Readmissions Battle Gets Help from Tech

Last week's column on the shortcomings of some EMRs hit a nerve, and introduced what will be a continuing theme for me going forward: pointing out technology that makes other industries look good, but has yet to really impact healthcare.

The example I gave last week of such a technology was "big data," which marketing mavens are tapping to delve into the psyches of their customers to help them figure out what customers want even before the customers know.

This week's example comes from the travel and leisure industry, where a cornucopia of online choice and scheduling make vacation planning a breeze—a far cry from the days when travel agents (however skilled) made vacation planning tedious at best, and woefully misinformed excursions at worst.

Nurses and others involved in the hospital discharge process are still acting as healthcare's travel agents today, as they labor to find care for patients being discharged. The process is labor-intensive, taking nurses away from the care they need to provide and instead chaining them to telephones and fax machines requesting patient transfers to this long-term care facility or that nursing home.

If that facility turns out to be a poor fit, it can become a factor in high readmission rates to hospitals. It's a shame to think after all that non-nursing-skilled labor, nurses could be inadvertently contributing to readmissions.

What if, instead, hospitals were able to borrow a best practice from the travel industry? Now some case management directors say they've found a service provider that does just that. Massachusetts-based Curaspan Health Group provides software-as-a-service that takes care of transmitting patient records and clinical documentation and sending them to the next provider in the chain of care. That eliminates the phone call and fax labor and speeds the process of getting a referral request on its way.

Here's the travel industry tie-in: Because it's an online service, the solution enables providers to search a database of those care facilities, and hospitals benefit from reports detailing which facilities were referred to most often, and which ones declined or delayed care and for what reason, such as insurance denials.

The software-as-a-service also enables discharge personnel to communicate with and share documents with transport companies and payers, traditional sources of phone and fax labor.

Here are some other ways software-as-a-service solutions could curb readmissions:

• Identifying the highest readmission rates by post-acute-care provider, diagnosis, and time of day. That way, hospitals can zero in on the problem providers, particular caregiver issues with those providers, and troubleshoot getting the right care to the right patients at the right time at those facilities to reduce readmissions.
• Looking at how post-acute providers processed referrals. Did they review them all in a timely manner? Did the information provided lead to better matches between hospitals and post-acute facility? That could reduce readmissions.
• Time-and-date stamping all online activities by personnel at all facilities using the software to  create an automatically-generated audit trail that can improve accountability at those facilities, enhancing treatment and reducing readmissions.

Think about how the travel industry exploits the information they now have about travelers to maximize their profits and yet pamper their customers. This is the mindset that healthcare needs to adopt.

Data-driven technology is the linchpin to making this happen in hospitals. Think of how those in the travel and tourism business have been freed from the drudgery of manual tasks in order to spend more time with customers. That should be happening across the board in healthcare too.

The move to Accountable Care Organizations will pull in the stragglers, but it's clear many providers aren't waiting for that in order to fix broken and costly processes today.

There's also increasing federal funding for making programs like this happen. Earlier this month, the Centers for Medicare and Medicaid services announced a second set of sites for its Community-Based Care Transition Program (CCTP). CCTP provides funding to test models for improving care transitions for high-risk Medicare patients. For more information on these sites, check out the March 14 announcement by the National Transitions of Care Coalition.