Telemonitoring, electronic orders improve efficiency

Check state regs for use of electronic signatures

A shrinking workforce, expanding patient base, and sicker patients are challenges that many home health agencies are meeting with technology.

Most home health patients have chronic conditions not related to their referral to home care, but agencies must often address them in order to provide needed care, points out Beth Carpenter, president of Beth Carpenter and Associates, a Chicago-based healthcare consulting firm. Diabetes, congestive heart failure, and chronic obstructive pulmonary disease cannot be ignored by home health nurses caring for a patient who is recovering from surgery, she points out. "These patients often require more frequent monitoring, but home health agencies may not have the staff to increase visits - and reimbursement may not cover the cost," she says. "Fortunately, technology that helps home health agencies become more efficient exists," she adds.

Telemonitoring is one way to increase contact with the patient and to monitor the patient on a daily basis without making a visit, Carpenter points out. "Small agencies find it most difficult to implement telemonitoring because of the financial commitment," she adds. "Although telemonitoring can keep nurses from making too many visits, it can also help a nurse identify the need to amend a visit schedule," she adds.

Frequent monitoring of a patient's vital signs helps a home health nurse identify potential problems or the need to adjust a patient care plan quickly, Carpenter points out. "This flexibility is important to good patient care, but CMS [Centers for Medicare & Medicaid Services] regulations don't help us be flexible, because we are still required to get orders and physician signatures for every change," she says. Electronic orders and electronic physician signatures are one way to speed up changes in care plans, but the ability to use them varies from state to state, she points out.