The integration of technology in home healthcare has transformed care delivery, presenting promising solutions to major healthcare challenges. Consequently, it is unsurprising that 99% of U.S. Health System leaders see digital transformation as a crucial investment for advancing health care within their communities. As we progress through the digital era, it's evident that technology is not merely an enhancement but an essential part of contemporary healthcare.
The Evolution of Digital Health Technologies
Digital health technologies (DHTs) encompass systems that utilize computing platforms, software, sensors, and connectivity for healthcare and related uses. These technologies range from general wellness applications to sophisticated medical devices, playing a crucial role in enhancing patient care and operational efficiency.
Technological Innovations Improving Care
Technological advancements continue to improve nursing and patient care in several ways. Predictive analytics, clinical mobility, mobile robotic systems, AI in clinical decision support, streamlined user interfaces, remote patient monitoring, and telehealth/telemedicine are just a few examples of how technology is transforming the healthcare landscape. For instance, AI applications are predicted to significantly impact areas such as robot-assisted surgery, virtual nursing assistants, administrative workflow assistance, fraud detection, and dosage error reduction by 2026.
The Impact on Nursing Practice
Innovative nursing technologies are revolutionizing both patient care and the nursing profession itself. According to a LinkedIn survey, 82% of professional nurses foresee ongoing positive impacts from these advancements. By automating routine tasks, improving communication efficiency, and offering precise diagnoses and personalized treatment plans, nurses are able to dedicate more time to delivering compassionate, individualized care. Additionally, nurses trained in technology can enjoy greater career advancement opportunities while furthering their mission to care for patients and save lives.
Virtual Care in Home Health
The COVID-19 pandemic accelerated the adoption of virtual care in home health. Initially met with hesitation due to concerns about patient outcomes, virtual encounters have proven to offer significant benefits. Today, health organizations face challenges to providing in-home care due to staffing shortages, and budget constraints. By incorporating virtual encounters into skilled nurse home health care plans, agencies can improve productivity, increase patient engagement, and reduce costs. Virtual care allows field staff to visit more patients during the acute illness phase, enabling agencies to take on more patients and retain staff by increasing satisfaction.
Benefits of Virtual Care in Home Health
Virtual care in home health addresses patient reluctance to accept in-person visits, addresses SDOH concerns related to transportation, loneliness, environment, and compliance with the plan of care. It provides real-time patient access to health services, increases patient engagement with the plan of care, decreases hospital readmission rates and emergency department utilization, reduces the cost of home health agency staff time and mileage, and increases touch points with patients, potentially improving the patient experience of care and CMS star ratings.
A recent study by Gorodeski et al. (2020) demonstrated that reducing in-person visits for post-discharge heart failure patients and incorporating virtual visits did not significantly affect hospital readmission rates, emergency department visits, or mortality. The study also noted an increase in the adherence of study participants to their PMD visits, demonstrating the value of virtual encounters.
CMS Guidance on Virtual Visits
The Centers for Medicare and Medicaid Services (CMS) have increased support for virtual encounters and telehealth services in home care. According to CMS guidelines, virtual visits must be part of the patient's plan of care, with specific frequencies and interventions outlined. This ensures that virtual visits are tailored to meet the patient's needs and help achieve the stated goals on the plan of care.
Tips and Recommendations for Setting Up a Virtual Visit Model
Here are some key tips and recommendations for setting up a successful virtual visit model. These steps can help ensure that your virtual visit model is effective, efficient, and provides high-quality care to patients.
- Define a Standard of Care: Establish a care standard to maximize skilled nurses’ home visits, addressing patients in acute stages, preventing disease exacerbations and hospital readmissions, monitoring conditions through symptom surveys and biometric data, intervening promptly via risk alerts, confirming medication regimens, and educating on medication use. Set a clear schedule for virtual and in-person visits, with more in-person visits initially to better manage acute cases and prevent complications.
- Develop a Clinical Workflow: Outline procedures for documenting virtual visits in the Electronic Medical Record (EMR). This includes how to notify the SOC RN that Remote Patient Monitoring (RPM) and virtual visits are recommended, how to admit patients to RPM, and how to write RPM and virtual visit frequency orders.
- Create Policy and Process: Create agency-specific policies and procedures to document the process, responsibilities, and requirements for skilled nursing virtual encounters. Ensure that clinician reimbursement reflects the time spent on virtual encounters and that the scheduling department understands productivity expectations.
- Tips for Providing Virtual Care: Be mindful of your background during virtual visits. Use a clean, uncluttered background and ensure it is HIPAA secure with no patient files visible. Position the camera to show your face and shoulders, with the camera slightly higher than eye level, aiming downward. Use front lighting on your face. Dress professionally, wear your agency identification badge, and demonstrate good grooming. Be prepared and use assessment guidelines to include everything needed during the visit. Complete documentation during and immediately after the visit.
- Recommendation to implement virtual care features: The Health Recovery Solutions (HRS) remote patient monitoring system supports every component of your virtual interactions, such as Bluetooth biometric tracking, live video calls, phone conversations, and texting. It also includes symptom surveys, condition-specific education, medication alerts, wound imaging, and tailored risk notifications.
Conclusion
The rise of technology in home health holds immense promise for the future. By embracing digital health technologies, healthcare providers can enhance patient care, improve operational efficiency, and address some of the most pressing challenges in the industry. As we continue to innovate and integrate these technologies, the future of home health looks brighter than ever.