It may not be a 1-size-fits-all solution, but least 1 fairly large home health care agency thinks it may have hit upon the technology that can best coordinate care, reduce costs, and minimize privacy concerns: the 7-inch mobile tablet.
A recently published case study (.pdf) from the College of Healthcare Information Management Executives (CHiME) tells the story of Sutter Health at Home, a division of Northern California-based Sutter Health. With a program that employs about 1,300 caregivers who make home visits to nearly 100,000 patients across 23 counties, Sutter was on the lookout for technologies that could improve coordination of care and reduce costs.
After experimenting with individual laptops (too big, too hard to learn, glitchy) and smartphones (too small, limited computing and document-handling capabilities, spotty connections), Sutter switched to 7-inch Android-based devices. The devices themselves are the same tablets commonly available to consumers, but these are equipped with electronic health records (EHR) software specially made for Sutter Health at Home. Caregivers are also supplied with a bluetooth-enabled keyboard and a stylus.
According to the case study, the use of tablets dramatically reduced turnaround for patient documentation from 72 to 24 hours. "In the past, if 1 of the clinicians went to see the patient on Monday and the physical therapist would go on Tuesday, the therapist would not have the information about the Monday visit available," said the program's project manager. "This is better from a productivity perspective and better for the patient." Sutter Health at Home also estimates that it has reduced costs in a number of areas, including supply ordering, which is now done directly through the tablet rather than by calling a medical supply vendor.
The home health agency is also pleased with improvements to privacy safeguards. Built-in cameras allow clinicians to send photos quickly and securely—an improvement over past practice of taking pictures with a separate digital camera (that could be lost) and uploading the photos later (a time-consuming process). Another significant benefit: greater IT control over security and the ability to remotely wipe a device clean if it is lost or stolen.
The case study reports that the switch to tablets is not without challenges. Sutter Health at Home invests heavily in training, requiring 18 hours of education on the tablet for any new user. And while the fact that Sutter is using easily available devices makes purchasing easier, it also means that the devices are subject to the same kind of forced obsolescence that can frustrate individual consumers. The platform has also required the agency's IT department to relinquish control of when patches and updates are installed—for tablets a process typically managed by the communications carriers.
APTA offers a variety of resources on home health and physical therapy, including a free video on the role of home health physical therapy in the continuum of care, and a webpage devoted to payment, coding, and billing for home health patients in the Medicare system. The association also offers resources on electronic health records at its EHR webpage.
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