You never realize how quickly technology can transform an everyday human interaction for the better until you’re already reaping the benefits. Think about mobile banking. The days of regularly walking into a branch to visit a teller are long gone. Mobile banking is so ingrained in us now that, according to Pew Research, 76% of adults won’t even open a new account with a bank that doesn’t have a mobile app. The banks benefit from the improved experience too, with less overhead and streamlined workflows.

We are now seeing the same transformation in health care, including home-based care. Between value-based care models and technology advancements, health care is moving into the home. The COVID-19 pandemic has only accelerated this trend. Even seniors are growing comfortable having their health care take place remotely, while nurses are accustomed to incorporating time-saving technology into their workflows. And while there are still reasons for a senior to call their local, physical doctor’s office to schedule a home visit, which can lead to bandwidth challenges — there are only so many people in a physical office.

Instead, the true convenience of modern technology is the ability for a senior to simply call their provider and have their call routed to the first and best available clinician. The result is time saved, both in terms of patient travel and caregiver visit logging, which leads to more time invested in what truly matters: patient health and wellbeing.

This white paper will describe how home health agencies are using technology solutions to better route patient calls to nurses. Readers will learn how, with the latest technology tools, they can provide the most individualized care for the patient, including via remote patient monitoring.

New tools and systems, happier patients, better outcomes. Welcome to home-based care’s next normal.

The Best of Both Worlds: A Hybrid Approach

Lessons learned from millions of care interactions

When a patient needs a home health clinician, speed, in their mind, is of the essence. The more time they wait to connect, the more likely they are to simply go to the emergency room. This bloats the U.S. health care system — one 2019 study from United Health Care estimated 18 million avoidable ER visits annually at a cost of $32 billion. Avoidable ER visits is just one area where home-based care operators are confident that telehealth can help.

Wasting money goes hand-in-hand with wasting time. Healthcare providers that can cut down on misused time will save money and increase patient and employee satisfaction. A 2013 Becker’s Hospital Review study found that when health care providers focused on time management, they were able to achieve significant results. The analysis revealed that the Methodist Health System of San Antonio was able to add $150 million to its bottom line over two and a half years by simply extracting wasted time from its operations.

Utah-based home health experience management company CareXM is reducingthat waste. As a provider of after-hours access to nurses, clinical triage servicesand remote patient monitoring, among other services, the company has logged millions of interactions with home health and hospice providers and patients overthe last 10-plus years. In that time, the company has identified three approaches to providing patient care. They are:

• Decentralized – The traditional doctor’s office approach that keeps care with the local office team.
• Centralized – A single call center, which helps patients connect with care providers no matter the time or location.
• Hybird – A combination of the two, using the best of both.

Each of these approaches comes with its own set of realities that impact the patient and caregiver experience.

Decentralized Approach vs. Centralized Approach:

Decentralized

In this familiar approach, patients call their provider to schedule an appointment or a question to an on-call staff member. This experience usually sends the caller to a voicemail box where they leave a message, or a queue where they may wait for an extended time to speak to a staff member.

Decentralized Pros:

• Patients and providers are familiar with the system.
• Patients typically get the care they are seeking.
• Patients and providers know one another.
• In-home care, geography, and local customs are known.

Decentralized Cons:

• Staffing for peak times is challenging, leading to long wait times.
• On-call after-hours staff can be inefficient and expensive, and unknown to patients.
• In-home health, patients calling after hours may wait 20-30 minutes for a callback, which can lead them to the ER.

Centralized

Decentralization fails when there are too many patient calls that overwhelm available staff. Many providers look to call centers to address these challenges, whether small in-office setups or large offsite versions. The centralized call-center approach offers its own perks and problems.

Centralization Pros:

• Calls are answered faster with better coverage for peak times and after-hours problems.
• Fewer ER visits and 911 calls.

Centralizations Cons:

• Callers typically have to navigate complicated phone menus.
• Busy call centers lead to long queues and hold times.
• Patients aren’t interacting with local providers who know them and their situation.
• Patients may experience a lack of personal touch.

Hybrid Approach: The CareXM Model

Under the Hybrid Approach

Calls are forwarded intelligently to whichever providers are available to take the call. This can be in the local office, a centralized call center or, better still, a decentralized model, be that a call center or local nurses who can make a home visit quickly because they’re already nearby, finishing up another patient visit. CareXM’s intelligent call routing technology, mobile app and nurse triage work seamlessly together to provide this level of personalized, efficient, patient care day and night.

A patient does not have to wait nearly as long for a response. This is because the system has the capabilities to route the call either to the actual home health provider — and to a specific, geographically convenient nurse — or to a call center staffed with nurses or non-clinical agents.

Providers can drive efficiency while improving the patient experience. It allows easier scheduling, quicker nighttime to daytime hand-offs from its call centers to the provider and seamless technology that makes things easier on the caregiver and patient.

Triage During the Pandemic

During the pandemic, CareXM’s platform and triage services allowed its provider partners to seamlessly switch to remote work without suffering patient communication drawbacks. “Stay at home” efforts over the last year have made it easier to get faster service via phone or video from their homes. They also raised fear for seniors who were worried about their own conditions or potential complications from a COVID-19 infection.

Under the Hybrid Approach Continued

“The ability to have arranged and scheduled calls with the patient improves that efficiency in the experience for the patient and caregiver, first and foremost,” says Laurie Nelson, a clinical advisor for CareXM. Further, the platform’s ability to integrate with EHRs and provide remote patient monitoring can provide an even more individualized approach.

“Before we answer any call, we have access to the patient’s information. We have the opportunity to have connections or interfaces with EMR software that gives us the information available about that patient so that when that call comes in, I can have that information populating very quickly so I can quickly address that patient and caregiver’s needs with the information that’s already in front of me.

“That way, we can really focus on the matter at hand.” These expedited, organized processes for communication are commonplace in other industries. Health care is just behind.
But getting ahead can give an agency a competitive advantage.

“CareXM has allowed us to take one more giant step forward in having a complete and comprehensive medical record that shows the whole gamut of the services that we’re supplying for patients,” says Nycole Snodgrass, an operations manager at Providence TrinityCare, a Torrance, California-based home health, hospice and palliative care provider.

Why The Hybrid Approach Makes Sense

Whether after hours or during peak times, CareXM’s clinicians can handle the calls for clinical matters.

“I think one of the most important things to remember about health care is that it’s always changing,” Nelson says. “When we talk about decentralization versus centralization, we focus on that hybrid approach because what works for you today may not work as your business changes.”

This sort of operational consistency allows providers to maximize their staffing for regular hours instead of covering peaks and valleys with the dreaded rotating on-call shifts. It provides a better patient and caregiver experience and helps mitigate risks that could come from stalled communication.

For Providence TrinityCare, that’s been especially true, and CareXM’s tools have made it easier on the staff as well.

“The application of CareXM’s tools has provided an additional layer of transparency around what our staff are really doing in the field and how available they are,” Snodgrass says. Snodgrass has received positive feedback from nursing staff about call routing — taking calls directly from their patients and families rather than having to deal with multiple touchpoints.

“It’s just so much more seamless,” she says.

A Personalized Touch

How the right technology tools can deliver on human needs

Post-acute care providers have historically been laggards about adopting technology, in part due to the belief that health care is based around human-to-human interaction. Paradoxically, CareXM’s technology increases the amount of human attention every patient gets.

Offering remote patient monitoring — in addition to a responsive nurse triage service — makes patients feel safer in their own homes, and allows the provider to collect more relevant data and information. Instead of just getting a look into a patient’s life and their social determinants of health once or twice per week on visits, the client and the patient are almost always connected.

“It’s absolutely true that we’re closer to our patients thanks to the CareXM technology,” Snodgrass says. “When working for a large health care organization, hospice, for instance, is only one piece of the patient’s care. They have primary care physician specialists and other health care touch points. If they go to the emergency room within Providence, all of that information is very transparent.”

CareXM’s remote patient monitoring — dubbed TouchPoint Care — creates a self-guided experience for the patient and gives the provider “touchpoints” of the patient’s extended care – including remote monitoring to measure vitals, heart rate, blood pressure and blood glucose, among other things.

Staying Close to Patients: Remote Monitoring and Care

Seniors were already adapting to modern technology before the pandemic began. Pew research in 2017 found that senior smartphone usage had doubled since 2013.

Anecdotally, providers have reported that when seniors are forced to adapt to technology — such as during the COVID-19 crisis — they fare better than expected.

But many providers still don’t have the right technology systems set up in order to communicate with their patients, even if those patients are more than capable of using it. TouchPoint Care, CareXM’s remote patient monitoring (RPM) system, offers myriad ways to stay connected to the client clinically and even socially. Its embedded video calling feature gives providers another way to communicate with clients and check on their health and surroundings.

This RPM offers many benefits, including:

• Flexibility
• Patient engagement survey questions
• Video calling
• Personalized communicative care for patient groups
• Automates workflows & processes for healthcare provider
• An experience built around billing codes and efficient reimbursement models

An improved RPM communication experience helps providers gather more data points, and empowers patients to be more engaged in their quality-of-care experience. More importantly, increased patient contact and understanding of the patient’s own health in the home leads to better quality of care.

A Personalized Touch Continued

Adding value to the experience, CareXM remote patient monitoring allows the patient to self-report conditions of their health through interactive health surveys, by SMS text with the clinic, through email responses, IVR phone interactions, on-the-go video chats with their provider or to be connected with a triage nurse experience. In the simplest form, the patient decides how to interact with the provider, as opposed to the provider driving a one-size-fits-all approach.

Using intelligent call routing and clinical triage support, CareXM is beginning to integrate RPM technology with its hybrid approach. As a result, the power of these systems working together will be unrivaled, transforming home health, remote patient monitoring and chronic care management at the same time.

Like the shift to mobile banking, patients now can navigate a similarly self-guided experience in health care. From quick access to nurses and other health care staff and the support of remote monitoring, the next normal for health care is now a reality.

The future of human care rests with technology. It’s driving the next normal, where patients and providers are better connected and can be safely given live triage help when needed. It’s creating a patient and provider experience that is more responsive and more personal than ever. And someday, when we look back at the change, we’ll wonder how we ever lived without it.