Breakthrough Tools to Increase Aide Performance

The Issue
Home health care agencies have embraced electronic medical records and workflow automation. But home health care aides continue to be managed using ineffective, low-technology methods - landline phones, voicemail, inefficient trips to the office as well as paper and pen.
The benefits of communicating updated schedules, point-of-care documentation and treatment plans are obvious - improved outcomes and increased efficiency, not to mention greater profitability.

Home Health Line reports that up to 70 percent of agencies rely on manual methods to track and schedule the home health care aides' patient visits. But it is not practical to equip every aide with a laptop.

Home health care aide management needs technology that closes the communications gap between the agency's office and workers in the field.

Home health care aides generally do not have work cell phones - or even personal cell phones. It is a struggle to maintain adequate communication between aides and the agency. Communication that is required to maintain profitability and effectiveness.

Aides experience daily schedule changes. And often additional changes occur as the day goes on, requiring the agency to remain in contact with the aides. Without a reliable, stable means for aides to communicate with the office, service gaps can occur. Schedule changes are lost, causing a productivity drop or a missed patient visit. Employee morale also drops - aides realize productivity plummets when a visit cannot be made and they weren't alerted in advance. Employees like to know what their next stop is and where they will be going the next day.

In addition, schedule changes are not always pushed from the agency to the aide. Aides may encounter care challenges or schedule change requests while on-site, which must be communicated back to the agency. Today, most communication is handled in person, with aides making multiple trips each day to the office to communicate with the agency. The time wasted driving to the office could be better spent making additional patient visits. Additional agency costs include office staff and mileage reimbursement. The agency also must maintain paper forms to document visits and visit duration.

The Solution: AirClic + NDoc®
Thornberry healthcare clients now have a solution - a simple cell phone with incredible functionality. The integration of the AirClic mobile application to Thornberry's NDoc product provides aides with more real-time job related data than ever before - and gives management greater control. The AirClic application closes the gap between the mobile worker and the electronic system where patient and trip data are maintained, providing end-to-end, two-way voice and data communication between the office and field workers. The end results are improved outcomes, greater efficiency and higher profitability.

How AirClic + NDoc Solves the Problem
With the NDoc+AirClic solution in place, both agencies and aides are in a much better position to work together effectively. For example, nurse case managers can create daily schedules and patient care plans in the NDoc application. The aide can access these treatment plans through the AirClic-enabled cell phones - while in the patient's home. Not only is the aide able to see the agenda, but is able to interact with it, following menu-driven prompts to track and confirm care activities. Once entered into the AirClic-enabled phone, the data is automatically uploaded to NDoc, updating the patient information in real-time. What was once a complex, paper-driven process is now very simple and much more efficient.

Yet the quality-of-care isn't compromised. Instead, the ability to confirm a series of treatment activities can lead to improved quality-of-care. For example, a case manager may have changed the care plan of a long-term patient. Because some long-term patients have the same care needs for a period of months, it can become repetitive and the aide may not review the care plan with the same attention to detail. Because the care plan is now pushed to the handheld device, the aide must confirm a series of care activities for each patient. Even if there is a new addition or edit, an aspect of the patient care plan is less likely to be overlooked.

Additional benefits include reduced paperwork and increased security. The application prompts aides to record trip start and stop times as well as mileage and expense data, simplifying what was a time-consuming process. AirClic also provides an additional measure of security for aides in the field - the walkie-talkie feature optionally available with AirClic-enabled phones enables instant communication in case of emergency. And to ensure only professional use of the phones, calling functionality can be disabled. Since the two-way radio provides communication to the office, the ability to place calls becomes unnecessary.

Agencies benefit from AirClic's optional built-in GPS tracking capabilities, ensuring the office knows the location of every aide. In the case of a patient emergency or unexpected staffing or scheduling change, the agency can quickly assess available resources and reassign individual(s) as necessary.

Case Study
St. Joseph's Certified Home Health Care Agency operates in the greater Syracuse, N.Y., area. Bob Aber, St. Joseph's director of information technology, and his team successfully deployed the NDoc+AirClic solution. So successfully they realized $67,000 in savings during the first year of using the integrated products.

Since the mobile application differed significantly from the previous manual processes, it was rolled out gradually over a four-month period, beginning with a pilot group of five aides. The pilot group thoroughly field-tested the application, making certain unanticipated issues were addressed prior to the mass deployment.

Aber notes, "The whole concept is so simple that the implementation didn't take as long as I thought it would." Hands-on training provided by Thornberry was key. The group relied heavily on Thornberry's training materials to ensure a smooth go-live. St. Joseph's has now deployed the NDoc "Mobilized by AirClic" solution to 40 home health aides.

The results have been nothing short of spectacular. St. Joseph's has realized a significant financial ROI and expects additional gains in both patient and employee satisfaction.

Aber sees major process improvement. For example, previously the care plan was paper driven, initially completed by the nurse at the time of the admission. During a subsequent visit, a different nurse may discover new information, requiring a change to the care plan. The manual process required the nurse to remember to change the plan in two places. Now changes in the clinical package are uploaded automatically into the aide's AirClic-enabled handheld device. The care plan change creates a line item that has to be acted upon.

Schedule changes, too, have become much easier. Aber's team is able to react quickly to, and even anticipate, the inevitable changes caused by forces like severe weather.

These improvements have had an unanticipated effect on staffing, too. Aber finds that aides seek St. Joseph's as an employer of choice because it has the NDoc+AirClic solution in place. Having made an investment of this kind proves that St. Joseph's has the well-being of both its patients and its staff at heart. Aber highlights, "It's not just a return on investment in dollars and cents. It's also an ROI on patient satisfaction and being able to deliver better patient care. Care that comes from employees who are satisfied and happy with their jobs. I think this brings them that kind of enjoyment from being more efficient and having the tools to do a better job."

And the ROI is certainly significant. St. Joseph's realized savings of $67,000 during the first year of use, all related directly to the two-way data communication that the NDoc+AirClic solution enables.

Reduced Mileage - $22,000 savings in year one
Reduction in the Use of the Forms - $4,500 decreased forms usage
Reduction in Time to Manually Provide Directions - $17,000 saving having directions to the next appointment appear on the phone. Previously, directions were provided in person or verbally by phone.
Reduction in Administrative Costs - $3000 savings by reducing administrative work by two days per month
Reduction in Non-Billable Visits - $8500 reduction in non-billable visits, due to missing documentation
Reduction in Non-Recoverable Cancellations - $12,000 in potential billings recovered in the event of a cancellation through the ability to redeploy the aide in a timely manner

And that $67,000 is just the beginning. Processing patient visit reminder calls and paper visit schedules to patients will be the next tasks automated and mobilized.

Conclusion
St. Joseph's success with the NDoc+AirClic solution is just one example of the success that can be achieved through integrated technology. In an era of reduced reimbursements and skyrocketing costs, no agency can thrive without aligning the office and field staff. By providing a platform for connected care, agencies improve profitability, patient quality-of-care and employee satisfaction. And that's something every agency is interested in providing.

About Thornberry
Thornberry and AirClic have partnered to integrate AirClic's business process mobilization solution into Thornberry's NDoc® point-of-care software. The integration provides a market-first solution that assists health care clients with mobile and real-time home health aide scheduling, care planning and documentation.

Thornberry Ltd is a developer and marketer of intelligent, leading-edge management information systems for the home health care and hospice industry. With a heritage of offering customer-centric solutions since 1992, Thornberry and its best-in-breed technology partners are dedicated to building home health care management software solutions that solve real problems and ready home care agencies for the introduction of universal electronic records and regional health information organizations (RHIOs).

About AirClic
Headquartered in Trevose, Penn., AirClic is the leading mobile applications provider offering organizations real-time, 360-degree visibility into their entire field operations. This improved visibility means customers can reduce costs, differentiate revenue and improve customer service. AirClic's flagship, patented product, AirClic MP, is a cost-effective, end-to-end solution for anytime, anywhere access to field business data; connecting the mobile workforce and translating data into business insights for better business decision-making. With its unsurpassed user-adoption rate, AirClic is driving new levels of accountability for best-in-class companies around the world.