Choose point-of-care based on your needs
Look at cost, benefits, and clinician acceptance
Better documentation, quicker reimbursement, fewer mistakes, and reports that improve management decisions are only a few of the benefits touted by vendors who say that your agency won't survive if you don't switch to a point-of-care system.
While experts interviewed by Hospital Home Health say that there are benefits to point of care systems, they warn that you need to choose your system carefully to avoid buying a system that doesn't work for your agency.
"Home health is such a high-touch business that it is hard to get nurses to comply with requirements to use an automated system," points out David Ganzsarto, CEO of Alternate Solutions Homecare in Kettering, OH. "It's important to choose a tool that is seamless as you introduce it because when a tool becomes a barrier to getting the job done, no one will welcome it," he explains.
Alternate Solutions' first step toward automation began in 2003 with a software program for billing and scheduling. "After two years, we began to look for a point-of-care system that would tie everything together," says Ganzsarto. "We compared systems that used laptops and handheld personal computers," he explains. His agency chose to use a system that relies on handheld PCs because nurses complained that the laptops "got between them and their patients," he says.
Because they were introducing a point-of-care system for the first time, Ganzsarto wanted to choose something with which the nurses felt most comfortable. "We also found the handheld PCs to be more efficient because they do not take the amount of time to boot up as a laptop because this system does not store a database; instead it stores only seven days of data," he explains.
"The pocket PC is schedule driven, so the nurse gets the information on visits scheduled for seven days," says Deryll W. Durr, director of business application development for Sta-Home Health Agency in Jackson, MS.
Each morning the nurse must log in and "synchronize" the data on the pocket PC with the data from the agency scheduling system. All appointments for the next seven days are updated and patient records for those visits are downloaded. "If there is a change made by the schedulers that the nurse needs to adjust because the patient won't be home at that time, the nurse makes the change on the device and synchronizes again," he explains. "The clinician does not lose control of his or her schedule but the office always stays up to date as well," he adds.
Durr's agency went to a point-of-care system in 1999 and used laptops for all clinicians. "We switched to a pocket PC system in 2006 for a number of reasons," he says. "Overhead costs were significantly lower since each pocket PC costs about $300 compared to the $1,500 to $2,000 needed to purchase sturdy laptops with a high speed processor to run other systems," he explains. "Clinicians also liked the ability to synchronize data in a matter of a few minutes compared to 30 to 45 minutes for a laptop."
Financially, the new system helps with billing, admits Durr. "If our clinicians are in an area in which there is cell phone coverage, they can synchronize after every visit," he says. "Once the data come in to our billing staff, they can drop a Request for Anticipated Payment within nine hours of the visit," he points out.
Even though his agency had utilized a point-of-care system for many years, there were still a few hurdles, admits Durr. "Nurses were accustomed to having access to all patient records all of the time," he says. "The pocket PC gives you access only to the patient records you need for the next seven days," he explains. Once nurses realized that they don't need access to every patient record every day, they liked the system, he adds.
Whether you choose a laptop or a pocket, or handheld, PC-based system, be sure you offer enough training to your staff, suggests Ganzsarto. "We did not spend enough time training staff members," he admits. The agency started with the basics: how to turn the device on, how to use a stylus, and how to open documents. "We found that as nurses worked through the OASIS they did not know where to enter details and if another nurse was seeing the patient, she or he could not find the details entered in the previous visit," he says.
Because Ganzsarto's agency had not used point-of-care before, some nurses were very reluctant to try to use the device, he says. "We'd have nurses say the device was broken, so they did all of their assessments on paper," he says. One-on-one training helped overcome the resistance, he adds.
"Older nurses resisted the most, and we did lose five employees, but we've found that the system is a good recruiting tool," says Ganzsarto. "We've had nurses come to us to apply for positions because a friend works here and has told them about how much easier their job is with the point-of-care system."
Sources
For more information about purchasing a point-of-care system, contact:
- David Ganzsarto, CEO, Alternate Solutions Homecare, 1251 E. Dorothy Lane, Kettering, OH 45419. Phone: (937) 298-111 or (877) 298-1188. Fax: (937) 298-7210. E-mail: [email protected].
- Deryll W. Durr, Director of Business Application Development, Sta-home Health Agency, 406 Briarwood Drive, Building 200, Jackson, MS 39206. Phone: (601) 956-5100. Fax: (601) 956-3003. E-mail: [email protected].
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