Discharge planners can go on-line to place patients
eDischarge eliminates phone calls, faxes
Discharge planners employed by Winchester (MA) Hospital have spent the last several months getting a first-hand look at how technology and the Internet can simplify some of their duties.
In the spring, they began piloting eDischarge, an Internet-based program that links the hospital staff to post-acute providers and payers, centralizing information that a case manager needs to discharge patients efficiently to the most appropriate facilities. The program is clinically based and was designed by health care providers, says Jackie Birmingham, RN, MS, CMAC, vice president of clinical design at Newton, MA-based Integrated Healthcare Network, the company that developed eDischarge.
Before discharge planners at Winchester began using eDischarge, they spent quite a bit of time each day dealing with reviewers or case managers from post-acute facilities, says Ruth Pilote, RN, MSM, a care manager at Winchester. Although that’s considered just part of the job, it is time-consuming, particularly when four or five reviewers visit the unit within a few hours.
And when discharge planners weren’t dealing one on one with reviewers, they were making calls or faxing information to post-acute facilities just to find a facility with a bed for a patient.
Under the new system, however, discharge planners simply enter in the patient’s condition and post-acute care needs, and send an e-mail. A post-acute care facility that is enrolled in eDischarge and can accommodate the patient’s needs is identified, and the process is essentially complete within about 45 minutes.
"It definitely cuts down on the number of phone calls, and it increases efficiency," says Pilote. "And in this fast-paced world, it’s like a trigger. You know who you referred and you know where you referred them."
The system works this way:
• Post-acute providers that take referrals from a hospital, including skilled nursing homes, home health services, and rehabilitation facilities, complete an initial profile outlining the services they offer. Each day, the provider updates the bed or service availability.
• Case managers or discharge planners input the patient’s continuing care needs and the date the patient will be ready for discharge. The specific patient is not identified.
• The system matches the availability of facilities or services with the needs of the patient.
• The discharge planner sends a notice via e-mail to the matched provider, by way of a secure Internet server, that a bed or service is being sought.
• The provider’s intake coordinator reviews the patient care needs on the Web and responds to the hospital discharge planner.
• The patient and/or family is consulted in the final selection of the post-acute provider.
• To protect patient confidentiality, identifying information on the patient is sent to the provider only after the final match is made.
Many patients go to two or three levels of post-acute care before finding the level that fits their needs, often because they don’t go to the right place the first time. Birmingham points out.
eDischarge will make a difference she says, "because the discharge planner will have a work flow tool that automatically matches the patient to the provider based on needs and availability. Discharge planners also will have more time to work with the complex patient to develop a more precise discharge plan."
Response has been favorable, Birmingham adds. "Discharge planners no longer have to rely on phone calls and faxes to get the job done. I call it the virtual discharge planning tool.’"
And for the families, eDischarge offers "patients and distant families access to what we’re doing. We can e-mail the Web sites of nursing facilities to the families, where they can see a review of the nursing homes. They will have a unique code or password that will give them access to designated information they need to make a decision."
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