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How one hospital boosted care transitions

From HealtCare IT News

Taps DataMotion to build Web portal
February 27, 2015

Faced with the imperative of sharing patient information when patients moved from the hospital to a nursing home, the technology leaders at Hackensack University Medical Center learned that the facilities they would be sending information to had no way to receive it electronically.

It might not seem that important to some – “just an email, just an attachment,” Hackensack UMC Chief Information Officer Shafiq Rab, MD, told Healthcare IT News, “But when your life is at stake, and when that information is critical for the person that’s going to be taking care of you, and it’s you, it becomes very important.”

It was also critical to get it resolved. Patient safety was paramount, Rab said. Also, direct and secure messaging is required by Stage 2 meaningful use, and the medical center would start its reporting on the requirements on July 1.

Hackensack UMC is a 775-bed facility that employs 7,600 people, including 1,600 physicians. It has an Epic EHR, and all nursing facilities associated with the medical center use EpicCare Link to provide web-based patient information to authorized healthcare providers.

For long-term care facilities not part of the medical center – there are seven of them – there was no way to connect to the portal and no other way to transfer patient information electronically in a secure way.

“These organizations did not have Direct addresses, accessible to them,” Mike Fitzpatrick, enterprise project manager at Hackensack, said. Hackensack UMC launched a search for a vendor with a Web portal or some type of tool that the medical center would provide at no cost to the facilities.

How difficult or easy the portal would be to use, the implementation plan and the services the vendor could provide were top of mind for Fitzpatrick.

After reviewing offerings from several health information services providers, or HISPs, Hackensack UMC tapped DataMotion to get the job done.

Shafiq Rab, MDDataMotion seemed best aligned with Hackensack UMCs tenets, Rab said.

“The people we talked to at DataMotion seemed to also care about patients first and business later,” he explained.

The job was done within three weeks of launching the project – and in time for the medical center to meet a July 1 deadline to start the reporting required to attest to meaningful use Stage 2, Fitzpatrick said.

“It was a very quick and effective process that DataMotion provided,” he said.

“In Hackensack’s case, they’re very IT savvy,” said Bob Janacek, founder and CTO of DataMotion. “They’ve implemented Epic. They have a very smart technology staff, so they have the capability to implement the technology to benefit their workflows and such. They’re ahead of their broader community, though, of referral partners, their community of care.”

To address that, DataMotion set up a Web portal that makes it possible for the long-term care facilities to receive patient records and view the attachments that are not readable in their native form. They are able to read these documents and also they are able to reply and send a message back into the medical center’s Epic system.

Bob JanacekThe portal is easy to use – similar to webmail, such as Yahoo! or Outlook, Janacek said.

Before using Direct, whenever a patient transferred to another facility, the discharge documents were printed out and were either faxed or given to the patient to hand to the next provider, according to a DataMotion case study of the project. This manual process sometimes resulted in patient transitions taking longer than desired, and often depended on the patient remembering to deliver the documents to the new provider. Automating the process is not only expected to improve the quality of care patients receive after discharge, but also decreases the time it takes to complete the transition.”

To Rab, quality of patient care is paramount.

“It’s not about the success of Hackensack, and it’s not about the success of DataMotion,” Rab said. “It’s not the success about Direct messages and that we got to meaningful use Stage 2 and the money. It’s not about that. I think the message in all of this is that different tools that different people are using make the lives of patients and the care coordination better so that we make our people healthier, quality of life better and at the same time decrease the cost of care.

“Healthcare needs urgent work,” he added. “As fast as we finish this conundrum, then we can get to the second and third layer of healthcare. That is using information and then analyzing it – what is the most appropriate way to decrease the cost of healthcare and how to maximize the benefit for the patient.

“Let the world know that those people who don’t have these things, they are waiting for it. They really want this information, and it’s our moral and ethical duty to provide it to them.”

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icon form health care hospital

Patient Home Care Monitoring Will Revolutionize the Health sector in 2016

Real-time health care monitoring including the patient’s home continues to gain importance as pressures come from a variety of sources to reduce risks and costs of readmissions and hospitalizations.

The Centers for the Medicare and Medicaid Services (CMS), enforcing the 2012 Medicare Readmission Reduction Program, the States and managed organizations have to deal with tighter budgets, rising costs of service, and stricter capitation rates.

Until recently, homecare reporting was archaic at best. The home was a “black box” where no information was generated when a home aide entered the residence and closed the door. Well-intentioned aides and nurses visited a patient’s home, administered and documented their visit in piles of paperwork that were often not reviewed or actionable.

Data input was first “modernized” to record home aide hours and minimal data about care by telephone. Such systems are used primarily for time and attendance. Aides visit the patient’s homes and use the patient’s home phone to document that their work shift has started. When the shift ends (and only when the shift is over), the home aide dials the phone to report the end of their shift, and with all the limitations inherent in pressing numbers on a dial pad, report that they had administered a few elements of care. Since they cannot see the output of what they entered, such data entry is error prone and of limited value.

To move home health care forward and to reduce costs requires a new approach. Forward thinking home aide agencies, health care providers, managed care organizations and hospitals are looking for innovative solutions that leverage the proliferation of tablets, smartphones and the ubiquitous Cloud to improve care at home, where patients spend most of their lives and where so many significant health events occur.

Thanks to technology, the “black box” of healthcare monitoring can be transformed into a sea of data where home health aides can gather 500-1,000 data points per month. The real-time collection and utilization of data from the home will offer these ten key benefits for specific patient populations, their families and every member of the patient’s care team in 2016.

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Health Sense: Group tries to reduce hospital readmissions

Group tries to reduce hospital readmissions

MADISON.com: Under the Affordable Care Act, Medicare penalizes hospitals that have too many readmissions, or admissions within 30 days of discharges, for patients with pneumonia, heart attack and heart failure.

But hospitals aren’t the only places that influence whether patients return. Nursing homes, home health agencies, home care agencies, aging agencies, hospices, pharmacies, ambulance services and others have an impact.

That’s a key motivation for the Dane County Community Transitions Coalition. Started in 2012, the group includes representatives from about 30 facilities or agencies that care for the elderly or chronically ill. The coalition meets monthly in an effort to improve transitions of care and keep readmissions down.

“We’re sending these people home and often they’re falling off the radar,” said Maria Brenny-Fitzpatrick, transitional care program director at UW Health and a co-leader of the coalition.

Preventing patients from returning to the hospital isn’t only about avoiding Medicare penalties. It’s also better for patients, Brenny-Fitzpatrick said. “Readmissions, on the patients, are very traumatic and very difficult,” she said.

One tool the coalition developed is an emergency medical information form that patients or loved ones can keep at home and give to paramedics and emergency room staff when needed.

The form includes major diagnoses, a list of medications and contact information for a care coordinator. It says whether the patient needs glasses or hearing aids to communicate or a cane or walker to walk.

Another information sheet, explaining supportive home care services, was developed by six agencies that provide such care in the county: BrightStar, ComForcare, Comfort Keepers, Home Instead, Midwest Home Care and Senior Helpers.

Other handouts focus on heart failure, when the heart doesn’t pump enough blood. One includes warning signs that should prompt patients to call a doctor or nurse, such as trouble sleeping or shortness of breath with regular activity. The handout also includes “red zone” symptoms requiring a 911 call, such as chest pain or a fainting spell.

In a related effort, Safe Communities of Dane County and the Wisconsin Institute for Healthy Aging plan to offer a Living Well workshop next spring focusing on heart failure.

Living Well workshops “build participants’ confidence in their ability to manage their health condition to maintain active and fulfilling lives,” according to the institute’s website. For more information about the workshops, contact Lynne Robertson, Safe Communities’ outreach specialist, at 608-836-9810 or lynnerob@charter.net.

Dane County’s readmission rate, of about 37 per 1,000 Medicare beneficiaries, hasn’t changed much in recent years. It’s lower than the state and national averages but higher than two-thirds of counties in Wisconsin.

Alzheimer’s research

I wrote an article in November about a study at UW Hospital of whether an experimental drug can protect healthy seniors whose brain scans show signs of risk for Alzheimer’s disease.

Now UW Hospital is part of a different study to see if another drug might slow the progression of the disease in people with mild to moderate Alzheimer’s. Patients who are ages 55 to 85 and have been taking the drug Aricept for at least six months might be eligible.

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Home Care in Switzerland

Home care continues its negative showing due to maturity and pressure from private label

Sales of home care registered retail value declines across many categories in 2013, in part due to the maturity of a number of categories, such as laundry care, and the pressure from private label on value sales. While private final consumption grew at a fairly healthy level in 2013, consumers continued to display a strong preference for value-for-money home care. A further obstacle to growth was the strength of the Swiss Franc, which continued to provide a strong incentive for cross-border sales.

Home care continued to be heavily impacted by declining unit prices across virtually all categories as competition from private label and between branded manufacturers remained fierce. The strength of retail giant Migros’ private label continued to be detrimental to unit prices, given the fact that the retailer offers a large and popular range of value-for-money home care. Another source of pressure was the higher inflow of cheaper imports from the EU/EEA following the opening of the Swiss market in July 2012. In the face of growing competition from private label and cheaper imports, branded manufacturers responded with more frequent price promotions, thereby adding further downward pressure on unit prices.

Private label and large multinationals compete vigorously

Although there is a fairly large number of players present in Swiss home care, the majority of sales remained in the hands of private label and a small number of leading global players. The most significant player remained Swiss retail chain, Migros, with its private label range of home care accounting for the largest value share in 2013, and resulting in overall private label being ahead of branded products. After private label, the three leading global players, Unilever, Procter & Gamble and Henkel, took the leading positions, relying on their well-known global brands.

Discounters continues to gain but supermarkets remains the strongest channel

In line with the growing demand for private label home care, discounters registered the fastest growth in value sales in 2013. This was particularly detrimental to the value share of health and beauty specialist retailers and traditional grocery retailers, but also supermarkets and hypermarkets felt the pinch. The growing strength of discounters was further underpinned by the fierce outlet expansion pursued by German discounter chains, Lidl and Aldi, which in turn also put pressure on domestic discounter chain, Denner. However, in absolute terms, supermarkets remained the most important channel in home care in 2013, supported by the strong performance of the private label ranges of leading supermarket chain, Migros.

Lack of demand for premium products expected to hamper future sales of home care

Sales of home care are expected to register a stagnant performance in constant value terms at 2013 prices over the forecast period. While demand will remain positive across most categories, consumers are expected to grow increasingly reluctant to spend on premium products, especially in view of the growing availability of higher-quality private label alternatives. The uncertain outlook for Switzerland’s economic performance is further expected to impact consumers’ spending decisions to the detriment of home care. In addition, growing price competition between manufacturers, retailers and private label, especially following the recent opening of the Swiss market to cheaper imports from the EU and EEA, will result in unit price declines across virtually all categories, thus adding further pressure on value sales.

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Healthy living facts

Healthy living facts

This article is designed to give tips to readers about how they can improve or augment actions in their life to have a healthy lifestyle; it is not meant to be all inclusive but will include major components that are considered to be parts of a lifestyle that lead to good health. In addition to the tips about what people should do for healthy living, the article will mention some of the tips about avoiding actions (the don’ts) that lead to unhealthy living.

“Healthy living” to most people means both physical and mental health are in balance or functioning well together in a person. In many instances, physical and mental health are closely linked, so that a change (good or bad) in one directly affects the other. Consequently, some of the tips will include suggestions for emotional and mental “healthy living.”

Eating (diet)

All humans have to eat food for growth and maintenance of a healthy body, but we humans have different requirements as infants, children (kids), teenagers, young adults, adults, and seniors. For example, infants may require feeding every four hours until they gradually age and begin to take in more solid foods. Eventually they develop into the more normal pattern of eating three times per day as young kids. However, as most parents know, kids, teenagers, and young adults often snack between meals. Snacking is often not limited to these age groups because adults and seniors often do the same.

Tips:

  • Eat three meals a day (breakfast, lunch, and dinner); it is important to remember that dinner does not have to be the largest meal.
  • The bulk of food consumption should consist of fruits, vegetables, whole grains, and fat-free or low-fat milk products.
  • Choose lean meats, poultry, fish, beans, eggs, and nuts (with emphasis on beans and nuts).
  • Choose foods that are low in saturated fats, trans fats, cholesterol, salt (sodium), and added sugars; look at the labels because the first listed items on the labels comprise the highest concentrations of ingredients.
  • Control portion sizes; eat the smallest portion that can satisfy hunger and then stop eating.
  • Snacks are OK in moderation and should consist of items like fruit, whole grains, or nuts to satisfy hunger and not cause excessive weight gain.
  • Avoid sodas and sugar-enhanced drinks because of the excessive calories in the sodas and sugar drinks; diet drinks may not be a good choice as they make some people hungrier and increase food consumption.
  • Avoid eating a large meal before sleeping to decrease gastroesophageal reflux and weight gain.
  • If a person is angry or depressed, eating will not solve these situations and may make the underlying problems worse.
  • Avoid rewarding children with sugary snacks; such a pattern may become a lifelong habit for people.
  • Avoid heavy meals in the summer months, especially during hot days.
  • A vegetarian lifestyle has been promoted for a healthy lifestyle and weight loss; vegetarians should check with their physicians to be sure they are getting enough vitamins, minerals, and iron in their food.
  • Cooking foods (above 165 F) destroys most harmful bacteria and other pathogens; if you choose to eat uncooked foods like fruits or vegetables, they should be thoroughly washed with running treated (safe to drink) tap water right before eating.
  • Avoid eating raw or undercooked meats of any type.

Tips for special situations:

  • People with diabetes should use the above tips and monitor their glucose levels as directed; try to keep the daily blood glucose levels as close to normal as possible.
  • People with unusual work schedules (night shifts, college students, military) should try to adhere to a breakfast, lunch, and dinner routine with minimal snacking.
  • People who prepare food should avoid using grease or frying foods in grease.
  • People trying to lose weight (body fat) should avoid all fatty and sugary foods and eat mainly vegetables, fruits, and nuts and markedly reduce his/her intake of meat and dairy products.
  • Seek medical advice early if you cannot control your weight, food intake, or if you have diabetes and cannot control your blood glucose levels.

Physical activity and exercise

Physical activity and exercise is a major contributor to a healthy lifestyle; people are made to use their bodies, and disuse leads to unhealthy living. Unhealthy living may manifest itself in obesity, weakness, lack of endurance, and overall poor health that may foster disease development.

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October 10, 2015 / Posted by / Healthy living facts