CareAnyware, LLC, based in Research Triangle, N.C., is the leading home care technology solutions company delivering Web-based and mobile applications to support all parties involved in the home care process: hospitals, home care agencies, physicians, home care clinicians, patients and family caregivers.
Maria Parham Regional Home Health, located in Henderson, N.C., is a licensed and Medicare Certified Home Health Agency and is accredited by the Joint Commission on Accreditation of Healthcare Organizations. Since becoming a member of the Maria Parham Hospital system in 1997, the agency has serviced more than 2,300 clients residing in Franklin, Granville, Vance and Warren counties. The agency offers a full range of services including skilled nursing, physical therapy, occupational therapy, speech therapy and medical social work.
Located in Wayland, Mass., Parmenter Visiting Nurses Agency (VNA) & Community Care offers a range of home care and hospice services to clients of all ages. Services are available 24 hours a day, 7 days a week. Parmenter delivers customized health care for short term, long term, and chronic illness through a variety of programs and services. Its professional staff members provide compassionate, patient-focused care after a hospital stay, during a rehabilitation program or through a prolonged or terminal illness. Parmenter’s services include skilled nursing care; rehabilitation programs in physical therapy, occupational therapy and speech therapy; home health aide services; palliative care; nutrition services; medical social work; and adult day health.
Facing increased federal regulation, Medicare reimbursement rollbacks and significant growth in the home care population, the $42 billion home health industry has been adapting to changing times. Since 1999, Medicare certified home health agencies (HHAs) are required to conduct comprehensive assessments of all patients and participate in the federal program Outcome Assessment Information Set (OASIS). HHAs must electronically submit OASIS health information on Medicare patients to measure patient outcomes for quality improvement. Another federal mandate, the Health Insurance Portability & Accountability Act of 1996 (HIPAA), requires improved efficiency in healthcare delivery by standardizing electronic data interchange, and protection of confidentiality and security of health data through setting and enforcing standards.
These federal regulations, coupled with state reporting rules and normal charting procedures, now require the average home health therapist or nurse to collect more data than ever on each patient. The collection instrument at many HHA’s is still pen and paper, requiring clinicians to constantly make copies of their reports and carry large binders of patient information, a HIPAA security issue. In addition, paper reports and separate clinical and billing systems require intensive manual data entry by clerical workers at HHA offices, which slows clinical, billing, insurance, reporting and other processes and increases the chance of errors.
Both Maria Parham Home Health Agency and Parmenter VNA faced these issues and several others. The clinical and billing systems at both agencies were separate, requiring manual data input that led to errors and duplicate entries. Both agencies needed their front and back office systems to be HIPAA compliant.
More than four years ago, CareAnyware’s founders recognized a need for an easy-to-use, affordable and cost efficient information technology solution tailored to the changing needs of home care providers and patients. However, the company found that small handheld devices were not robust enough to run its software for clinical data collection.
This was Maria Parham’s experience, as the agency moved from being completely dependent on paper to deploying CareAnyware’s software on small pen tablets in May 2003. While pleased with the efficiencies of CareAnyware’s software, the agency found the pen tablets’ small screen, slow processor and low memory capabilities could not fully meet their needs.
“The old pen units did not allow us to fully benefit from the CareAnyware software,” said Suzanne Crumpler, clinical staff development coordinator at Maria Parham. “The lack of speed and the poor memory caused constant problems for our clinical staff.”
Parmenter VNA deployed a small mini-laptop device with a different vendor’s software several years ago to help with data collection in the field, but the clinicians also found the small screens and slow processor inefficient for their everyday tasks.
CareAnyware discovered that the new tablet PCs based on Microsoft’s Windows XP Tablet PC Edition finally would enable HHAs to realize the full potential of the ehomecare.com software. CareAnyware recommends deploying its software on the Motion Computing slate tablet PC because of its light weight and large 12.1-inch screen, which approximates the size of a sheet of paper. Because of its clipboard-sized shape, nurses and therapists can carry it in one arm while using the stylus to input patient data. The Motion tablet’s integrated wireless capabilities and speedy, ultra-low-power Intel processor also impressed CareAnyware.
CareAnyware’s ehomecare.com software is a Web-based billing and emergency medical record (EMR) system. The software helps streamline all operations (data entry, payment data, billing and reporting, information exchange, etc.), support the delivery of quality patient care, and improve profitability. The Clinical Module includes both Web-based Agency Front Office and Clinical Point of Care software that is easy to use, comprehensive and intuitive. The Web-based clinical application is accessible at the point of care using the Motion tablet PC, yet users do not have to be online to use the freestanding, pen-based module.
After its experience using small pen tablets with CareAnyware’s software since May 2003, Maria Parham transitioned the software to 12 Motion tablet PCs in November 2003 for use by 16 licensed staff, including nurses, therapists and social workers.
Parmenter deployed 26 Motion tablet PCs with CareAnyware’s software in November 2003, and 20 clinicians are using the technology.
According to Maria Parham and Parmenter, the Motion tablet and CareAnyware software has made each staff member’s day more efficient, letting them experience the full capabilities of the ehomecare.com application.
The Motion tablet’s full-fledged operating system, large memory capacity and speedy processor have enabled the clinical staffs at both HHAs to quickly and accurately input data. After using smaller pen-based devices for several years, Parmenter clinicians were particularly excited by the combination of Motion’s large 12.1-inch screen size and the CareAnyware application, which minimizes the inherent need to scroll around for information on smaller devices. Parmenter’s staff also appreciates the Motion tablet’s portability and handwriting recognition capabilities.
The tablet’s light weight and clipboard-sized shape enable the clinicians to easily hold the tablet in one arm and use the pen to unobtrusively collect data while with a patient. Motion’s robust battery life is also an advantage. The staff at Maria Parham needed a car adapter to keep the old pen tablets running, but found they had no need for the car adapters with the Motion tablet. Maria Parham’s staff also likes the Motion tablet’s user-friendly interface with built-in user’s manual and tutorials. The agency appreciates Motion’s peripheral offerings as well, since some staff members use Motion’s clamshell cover with the mobile keyboard inside of it. Maria Parham also found the Motion tablet was more cost-effective than similar products, especially with the lease option.
“Our clinicians prefer the tablet,” said Crumpler. “It was only once we changed to the Motion tablets that we were able to fully experience the ease and all the benefits of using the CareAnyware application. The ehomecare.com software is state of the art and truly needs to be used on a computer with capabilities that can match those of the application.”
Serving a rural four-county area, Maria Parham’s staff visits an average of five patients per day. Parmenter’s staff sees an average of five to six patients per day. On the road constantly, the ehomecare.com system on Motion’s tablets has reduced the time clinicians need to spend in the office. Because all the patient’s records are now electronic, and they have a robust computer in Motion’s tablet, the staff just needs to synch with the agency’s server a couple of times a day, from anywhere, to upload and download information.
CareAnyware’s software on Motion’s tablets has enabled Maria Parham to go paperless except for forms that require the patient’s signature, creating additional benefits. The staff used to spend considerable time making copies of everything, but the EMR function created by ehomecare.com has eliminated this task. CareAnyware’s clinical module includes forms that facilitate OASIS data entry right on the Motion tablet, in addition to other state and federal reporting requirements. With fast, accurate electronic data collection, records are kept much more current and accurate. Duplicate entries are no longer a problem and errors have been reduced since manual data entry from paper notes is no longer required. Maria Parham has been able to eliminate several clerical tasks as a result. In addition, the staff does not have to worry about losing file folders or paper records, complying more fully with HIPAA security guidelines.
Maria Parham used to outsource its billing, but CareAnyware’s software has enabled the agency to easily take the billing function in-house. Billing and clinical are now integrated, and because of the clerical efficiencies created by the system, the clerical department is handling billing functions.
Another benefit of the CareAnyware system was Maria Parham’s gradual transition from the paper-based system to the paperless one. The agency took six to seven weeks to transition to the Motion tablets, and the staff spent 10 to 12 hours in classroom training, steadily moving their caseloads from paper to computer.
“The system doesn’t force you to put in all information at once, so you can build patient records gradually,” said Crumpler.
In addition, CareAnyware’s software allowed Maria Parham to customize the application by tweaking assessments and adding questions based on state requirements.
Parmenter has experienced similar results. By integrating Parmenter’s clinical and billing systems, together with the fast and accurate data collection made possible by the Motion tablet, CareAnyware allows Parmenter to have one point of entry, decreasing mistakes and improving accuracy. Because there is no longer a need to reenter paper notes, duplicate entries have been eliminated and charting is much more streamlined.
According to Anne Foskett, home care supervisor at Parmenter, the comprehensive system has improved their overall processes.
“We would not have opted for a different technology,” said Foskett. “The system has made us more accurate.”