Field Staff Automation
Select Data:Scanning system offers
Sick of laptops? Scanning system offers HHAs a cure
While many home health agencies are switching from paper to laptops, two West Coast agencies have taken a step in the opposite direction. They’ve traded their laptops for a scanning system called SmartScribe, offered by California’s Select Data. Surprisingly, perhaps, the switch has improved the agencies’ productivity and retention rates. After shutting off its laptops and turning to scanning last October, Assured Home Health & Hospice in Centrailia, Wash., improved its clinicians’ productivity to an average of 6.5 visits a day, says Richard Block, the agency’s president. That’s the same productivity level the agency had before the adoption of laptops dropped its productivity level to about 4.5 visits a day. Block found that laptops simply weren’t userfriendly and nurses were quicker and more efficient when they manually completed the paperwork. Here’s how the scanning works: When HHAs work with Select Data offers access to dozens of standard scannable forms, including an 11-page comprehensive assessment, nursing note, skilled nursing follow-up and nursing care plan, says Adam Conrad, Select Data’s executive vice president of sales and marketing When completing the comprehensive assessment, for example, clinicians use a regular pen to either check or put a line through circles or boxes next to the appropriate response for each OASIS and comprehensive assessment question, Conrad says. [See p. 6, for a sample]. At the end of the day, or before starting the next day, a nurse drops off the scannable paperwork at the office where a receptionist or other office staff member scans it, says Michelle Oliver, nurse manager for Loma Linda [Calif.] University Medical Center, an agency that adopted this system last May. Within 24 hours of scanning the information, “we have everything we need on the patient right in our system,” Block says. This process eliminates the risk for data-entry errors when agencies have a separate person entering the data. The only information that needs to be entered manually is in the handwritten notes. Scanning is not new to the health care field, says Conrad, but “home care never really embraced scanning as a technology.” In recent years, though, Conrad has found more and more HHA interest in scanning. Select Data has 50 HHA clients using this program because they can’t afford point-of-care devices, tried it with disappointing results or have no interest in trying it at all, he says. Note: Select Data isn’t the only vendor offering scanning options. Other vendors offering similar programs are: Sansio in Duluth, Minn., and Ingenix in Eden Prairie, Minn.
Scanning improves turnover rates
Both Loma Linda University Medical Center and Assured Home Health found that scanning reduced turnover and saved money on recruiting costs. Assured Home Health has budgeted $125,000 less this year in recruiting than in 2006 and 2007, Block says. That is a direct result of “keeping staff happy by making sure they are not stressed out over data entry.” After starting to use laptops in 2000, Assured Home Health & Hospice, which always had better than average turnover rates, suddenly had nurses fleeing, Block says. Nurses actually were taking notes on Post-Its and other pieces of paper during the day, Block says. When they got home at night they spent two to three hours trying to complete their patients’ charts. Clinicians were burning out, and the agency lost about 30 clinicians in less than two years, he says. Savings on recruitment costs make the scanners worth the cost. The scanners, which are the size of a home printer, cost about $2,000 each, Conrad says. Other costs include the salary or payment for the office person doing the scanning, and charges for using the scanning service, Conrad says. As for the scannable forms, there’s no additional cost for Select Data’s clients, Conrad says. HHAs can print the forms online from their offices or from homes and make copies as needed. Compare the upfront cost of scanners with the costof laptops, which run about $2,000-$2,500 each plus $2,500-$3,500 for the software, Conrad says.
5 tips for effective scanning
To ensure accurate patient records, you’ll need a verification system, agencies using this process warn. Most Scan Data clients have purchased the vendor’s verification service, which costs about $15 per episode, Conrad says. Select Data’s staff looks at errors that arise due to stray marks or human error and contacts the agency via e-mail or telephone, Conrad says. Select Data recommends that agencies designate someone in their office to centralize the communication between the verification team and the agency’s numerous clinicians, Conrad says. The verification team would contact this point-person when there’s an error or incomplete information. The pointperson would double-check that information with the clinician involved and pass any corrections or clarifications back to Select Data. But Loma Linda chooses to handle the verification process in a different way, Oliver says. The agency has its clinicians communicate directly with the verification team. When Select Data has a question, it e-mails clinicians directly, and clinicians are required to check their e-mail at least once a day. Rather than having an office person review this information, “we felt strongly that since it’s the clinicians’ documentation, they should be the ones to communicate with Select Data,” Oliver says. Here are four more tips to consider if you’re thinking about making the switch to scanning:
- Look for a Web-based product.
- Teach clinicians how to access patient information to overcome resistance to buy-in.
- Consider combining scanning with use of laptops.
- Work with your vendor to create agencyspecific forms.
Select Data offers a Web-based system that stores all of its software and data on its own servers. This was a selling point for Loma Linda, a hospital-based agency which requires its software to integrate with the hospital’s system, Oliver says. Everything in Select Data’s system is available to users working from any computer and doesn’t have to connect to the hospital’s internal computer system in any way, Oliver says. This makes the information accessible to clinicians, who can check the patient’s records from the office, their homes or even a smart-phone or Webenabled device, Conrad says.
Staff at Loma Linda went through the standard difficulties that often come with change, Oliver says. “We had the challenge of a lot of staff feeling that it was going backwards. Some days we still have to work on overcoming that.” The agency is working with clinicians who miss the laptop days to demonstrate how they can access the information in the Select Data system. Clinicians have to understand that the information is available to them electronically so they just have to know “where to look for it,” Oliver says.
This year, Select Data has started two clients on a system that combines point-of-care and scanning technologies, Conrad says. A combined system, says Conrad, allows full-time nurses to operate with laptops and part-time nurses to use paper scan sheets in a way that combines the two forms of recordkeeping. This is especially important as the nursing shortage forces more agencies to hire parttime nurses.
Loma Linda worked closely with Select Data to develop agency-specific forms, such as the visit notes, Oliver says. It took conversations back and forth to develop forms that worked for the agency and worked with Select Data’s system. – Brooke Howell [bhowell@decisionhealth.com]
