Homecare Homebase

Home Care Clinicians Use Synchronized Mobile Solution to Coordinate Patient Care

Home care agencies play a vital role in the healthcare industry, with an increasing number of patients receiving treatment at home rather than in the hospital. Not only is home care more economical than hospitalization, but studies have shown that patients recover more quickly when cared for in the comfort of their own homes. One of the challenges faced by home healthcare agencies is the ability to exchange patient information between home care providers (nurses, therapists, and home health aides) and the agency office. Dallas, Texas–based Homecare Homebase developed a dynamic wireless solution using Windows Mobile® software and devices manufactured by HTC, a Microsoft® Gold Certified Partner. Home care agencies using the solution report a reduction in IT and transportation costs, increases in cash flow, and simplified information exchange that helps improve patient care.

 

Situation

With the cost of hospitalization skyrocketing, home care services have become one of the fastest-growing segments of the healthcare industry. According to a recent report by the Medicare Payment Advisory Commission, roughly 2.5 percent of the population in the United States receives some type of formal home healthcare services each year. In 2006, nurses, therapists, and home health aides made more than 429 million medical and nursing visits to patients’ homes.

The cost savings of home care services versus hospitalization can be significant. For example, the National Association for Home Care and Hospice (NAHC) reports that the average hospital cost for a ventilator-dependent adult is U.S.$21,570 per month, while the cost for home care services is roughly $7,050 per month, a savings of $14,520.

“Insurance companies and the Centers for Medicare and Medicaid Services would prefer that patients recover at home because hospitalization is so expensive,” says Tom Maxwell, Chief Operating Officer of Homecare Homebase, a software solution provider for the home health industry. “Reimbursement for a 60-day episode of home care is about the same as a one-night stay in a hospital. That’s why home care is the fastest growing business in healthcare.”

As demand for in-home healthcare increases, so does the need for skilled field workers. The U.S. Department of Labor reports that employment in home care services has increased 45 percent since 2000, jumping from 633,300 to 913,300 in 2007. Even with this rapid rise in work force, home care agencies still struggle to hire and retain enough nurses, therapists, and home health aides. Successful agencies tend to place a high value on employee satisfaction and use technology to create greater work/life balance for field workers.

“The country is experiencing a serious nursing and therapist crisis right now,” says Tricia Collom, Vice President of Marketing for Homecare Homebase. “It’s difficult to retain these employees. So if an agency can give them tools to make their lives easier and to make them feel more empowered and like they’re doing a better job, that’s a huge benefit and goes a long way toward improving employee satisfaction.” 

One of the main challenges faced by field clinicians is the time-consuming task of documenting patient visits and submitting that information to the agency office. Many agencies still rely on manual, paper-based systems for documentation, which require field workers to drive to the office each morning to pick up their schedules and patient charts, and return to the office to drop off paperwork after completing their patient visits. According to NAHC, nurses, therapists, and home health aides in the United States drove an estimated 4.8 billion miles in 2006. With fuel costs on the rise, agencies are looking for ways to reduce the amount of miles driven by home healthcare providers.

Even though some agencies have upgraded from paper to portable computers, this solution also has its drawbacks. “We found that the majority of these nurses do their follow-up documentation in the front seat of their cars or at their homes at night because they don’t want to put the barrier of a computer between themselves and their patients,” says Collom. “If they’re not taking that laptop into the patient’s home, then they’re spending their evenings or weekends doing a lot of paperwork.”

Solution

In 1999, April Anthony, then Chief Executive Officer (CEO) of one of the largest home health agencies in Texas and now also President and CEO of Homecare Homebase, began looking for a software solution to help simplify the arduous process of collecting patient data and exchanging that information between field workers, home health agencies, and physicians. Anthony knew exactly what she wanted—a handheld tool that was unobtrusive, easy to use, and able to transmit patient information in real time. She was unable to find an existing solution that met those requirements, so she decided to develop the software in-house.

Using our solution with Windows Mobile on an HTC device dramatically reduces the cost for our customers. There’s a big difference between buying a $2,000 laptop versus a $200 handheld device. Tom Maxwell Chief Operating Officer, Homecare Homebase

After implementing the solution within her own agency, Anthony realized that this application could make life significantly easier for other home health agencies across the country. She launched Homecare Homebase in 2001. “Homecare Homebase was born directly from an industry need,” says Collom, “the need for simplified, real-time coordination of care. Our mobile solution allows field workers to do most of their documentation during patient visits rather than in the evenings or on weekends.”

From the very beginning, Homecare Homebase has relied on Windows Mobile® software as the foundation for its wireless solution. “During development, we looked at other mobile technology, but the amount of data that we can push back and forth is tremendously larger with Windows Mobile than with other environments,” Maxwell says. “Also, Microsoft is on the leading edge of mobile technology, while companies that were major players a few years ago have faded away.” Homecare Homebase currently offers its solution on Windows Mobile 6.1, Windows Mobile 6, Windows Mobile 5.0, and Windows Mobile 2003 for Smartphones, depending on the equipment needs of its customers.

The Homecare Homebase solution is a Microsoft® ASP.NET–based application built on Microsoft .NET Framework version 2.0. Developers use the Microsoft Visual Studio® 2005 development system to continually augment and update the solution. “Another factor in our decision to choose Windows Mobile was the ability to develop easily in that environment,” Maxwell continues. “All of our developers have earned Microsoft certification, so we’ve been able to advance the application and add features to meet changing regulatory requirements and industry needs.”

In addition to Windows Mobile, the solution includes Microsoft SQL Server® 2005 Compact Edition 3.1 data management software running on the user device, and SQL Server 2005 Enterprise Edition and Microsoft BizTalk® Server 2006 running on the back-end servers to process and store the data being transmitted by the Windows Mobile devices.

Homecare Homebase partnered with mobile device manufacturer HTC, a Microsoft Gold Certified Partner and one of BusinessWeek’s Info Tech 100 top information technology performers, to design and develop custom Windows Mobile devices specifically for use by home healthcare providers. “We noticed that the handheld devices on the market were becoming smaller and smaller,” Maxwell explains. “The screens had shrunk to 2.8 inches, which becomes challenging for our users. We formed a really great relationship with HTC, so now we can offer the Homecare Homebase solution on Windows Mobile devices with 3.5-inch or 5.5-inch touch screens, extended battery life, Global Positioning System technology, and even full-sized stylus pens to help prevent repetitive stress injuries.”

More than 14,000 field workers currently use the Homecare Homebase solution on Windows Mobile devices, including nurses, physical therapists, occupational therapists, home health aides, medical social workers, Reiki (healing energy) therapists, and massage therapists. “We are really making an effort to support everybody who plays a part in patient care,” Collom says. “Windows Mobile devices are much easier to use than a laptop or paper-based system, so training takes very little time. New users quickly embrace the new technology as soon as they see how much more patient information they have at their fingertips and how much more efficiently they can complete their documentation.”

During development, we looked at other mobile technology, but the amount of data that we can push back and forth is tremendously larger with Windows Mobile than with other environments. Tom Maxwell Chief Operating Officer, Homecare Homebase

Field workers using the Homecare Homebase solution on a Windows Mobile device can easily coordinate their daily schedules, patient information, and billing details. For example, a nurse using the Homecare Homebase solution would start the workday by tapping the Sync button on the device. Within two minutes, all of the data is synchronized, including patients’ charts, medications, and visit notes from other care providers. With this information in hand, the nurse can drive directly to the patient’s home rather than go to the office.

“This real-time synchronization is quick, easy, and intuitive,” says Maxwell. “Press Sync, and the screen turns green if it’s done, red if it’s not. It’s that simple.”

Benefits

As demand for home care continues to increase, home healthcare agencies are turning to a mobile solution that helps reduce IT and transportation costs, increase cash flow, and simplify information exchange, while also improving the quality of care provided to patients.

Reduces IT and Transportation Costs
Hardware cost was an important consideration in developing the Homecare Homebase solution. “Using our solution with Windows Mobile on an HTC device dramatically reduces the cost for our customers,” Maxwell says. “There’s a big difference between buying a $2,000 laptop versus a $200 handheld device. Equipment costs can add up quickly. That’s why we offer a large selection of HTC devices in a wide range of prices to meet our customers’ needs.”

Another cost-saving benefit of using Windows Mobile devices rather than portable PCs is the amount of IT support required to maintain the solution. “One of our customers, Residential Home Health, has 350 Homecare Homebase users,” Maxwell explains. “If this company used a laptop solution, it would need several servers plus roughly 11 IT employees to do maintenance and troubleshooting. But, because Residential Home Health is using Homecare Homebase, it needs only 2 IT employees.

“Homecare Homebase is a hosted solution, known in the industry as ‘software as a service,’ meaning we host the back-end servers for our customers,” Maxwell continues. “The daily IT requirements on the customer’s end are minimal. Even if we had to completely reset a device and build it out again, it would take only five minutes, and we would do it remotely so the user would barely be affected at all.”

As fuel prices continue to soar, home health agencies are eager to reduce the number of miles driven by field workers. “A nurse who lives 50 miles away from the office can synchronize patient data with the touch of a button and not have to drive to the office,” says Maxwell. “Gas mileage and time savings were our big reasons for choosing Windows Mobile.”

Increases Cash Flow
Because clinicians can synchronize data from the field in real time, the agency office is able to process claims significantly faster than with a paper-based system. “After a nurse completes a patient visit and synchronizes that data back to the office, an automated process kicks in that allows agencies to submit the RAP [Request for Anticipated Payment] for Medicare reimbursement within 24 hours of the patient visit,” Collom says. “Agencies don’t have to wait for the nurse or therapist to drive into the office and submit the paperwork.

“Most of our customers report a large increase in cash flow because they’re able to process billing information so much more quickly,” Collom says. “They’re receiving payment in a few days versus two weeks or more, which has a big impact on the financial health of the agency.”

Simplifies Information Exchange, Improves Patient Care
Thanks to the real-time connectivity of the Homecare Homebase solution, users are able to synchronize data within two minutes, sharing information between the office, other caregivers, and physicians. Field workers can provide the best possible care based on the latest information regarding their patients’ treatment. In addition, field workers are able to complete their documentation during patient visits rather than in the evenings or on weekends. “We’ve been able to document that on average 90 percent of all Homecare Homebase users complete their documentation in the patient’s home and have very minimal notes or paperwork to complete after the visit,” Collom says.

Deanna Learman, Director of Clinical Systems at Residential Home Health, can attest to the time savings generated by using the Homecare Homebase solution. “Originally, all of our processes were done on paper,” Learman explains. “The visit notes and the orders were on paper, so we had to depend on the clinicians to come into the office, drop off the visit notes and orders, and do their scheduling. It was challenging to get all the paperwork done on time, which compromises patient care. It used to take one employee 40 hours per week to check for completeness and file the visit notes for 350 caregivers, but with Homecare Homebase it takes only 4 hours per week.”

The simplicity of Windows Mobile makes training new users on the Homecare Homebase solution quick and easy. “We currently hire at least 10 nurses or therapists per week,” says Learman. “Homecare Homebase provides us with a structured training program so we’re able to get new clinicians out in the field within a couple of hours. Because the technology is so intuitive and easy to use, we can spend our training time teaching new employees about Residential Home Health policies and protocols. The technology is not a deterrent to recruiting at all.

“Studies have absolutely proven that people heal more quickly at home than in the hospital, and effective, simplified coordination of care is essential to the well-being of those patients. In addition, nurses and therapists are using Windows Mobile devices to complete their documentation in real time, which essentially gives them their lives back. Now they have more time to spend with their own families. That is extremely compelling.”

Windows Mobile
Windows Mobile brings the power of the Windows® operating system to mobile devices, helping businesses and their mobile employees stay connected while on the go. Windows Mobile runs mobile versions of Microsoft programs, including Microsoft Office Outlook® Mobile, Internet Explorer® Mobile, Pocket MSN®, Windows Media® Player Mobile, and Microsoft Office Word Mobile, PowerPoint® Mobile, and Excel® Mobile. With Windows Mobile, information workers get powerful software combined with the familiarity of Windows. Combined with available service plans and connectivity options, Windows Mobile–based devices, available from 42 device makers and 68 mobile operators in 48 countries, can be used to make calls, send e-mail and instant messages, surf the Web, and access critical business information even when users are away from the office.

More information about Windows Mobile can be found at:
www.microsoft.com/windowsmobile 

 

For More Information

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For more information about HTC products and services, call (425) 861-9174 or visit the Web site at:
www.htc.com

For more information about Homecare Homebase products and services, call (866) 535-4242 or visit the Web site at:
www.hchb.com