Case Study

Medcenter One Home Health and Hospice and Applegate HomeCare & Hospice
Boost Staff Efficiency with Mobile Technology
Medcenter One Home Health and Hospice in Bismarck, N.D., and Applegate HomeCare & Hospice of Ogden, Utah, followed different paths in their adoption of technology to help paraprofessionals deliver and document care to homebound patients. One was using an entirely paper-based system of scheduling and recordkeeping, while the other wanted to adopt a different smartphone application that integrated with its parent hospital. Although they had been on different paths, both organizations wanted to become more efficient and selected McKessons Horizon Homecare MobileCare solution to automate and streamline their services. Using a paper-based record keeping system, Applegate confronted time consuming delays and inefficiencies in collecting time cards and other records. As a result, payroll deadlines were frequently not met. They also found modifications to care plans were often delayed as they were transferred from clinician to office staff and finally to home health aide.

At a Glance
Organizations Medcenter One Home Health and Hospice Bismarck, N.D. Serving patients in 23 communities in western and central North Dakota Integrated health system including 232-bed hospital, multispecialty and primary care clinics, kidney dialysis centers and four long-term care facilities Applegate HomeCare & Hospice Ogden, Utah Eight locations in Utah and Idaho Provides skilled nursing, social services and infusion therapy Solution Spotlight Horizon Homecare MobileCareTM Critical Issues Inefficient paper-based documentation system Slow communication of changes in care plans Inability to accurately measure visit times for aides Lack of documentation for payroll Results Eliminated paper-based visit documentation Improved payroll processing Reduced staff time devoted to data entry

Answers
Both organizations wanted to drive greater efficiency in their day-to-day activities. For Medcenter One, switching to the new solution would mean no downtime for staff because Medcenter One already used BlackBerry smartphones the same devices supported by McKesson. According to Jill Becker, home health aide manager, I was not willing to go backwards to paper or telephony or anything other than what we were using. We had already seen how much more efficient we could be with the aides doing their documentation on BlackBerry. Medcenter One decided to implement the Horizon Homecare MobileCare solution in conjunction with the hospitals roll out of McKessons electronic medical record. The initial training session for its 15 users required about two hours in a test environment. Most of the training was conducted by a super user who demonstrated

Challenges
As part of a nonprofit, integrated health system that includes a hospital and network of primary care clinics and long-term care facilities, Medcenter One serves patients throughout western and central North Dakota. The agencys home health aides were already using a smartphone-based scheduling and recordkeeping solution, but found they were still tied to paper care plans. Recordkeeping tasks such as logging travel and hours for payroll were performed manually during daily trips to the central office.

Case Study

Horizon Homecare MobileCare directly joins nurse care plan management to the home health aides by ensuring that a current plan is put in place on day of admission because the aide is not able to chart without one. It puts more pressure on the nurses to manage cases in a timely manner which in turn provides better care for the patient.

how to document patient visits using the smartphone. The nice thing about the solution is that the care plans are all on one screen, where you just hit complete or not complete [for each care plan task], explains Lindsey Kessler, Medcenter Ones home health aide scheduler. Applegate HomeCare & Hospice had considered a telephony system, but decided to wait until Horizon Homecare MobileCare was available. A lot of our managers didnt like the idea of the aides using a patient telephone, says Emily Puusalu, the agencys implementation specialist. The solution was rolled out to Applegate HomeCare & Hospices first branch in August 2010. To ensure that the nine aides were able to adopt the system quickly, the agency put phones in their hands prior to training so they could become familiar with their workings. Once in operation, the company eliminated paper time sheets along with other forms that slowed efficiency, according to Jeff Schmitt, Applegate HomeCare & Hospice chief information officer. The system provided managers with insight into the length of time required for aides to move from one appointment to the next. That knowledge made it easier to evaluate whether staff members were keeping accurate time sheets.

It has also improved the care they are able to provide patients. Horizon Homecare MobileCare directly joins nurse care plan management to the home health aides by ensuring that a current plan is put in place on day of admission because the aide is not able to chart without one, explains Schmitt. It puts more pressure on the nurses to manage cases in a timely manner which in turn provides better care for the patient.

Results
Both agencies have realized substantial improvements in efficiency. Aides no longer carry large amounts of paper to appointments, and they avoid daily trips into the office to file paperwork. In addition, data and time sheets are downloaded directly into electronic health records, and payroll is completed faster and more efficiently. Medcenter One was able to eliminate one position that had been dedicated to data entry. It makes the aides more efficient in terms of being able to chart right away, says Lori Nissen, MedCenter One informatics and education manager. It helps on the billing end too because theyre not having to wait to process or verify theyre here.

Jeff Schmitt Chief Information Officer Applegate HomeCare & Hospice

McKesson Provider Technologies 5995 Windward Parkway Alpharetta, GA 30005 http://www.mckesson.com

Copyright 2011 McKesson Corporation and/or one of its subsidiaries. All rights reserved. Horizon Homecare MobileCare is a trademark of McKesson Corporation and/or one of its subsidiaries. BlackBerry is a trademark of Research in Motion Limited. All other product or company names mentioned may be trademarks, service marks or registered trademarks of their respective companies. PRT468-07/11