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Home Health Care Management (HHCM) is the parent company of Berks Visiting Nurse Association, Pottstown VNA and Advantage Home Care. The company serves eight counties with advanced nursing and physical, occupational and speech therapies as well as medical social work, dietitian service and hospice and palliative care.

With a total of 5028 patients visited in 2017, it’s a busy operation with a lot of issues, which were being tracked and investigated using a home-grown system that was tethered to the office. This was causing delays and incomplete reports, resulting in incorrect and unavailable data.

A reliance on paper forms made tasks time-consuming and inefficient. And the system was becoming obsolete and was prone to crashing. HHCM needed a new case management system that better matched the needs of a large public service organization with a mobile workforce.

The Challenge

HHCM’s large staff of caregivers spend most of their time on the road, caring for their patients. The system they were using made reporting incidents, accidents, complaints and issues inefficient, inaccurate and time-consuming.

“Our current system couldn’t be accessed by the field staff, so things were reported through the manager instead of directly from the field clinicians,” says Lynann DeCusatis, HHCM’s interim CEO. Nurses and other clinicians would have to either return to the office to enter the information or call the office and leave the report on their manager’s voicemail. The manager would then enter
the report into the system. “The Department of Health in Pennsylvania always asks for a list of our incident reports when they come here to do a survey or if they come on a complaint, and we had a hard time getting that information out of the old system,” she says.

Another challenge was that HHCM was unable to use its data to identify trends because the system didn’t have a mechanism to report by field, type, agency, etc. In fact, some parts of the business were still using spreadsheets to track incidents, so there wasn’t one common source of data to analyze.

The company was at an increased risk of a citation by the Department of Health for missing reports. “With the staff not being able to report from the field and having to come in, we weren’t getting all
the reports that we should have,” says DeCusatis.

The Solution

HHCM was looking for a configurable system that made it easy for clinicians to enter data from the field.

“If they can get it first-hand from a patient as a patient is describing a problem, or if they have a specific complaint they can take it down, the accuracy of the information, the integrity is so much improved because you’re not getting it from a third party,” says DeCusatis.

They also needed to enforce a workflow that eliminated free-form input and incorporated drop-down menus to standardize the information being entered and make reporting and trend analysis easier.

The ability to build forms into the system was important to HHCM, to eliminate steps and paper. Some incidents required clinicians to fill out multiple forms, which was difficult to enforce. They wanted to combine the forms into one streamlined intake process to increase accurate reporting and ensure compliance with reporting requirements.

Tailored System

Many of the vendors HHCM contacted weren’t able to provide the level of customization the company needed. “They tried to make their system work for us and it wasn’t going to work,” says DeCusatis.
“Then we talked to a customer which was using Case IQ for similar processes. He explained the Case IQ process from beginning to end, how Case IQ was able to customize their system to meet their needs.
He was so pleased.”

It was this detailed attention and customer service that made HHCM choose Case IQ for their new system. “The development team came down here and spent time with us and really dug to find out exactly what
we did here, what our expectations of the system were. They asked so many questions. It was a very good experience,” says DeCusatis. “For not knowing what home health was or how we operated, it was incredible how they dug to get to the bottom of what we needed and how we wanted this system to work.”

The Result

Now that HHCM is up and running with Case IQ, DeCusatis is enthusiastic about the changes that have ensued. “It’s saving time,
it’s increasing our reporting overall. And it helps us to improve our compliance. We’re Joint Commission accredited and we must be compliant with our incident reporting so this really helps us to meet the Joint Commission standards as well.” she says.

Faster Resolutions

Increased efficiency has resulted in faster turnaround for investigations and resolutions for clients and their families and quicker, more effective, reporting:

• Incident resolution has decreased from two weeks or more to 72 hours.
• Ongoing reporting that used to take two people an hour is now done by one person in five minutes.
• Quarterly trend reporting that previously took eight hours now takes one hour.
• Submissions from the field have increased by four times providing the data HHCM needs to identify trends and address shortfalls.

DeCusatis estimates that the efficiency increases with Case IQ save HHCM about $50,000 per year in employee wages. “Employees are able to spend more time in the field producing billable hours versus time out of the field to complete reports,” she says.

Better Reporting and Compliance

Better reporting has prompted better training and education, resulting in fewer incidents. “For example, with falls we can tell where the falls occurred,” says DeCusatis. “Do the majority of falls occur in the bathroom? Do they occur in the bedroom, getting out of bed, getting out of a chair? For infections, are they catheter-related infections? Is it an education issue that we need to do with staff proactively to avoid an increase in infections?”

HCCM achieves better compliance with Department of Health and Joint Commission reporting requirements. “Citations from the Department of Health can result in a provisional license with monetary penalties –having a system to document incidents decreases the likelihood of this happening as a result of an undocumented client/caregiver complaint,” says DeCusatis. With better reporting, HHCM is able to provide thorough, organized, professional reports.

HHCM now has an efficient, effective case management system, tailored to their needs, that saves them time and money and improves their compliance and reputation with regulators.

“All along the way and all through development there were times that we were able to test and see what works and what didn’t work, so that the system was perfect when it was finally completed,” says DeCusatis. “I can’t say enough about the service that [Case IQ] provided; it’s amazing. We work with a lot of
vendors and [Case IQ was] the most accommodating and patient and took the time to explain everything.”