances.

Patient Centered Medical Home programs must also focus on patient communications using methods that have been proven effective, and must be managed for consistency. Simply leaving it to the health care providers only perpetuates a model that doesn't work well in the first place, and will certainly limit the success of PCMH programs everywhere. 

To read Steven Wilkins article on Mind the Gap simply click here. To learn more about how Ankota improves communications and coordinates providers in Patient Centered Medical Home programs, click here 

 

Learn About How Ankota Technology is Used to Manage PCMH

Topics: Readmissions, PCMH, transitional care, Accountable Care Organizations, Avoidable Readmissions, Patient Centered Medical Home

Rising Rate of Family Caregiving Driving Home Care Automation

Posted by Will Hicklen on Jun 24, 2013 1:35:00 PM

Two-fifths of U.S. adults care for sick, elderly relatives, according to recent Pew Research. 

High demand for Home Care is forcing Home Care agencies to automate operations and coordinate with other providers.

Reuters logo

Pew Research Center's Internet and American Life Project recently uncovered some interesting facts about the rate at which family members are acting as caregivers. The stress and absenteeism associated with caregiving is well documented, costing employers billions of dollars annually. Already at a crisis level, the recent Pew project discovered that 40% of the population is acting as the primary caregiver for a family member. Most staggering of all, perhaps, is the revelation that the number of family caregivers has increased more than 10% in the last three years alone (2010-2013) and continues to rise. 

Complicating matters, half of the US population has a chronic disease, and 75% of those 65 and over have at least one. As the population continues to age, every indication is that families will need to provide care for family members at an increasing rate with no end in sight. It's already an epidemic and well beyond sustainability. 

Automate Home Care Now

Families need help and they are increasingly turning to Home Care providers, also called Private Duty Home Care.  These are trained professionals with Certified Nursing Assistants (CNA) and nurse case managers, and Geriatric Care Managers (GCM) on staff who are expert in common conditions such as dimentia and fall prevention, trained to assist with activities of daily living, among others. With this type of help, elderly patients are able to live longer lives and remain more independent at home.  The demand for these services is only growing. Not surprisingly, the relief to families is instant once they hire a caregiver from a professional, reliable agency.

The call for staff in this area is so urgent that the Bureau of Labor Statistics predicts that this will be one of the fastest growing areas of employment in our economy for the next decade or longer.

As this segment of care takes on a greater role and continues to expand, the demand to coorindate care with other providers will become even more complex. Home Care Agencies must cooperate with Primary Care physicians, nurse case managers, and other types of home care services. Home health agencies, hospitals, accountable care organizations are fast realizing that home care is an efficient way to reduce hospitalizations among a fragile patient population and to keep patients healthier and happier in their homes.

As workloads and complexity of care rise, Home Care agencies must automate operations. Managing staff, schedules and point of care documentation is incredibly difficult and costly to do maually. Calculating payroll and billing using manual methods routinely consumes many hours and even days of administrative time in each billing (or payroll) period. Automation is required not only to be profitable, but also to coordinate care with other providers of various types.

Fortunately Ankota has made it easy for Home Care agencies to automate operations from start to finish: from scheduling to care plans and point of care documentation on tablets, to real time work tracking through a telephony (IVR) interface, automatically calculating billing and payroll, and managing communications with family members and other authorized caregivers. It even automates referral processes to make your agency easier to do business with. Most agencies learn very quickly and are up and running in only a couple of weeks. The system is so efficient that it typically pays for itself in a few months or less.

Learn more about the future direction of Home Care and Ankota's technology that takes you there.

Automate Home Care Now

Topics: Home Care Entrepreneurship, Home Care Industry, Care Coordination, transitional care, Home Care Technology, Will Hicklen, Home Care, Accountable Care Organizations, National Association of Geriatric Care Managers, ACO Technology

TED Says Move 50% of Health Care from Hospital to Home

Posted by Will Hicklen on Jun 21, 2013 8:00:00 AM

Ted logo red

If you're not familiar with TED, you're really missing out! Totally free and covering a wide range of topics, including this one talking about moving healthcare FROM the hospital TO the home.

TED is a nonprofit devoted to Ideas Worth Spreading. It started out (in 1984) as a conference bringing together people from three worlds: Technology, Entertainment, Design. Since then its scope has become ever broader. TED includes conferences, videos, and more...and now there's even TEDMED 

This one featuring Eric Dishman of Intel is especially relevant to Ankota's customers and our company's mission of a fully coordinated and efficient healthcare ecosystem. Dishman makes a bold argument: "The US health care system is like computing circa 1959, tethered to big, unwieldy central systems: hospitals, doctors, nursing homes. As our aging population booms, it's imperative, he says, to create personal, networked, home-based health care for all." Further, he challenges the healthcare world to move 50% of all care FROM the hospital TO the home.

I won't spoil Dishman's approach or some of the fun technology that he gets excited about. To deliver on the promise of a distributed and largely home-based healthcare delivery model requires an integrated delivery model, or an ecosystem of providers that are well coordinated and operate efficiently. It is imperitive that such an ecosystem develop quickly by connecting providers together and helping them to operate efficiently, manage dependencies and coordinate care. This is Ankota's mission and we're already well on our way. Thousands of provider organizations already rely on Ankota's Care Coordination technology to improve patients' lives and lower overall costs every day.

  Ankota Care Coordination Technology Improves Care -- Click Here!

Eric Dishman bio

Topics: TED, TEDMED, Eric Dishman, Care Coordination, transitional care, Aging in Place Technology, Care Transitions, telehealth

Are No Two Home Care Agency's Invoices Alike?

Posted by Ken Accardi on Jun 20, 2013 6:04:00 PM

It is said that no two snowflakes are alike.  I'm starting to think that no two home care agency invoices are alike either...

When we first started Ankota and created the invoice for home care agencies, we had no idea how many variations our customers would want.   Some of the variations that we've either implemented or have been asked for are as follows:

  • Fit into a number 10 envelope with one or two windows (for address and possibly return address)
  • Include home care agency information in the upper left or leave it blank so we can print on our letterhead or includehome care invoice our logo in the middle or the upper left (depending on whther it's just a logo or also has the address and phone numbers.
  • Bill to the client, or to one or more payers
  • When you bill to a payer other than the client put the client name on the right
  • Create an ability for a note like a long term care insurance policy number
  • Include the caregiver's name, or don't
  • Include the visit times (maybe the exact ones or maybe the rounded ones) or don't include them at all
  • Bill holiday rates for all visits that commenced on the holiday, or
  • Bill holiday rates for hours worked on the holiday
  • Provide one line per day with total hours and total price (e.g., if there where three different caregivers, total up all the hours and fees)
  • Provide a tear-off slip with the outstanding balance
Although we continue to strive to make our invoices more and more configurable, we get new requests all the time.  Thinking about your invoices, are there other features (not listed above) that you would like?
If you don't like your invoices (or other things about your private duty software) perhaps we can help.  Let us know!
Can we answer home care software questions?
Ankota provides software to improve the delivery of care outside the hospital, focusing on efficiency and care coordination. Today Ankota services home health therapy, private duty care, DME Delivery, and care coordination in accountable care organizations, behavioral health, dental care in nursing homes, and more. Ankota is always interested to learn about care coordination challenges where we can help. To learn more, please visit www.ankota.com or contact Ankota.

Topics: Elderly Care, Private Duty Agency Software, Home Care Best Practices, Home Care

Changing Private Duty Software Isn't As Hard as You Think!

Posted by Ken Accardi on Jun 11, 2013 11:32:00 AM

When we first started Ankota and launched our home care software for private duty home care agencies, we went to the trade show of the National Private Duty Agency (NPDA), which has since been renamed to the Home Care Association of America.  This organization caters to established agencies with employee caregivers and most had revenue over $2 million per year.

Home Care Association of America resized 600

People loved our software and it was a great reinforcement for what we were doing.  But when we asked if they'd be interested, we got the same answer a lot of times.  They said, "I like your software so much more than what we're using, but since it's up and running and we know how to use it, we just can't consider changing..."  

Changing Home Care Software is Not So Hard!

In the past three weeks, we helped two organizations go live with over 300 clients.  One was in Iowa and was acquiring an agency and started using Ankota for the first time.  The other is an Ankota customer in Canada that has been with us for a several years and is also acquiring a company that will result in them opening two new offices.  In both cases, the transition was quite easy.  

Here's the minimum you need to prepareso you'll be able to change to better software:

Information you Know, but should Compile:

  • Basic Agency Information: Like name, address, phone, fax
  • Billing/Payroll Approach and Rates: Do you price based on the services that you provide? With rates negotiated per client? With rates based on the referral source? etc.  Do you pay based on the type of service, based on rates set for each caregiver, based on negotiated rate with client, etc.?  Also, what are your bill and pay rates and special charging rules (holiday, overtime, times of day, etc.)
  • Service Types: What types of visits do you schedule (hourly, live-in, CNA vs. Companion, supervisory nursing visits, etc.)Home Care
  • Master Care Plan Checklist: What are all of the checklist items that you may put on checklists for your caregivers.  Note that it helps organize them if you categorize them.

Data to Prepare in Excel Spreadsheets:

  • Client information: such as Name, Address, Phones, Date of Birth Gender
  • Care Giver Information: Name, Address, Phones, Date of Birth, Gender
  • Payer Information: If most of your clients are billed directly this shouldn't be an issue, but if you have lots of family payers, programs that pay, long term care insurance, you should organize this information.
  • Scheduling Patterns: If you have 50 or less clients, it's probably easiest to enter the schedules in the application, but if you have many more, there might be a way for these to be uploaded.
  • Client Specific Care Plans: Which items are required for each client?
Advanced Data Conversion:
The information above represents the basics to convert and go live.  You can also convert client historical notes, caregiver historical notes, historical visits, and more.  
The most important question is WHY to switch...  This can (and will) be the topic of numerous other blog articles, but make sure that you have a good reason (like cutting down your admin time so you can spend more time on client service and sales, or upgrading so that you can connect electronically with family members and referral sources).
If you are interested in making a change, or understanding the effort in more detail, click on the button below and we'd be happy to help you.
Can we answer home care software questions?
Ankota provides software to improve the delivery of care outside the hospital, focusing on efficiency and care coordination. Today Ankota services home health therapy, private duty care, DME Delivery, and care coordination in accountable care organizations, behavioral health, dental care in nursing homes, and more. Ankota is always interested to learn about care coordination challenges where we can help. To learn more, please visit www.ankota.com or contact Ankota.

Topics: Private Duty Agency Software, Home Health Aide Software, Home Care Best Practices, Home Care, NPDA, Home Care Scheduling Software

AARP Video: The Lost Generation Views Aging

Posted by Ken Accardi on Jun 5, 2013 8:00:00 AM

The Lost Generation Turns Things Around With a View on Aging

The American Association of Retired Persons (AARP) held a contest in 2007 called "U@50". They asked for videos to be submitted by people between the ages of 18-30 on the subject of what they expect their lives to be like at the age of 50.

The video below, entitled "Lost Generation" didn't win the contest, but it has been viewed more than 11 million times on YouTube.  I watched it myself and I can see why.  It cleverly shares a poem that paints a pretty bleak picture of the the future for this "lost generation" but then the lines are read in reverse order and the meaning is totally flipped around. It cleverly delivers a message of hope.

I think that the home care community will be inspired by this video just as I was.  It really is a terrific message so please share this video with others. Also - it's really short!

 

Enjoy!

AARP

Ankota provides software to improve the delivery of care outside the hospital, focusing on efficiency and care coordination. Today Ankota services home health therapy, private duty care, DME Delivery, and care coordination in accountable care organizations, behavioral health, dental care in nursing homes, and more. Ankota is always interested to learn about care coordination challenges where we can help. To learn more, please visit www.ankota.com or contact Ankota.

Topics: AARP, Aging, Elderly Care, Home Care, Video

What My Cats Taught Me About Home Care

Posted by Ken Accardi on Jun 4, 2013 8:00:00 AM

We have two cats, Luke and Leia.  We adopted them as kittens from a local cat shelter.  The shelter has a policy that when you adopt kittens, that you need to adopt two, which was our plan anyway.  Luke and Leia were litter mates and inseperable and they really wanted to have them adopted together.  This also worked out well for us.  Luke is a tabby and Leia is a calico, and here's a picture.

Luke and Leia prefer home care

But the title of this article is "What My Cats Taught Me About Home Care" and, while my cats are lovable and affectionate, they're not all that smart so I generally don't think of them as teachers. The lesson came the first time our family went away and the cats needed care.  We sent Luke and Leia on vacation too.  They went to a Pet Hotel near our home.  We sent them with their bed and their favorite food and figured everything would be great.

When we returned from our vacation and anxiously went to pick up the cats the pet hotel gave them a report card and their scores weren't very good. Clearly, they were distressed by their stay. Apparently they were terrified by the barking dogs, didn't want to socialize with the staff, and didn't eat much. When they got home, they both had the sniffles. This was the first time they had ever been sick. They ended up needing to see the vet and having to go back in their car carrier a few days later - this was traumatic as well.

Since then, we've adjusted.  Now when we go away, we have a caregiver come to our house.  She comes twice a day, feeds that cats, cleans up their litter box, plays a radio for them, and likes to play with them.  Her fee is half the price of the pet hotel, and she also waters our plants and brings in the mail.  We like our caregiver and get to come home to happy healthy cats.

So in summary, my cats taught me that home care offers the following benefits over institutional care:

  • Better care
  • Lower cost
  • The comfort of your own home and surroundings
  • Avoids contagious diseases
  • Avoids traumatic transporation

Maybe my cats are smarter than I give them credit for...



Ankota provides software to improve the delivery of care outside the hospital, focusing on efficiency and care coordination. Today Ankota services home health therapy, private duty care, DME Delivery, and care coordination in accountable care organizations, behavioral health, dental care in nursing homes, and more. Ankota is always interested to learn about care coordination challenges where we can help. To learn more, please visit www.ankota.com or contact Ankota.

Topics: Home Care Entrepreneurship, Home Care

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About Ankota

Ankota provides software to improve the delivery of care outside the hospital, focusing on efficiency and care coordination. Ankota's primary focus is on Care Transitions for Reeadmisison avoidance and on management of Private Duty non-medical home care. To learn more, please visit www.ankota.com or contact Ankota.

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