Scaling Home Care Services With Telemedicine

Do you wish you could serve more clients? Home care has never been more in demand. As a result, most organizations that provide and connect patients to at-home services are looking to scale. Telemedicine can help.

While there are a lot of factors involved in growing an organization, communication is key. In order to assess and treat more people, home care providers must streamline communications.

This means standardizing care delivery and the transfer of client information – two goals that can be achieved through the use of telecommunications technology.

Skeptical? Read on to discover how telemedicine can improve the way your organization operates.

Adopt a New Mindset

Do you play a role in the operation of a home care agency or Health Link? However you’re involved in the provision of home care services, you likely have one major objective: to better serve more clients.

Of course, those who plan and coordinate care services want each client to receive the time and attention she needs. Following best practices is the surest way to make this happen, but it isn’t always enough.

The demand for services is growing quickly. According to the Canadian Patient Safety Institute, in 2011, 1.4 million Canadians received publicly-funded home care. That number represents a 55% increase since 2008.

Needless to say, what worked for service providers a decade ago isn’t sufficient today. Organizations involved in home care delivery are operating in new territory. Even those with advanced knowledge and experience in the sector need to adapt.

It’s true that Canadian governments have recently increased home care funding – especially in Ontario. And more resources is, without question, good for clients.

But organizations involved in service delivery need to be aware of how the home care landscape is changing. What do recent shifts in demand and funding mean for operations? Will a new crop of providers pop up to meet the growing need?

Answering these questions is the first step toward scaling your services.

In a recent Forbes article, contributor Philip Salter describes some of the secrets of scaling a business. Commit to growth. Build a team with a broad management skillset. Partner with complementary organizations.

Each of these factors can also play a role in growing a health care organization. But we believe there’s one overarching challenge you absolutely must tackle.

Clearing Your Biggest Hurdle

For new businesses, every challenge that arises is unique. That said, executive teams have to figure out what works. They must use this information to manage future projects more effectively. Without becoming more effective, how will leaders find the time to focus on growth?

Of course, caregiving isn’t the same as providing other types of services. Health care teams put people first. They consider the needs of individual patients and clients. This is the way it should be.

Just don’t let your commitment to delivering personalized care prevent you from seeing the big picture. In the current climate, caring for more clients means doing more with less. It means finding and eliminating inefficiencies.

In home care, there’s no bigger source of inefficiency than poor communication.

Those who directly plan and administer care – including care coordinators, nurses, and personal support workers – have to work together. Collaboration is key during the treatment of each and every patient.

Unfortunately, when care teams are spread out, they can easily become disconnected. Delays in diagnoses and treatment can occur. On the whole, poor communication means fewer visits and less care.

Another common issue is infrequent communication between providers and clients. Without engagement from those receiving care – and, when appropriate, their family members – complications can occur.

Whether your organization connects clients to service providers or provides care directly, communication issues should concern you. When the circles of care around patients aren’t well connected, service slows down. You’re forced to play catch-up, which leaves little time to consider growth.

For this reason, we believe in creating formal communication processes. By connecting circles of care and making it easy to share medical information, telemedicine can help.

Here’s how the right electronic tools can help you deliver quick and responsive care to more clients.

Telemedicine: the Key to Scalable Home Care

Poor home care coordination leads to inefficient services. In order to scale, the organizations involved in delivering these services need to focus on streamlining communication within client circles of care. One of the best ways of simplify these processes is through the use of telemedicine.

With the right digital telemedical technologies, care delivery can be standardized. caregiving and medical professionals will see more clients. And those in leadership positions will spend less time thinking about delivery details and more time focusing on growth.

What’s the quickest and most convenient way for practitioners to communicate medical updates and care information? The answer is clear. Provider organizations should encourage the use of mobile devices.

Of course, we’re not talking about random phone calls and emails. In order to improve coordination, each circle of care needs a virtual place to connect.

Communication apps with videoconferencing components allow frontline workers to find and connect with the doctors, pharmacists, and specialists who treat their clients  – instantly. Having real-time access to these providers speeds up care processes.

Consultations can also be carried out remotely between frontline workers and specialists. Experts can assess clients visually and give nurses the coaching they need to provide treatment.

In addition, videoconferencing can reduce worker travel time to make the most of human resources. In addition to enabling expert consultations, this technology makes it possible for frontline providers to have remote check-in visits with clients.

By increasing efficiency, new videoconferencing technologies make it much easier for home care providers to scale operations. Other forms of telemedicine can also help by streamlining communication.

For example, electronic health records (EHRs) are vastly improving coordination between healthcare providers. Like real-time conferencing, EHRs centralize patient information to improve efficiency.

Similarly, remote patient monitoring communicates medical data (such as vital signs) to care providers automatically.

The Bottom Line

The demand for home care is growing rapidly. There’s a real opportunity for successful agencies and other organizations involved in delivering care to scale operations.

But as the sector evolves, challenges are emerging. Communication issues are getting in the way of responsive and efficient at-home service. As a result, the need for telemedicine has never been greater.

If your organization is serious about serving more clients, consider combining strategy with telecommunications technologies.

Feature image courtesy of Helge V. Keitel

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COPD Education – Onboarding

Objective

To complete a thorough needs assessment / initial evaluation for a COPD patient of an outpatient clinic

Actors
Patient, Educator (Nurse, RT, the Physician could also be the educator)

Timelines
One 60-90 min session with the Educator

Description
  • This protocol should be established for all COPD patients from a given clinic, independently of whether they are new patients or they are known to the clinic. This protocol is the basis to engage the patient into other protocols such as education, exacerbation follow-up, etc.
  • We need to identify patient goals/concerns to guide the interventions
  • A thorough evaluation is carried on, with the objective of understanding where the patient is on their disease journey and follow-up treatable traits: dyspnea, exacerbation or dyspnea and exacerbation.
  • It includes the use of objective questionnaires such as the mMRC, CAT, HADS, Frailty Scale, etc.
  • Identify if the patient needs to be referred to other resources (e.g. Physiotherapist, social worker, occupational therapist)
  • Once Onboarding is completed, the patient continues to the COPD Education workflow
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COPD Education – Continuous Maintenance

Objective 

To cover in depth all the necessary elements of self-management education as per the LWWCOPD, with priorities based on patient goals and identified treatable traits

Actors
Patient, Educator (Nurse, RT or Physician)

Timelines
A number of “Core” educational modules have been identified which cover the basic COPD education from the LWWCOPD program. Additionally, optional modules can be used to respond to patient needs. The timeline (frequency, number of modules to be covered at a given education session) is fully customizable, although we recommend to have education sessions every 2-weeks during the “active” phase of education. Once this is completed, the patient continues to the Maintenance Mode (see below).

Description
  • Launched at the onboarding protocol
  • Provide basic overview of COPD self-management based on LWWCOPD (medication adherence, inhaler techniques, PLB technique & energy conservation) up to the development of an Action plan for early exacerbation recognition and management.
  • Prioritize self-learning by the patient (e.g. watching videos, reading educational materials, completing homework) in addition to live sessions with the Educator. Educational materials are sent to the patient directly via the platform, and become the patient’s own library. The Educator can customize which “homework” the patient receives.
  • Educators have access to “User guides” to standardise their educational intervention. These user guides include: objectives, interventions, suggested questions, evaluation of self-efficacy, and learning contracts for each module.
  • Once the core education is completed, the patient can continue to the Respiratory Status Follow-up Workflow (run in parallel)

The Maintenance Mode
  • As soon as the maintenance mode is engaged, the frequency of visits Educator/Patient is reduced to once every 6 months.
  • During the Maintenance Mode sessions, the educator has access to all the education modules and can choose any piece of content that needs to covered with the patient. 
  • A streamlined evaluation (similar to the initial eval.) is done during each “maintenance” visit to identify any substantial changes on the patient’s needs that will require some adjustment. The patient could come back to an “active” education mode (more frequent education sessions, e.g. every 2 weeks).
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COPD Respiratory Status Follow-up

Objective

Monitoring of stable patients from a clinic in order to identify early any aggravation of symptoms (exacerbation) and implement an action plan

Actors
Patient, Educator (Nurse, RT or Physician)

Timelines
Scheduled regular automated follow-up to the patient symptoms. Intensity/Frequency can be adjusted by the Educator depending on patient needs (e.g. daily, every week, etc.). Ongoing through the year.

Description
  • Launch: Patients who have completed the Core Educational including setting-up an action plan.
  • Regular automated questions allow to identify any change in patient’s symptoms and severity.
  • If an exacerbation is detected the patient gets a reminder to engage their self-management strategies while waiting for the Educator to call back.
  • An alarm is generated for the Educator, so they immediately call back the patient. At this call they will evaluate any further intervention required and schedule additional follow-up.
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