We live in a menu driven society. We want to choose the right color, size, shape, type, fabric, matrix, design, height, wood, smell, texture, comfort and on and on. And that was just to choose a couch. I listened to a colleague recently discuss his daughter choosing a mattress and it took her five hours. Five hours lying on over 40 mattresses.
We can choose from 71 sports drinks, 385 cereal brands, and 405 types of candy bars. But, until recently, a hard working diligent home health nurse (visiting 5-6 patients a day, who live many miles apart, and have at least 8 diagnoses and take an average of 15 medications each) had to complete an OASIS assessment tool only on paper OR only on a laptop, depending on where she worked. Hey, what about an iPAD?
What about choice?
One nurse knows she can complete an assessment more quickly and accurately if she uses paper. Why? Because that is how she learned as a child. To try to be faster on a laptop will be more difficult as she is a “digital immigrant”. Our children and grandones are “digital natives”. Without social networking and an MP3 player, they are lost. They need/like technology to feel a part of their group.
Many in my age group (very mature…and wise J) believe that technology should be used carefully as it could pose a barrier toward relationship development and establishing patient trust. We feel connectivity being near and around people. In homecare we know we are frequently visiting older persons and many of them are suspicious or less comfortable having data entered into a laptop while in their very home.
Now, just when one begins to slip into a stereotypical belief pattern, let me share a few statistics. The fastest growing group of internet users are ages70-75. Over 45% of seniors in this age group are now online. While social networking and blogging are very popular among the 18-44 year olds, a fully 74% of internet users age 64 + send and receive email routinely. We have clients whose patients want emails, not phone call reminders of clinician visits.
The beauty of home health care is that it is comprised of clinicians in their 20s to their 80s. Yes, I know of an agency with an excellent 82 year old MSW. She is quite the motivator.
I like both paper and technology. I am faster when I use paper to complete an assessment. I love both of my laptops and my iPAD and my iPhone and I read on them all. But, if I need to scrutinize a contract, I will print it out so I can read it ON PAPER. No kidding! That is how I learned way back when and it is my trusted reading medium to this day.
The Agency Leader
And what about the agency leader who needs to recruit and retain competent experienced clinicians? In both very rural and very urban areas this can be a challenge. As a contractor, it can be very painful to work for many agencies and try to use everyones’ special device or forms. Could the contractor be more efficient and prompter if (s)he could use their own laptop to complete the documentation? As a leader, it can be a problem in getting assessments in on time. Most of the therapists will tell you, it is because of the paperwork and frequently, it’s the device.
In my dream world as a prior home health agency leader (11 offices in three states), I wanted my OASIS Assessment tools available on line so ANY and ALL of the agency clinicians could complete them (with their favorite laptop if they wanted to) or I would give them a laptop or a notebook or a tablet. Whatever made them more comfortable and thus more efficient was one of my goals. In my dream world I also wanted a great electronic paper tool that could “scrape” OASIS data, electronically capture orders and goals on a careplan and move them to the POC. Did I mention that in my dream world, orders and goals were updated electronically on my smart paper progress notes, so I did not need to have a series of data entry processes that invariably slowed the information availability down? Also, I have believed clinicians need to see progress on the orders and goals no matter if on paper or laptop. The progress of each goal should directly relate to the visit note documentation. Because in the perfect world, if there is congruence between the goal and the visit note, the RACs, MACs, and Z-Pics must find some other target of insufficient documentation.
In my dream world one nurse could use paper, another a laptop, the therapist could now use an iPAD to collect data from one patient because the data would all be deposited in one smart EMR. Easy data collection. Easy viewing of the data. Easy access and monitoring.
Finally, a compliant system
It has always been intriguing to me that an agency invests thousands for a software program and cannot use it for every clinician. So, some clinicians must use paper that invariably awaits the frenzied data entry/receptionist clerk to enter it into the system. Right from the start, the agency is out of compliance. The conduit for safety and communication becomes the overworked clinical supervisor who must convey information to disciplines and share what occurred on visits. So, now the agency has two to three systems. One is on the laptop, one is the paper that has info that must be added to the software program, and what about all of the other extraneous pieces of paper like H&Ps, transfer and referral forms from other levels of care? No wonder the MAC and RAC auditors are having a field day.
In our real world, my dream world has now become a reality. I am not one to use this blog for sales (we are educationally oriented) but, having the ability to collect data any way you like is so very exciting. To not be tied to those expensive computer updates that must go on and on and on each and every computer or require everyone to have the same type of hardware or won’t allow paper. Worse yet, have a way to get “other” paper, like the H&Ps, consents, lab reports, psych work sheets, dietary supplement sheets, extra teaching tools etc into an EMR is so important.
To offer a clinical data capture system that allows you to choose, your choice, has been needed in this industry and will resolve so many efficiency and clinician retention issues. We tell our clinicians they must become more efficient. Now, we can actually show them how. We can offer them a choice on their desired medium. In order to enable this level of flexibility requires a very smart EMR or data repository. And, what if you have an existing MIS/billing system? No problem. LEVERAGE IT!
Collect your data your way, YourChoice and solve those operational and data collection headaches. Use SmartScribe EMR to collect ALL of your data and reports. Leverage your existing MIS/billing system. Get the clinical, patient, operational, and business results you deserve not what you have had to settle for. I love working with this team. They solve real problems for clinicians and leaders like you and me.
