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Improving care coordination for hospice patients in a paperless environment


In an effort to strengthen their collaboration in coordinating hospice care for mutual patients, Concord Regional Visiting Nurse Association and Genesis Healthcare (Genesis) partnered to create a pilot project focused on utilizing the latest Health Information Technology available. The result was a more complete and entirely paperless process for coordinating care.

In January of 2016, the two organizations set out to improve communication and care coordination by securely and electronically delivering hospice patient assessment information and other relevant health information from Concord Regional VNA to Genesis using the New Hampshire Health Information Organization’s (NHHIO) Direct Secure Messaging webmail product. The goal of the pilot was to prioritize the timely receipt of necessary healthcare records and apply effective quality improvement strategies using health information exchange (HIE) so that the required documents were accessible to clinicians at the point of care.

With the technical and operational support of the NHHIO team, Concord Regional VNA and Genesis met monthly to analyze their Direct messaging capabilities for both organizations, define personnel involved in the pilot, and identify documentation needed for improved care coordination for hospice patients cared for by Concord Regional VNA and Genesis. Over a six-month time-frame, the teams conducted a side-by-side analysis of documentation sent via traditional methods such as fax, mail and courier and compared it to the information received via the health information exchange. Both teams concluded that “it was very clear that the electronic process was more complete and current” than the paper process. Each team continued to analyze the timeliness of sending electronic documentation, redefined workflows to minimize paper handling and distribution, and maintained a strong commitment in leveraging the HIE opportunities available to them.

The pilot project between Concord Regional VNA and Genesis Healthcare is complete. All mutual patient healthcare information needed amongst the two organizations is now shared via Direct secure messaging, eliminating paper for patients cared for by Concord Regional VNA and Genesis Healthcare.

“The collaboration between Genesis, Concord Regional VNA and NHHIO to incorporate HIE into our patients’ care transformed an originally fragmented process into streamlined practice,” says Kristen Dubois, Project Coordinator for Genesis Healthcare. “We have increased our efficiencies by receiving timely and accurate patient healthcare documentation as well as reducing the time each organization took to manage the documentation for patients receiving hospice care.” Kristen continues, “This pilot program is so exciting because it prepared us for the many HIE opportunities that are coming our way. There are many other organizations with whom we need to exchange patient health information. This successful pilot demonstrated our shared efforts to improve increased efficiencies and processes to achieve higher quality clinical outcomes and better coordinated patient care.”

About Concord Regional Visiting Nurse Association: Concord Regional VNA is the largest home health and hospice provider in central New Hampshire. With more than 400 employees, the not-for-profit, community-based agency serves people of all ages by providing homecare, hospice, palliative care (as part of Capital Region Palliative and Hospice Program), personal home services, and wellness programming. In fiscal year 2015 and in consonance with their mission, Concord Regional VNA provided more than $3.6 million in community benefits to meet the needs of all individuals, regardless of a person’s ability to pay.

About Genesis Healthcare: Genesis HealthCare is the nation’s leading post-acute care provider of healthcare services, with approximately 500 skilled nursing centers and assisted/senior living communities in 34 states nationwide, 31 in New Hampshire alone. From short-term to long-term services, and a wide variety of living options and professional clinical services, Genesis HealthCare focuses on the vitality of the person. How and where we can make a difference in the overall well-being and healthy outlook of everyone we serve is the daily mission.

About the New Hampshire Health Information Organization (NHHIO): NHHIO is a 501(c)3 non-profit charitable trust organization whose mission is to securely connect healthcare communities to share patient health information needed for informed care decisions. We collaborate with hospitals, physicians, community health centers, long term care providers, home care providers and other clinicians involved in the delivery of healthcare.
Our vision is to be New Hampshire’s trusted resource for health information exchange, improving quality, efficiency and patient safety while reducing healthcare costs. To learn more about NHHIO and its services, please visit us at www.nhhio.org

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Provider organizations can increase efficiency by sharing data using a single electronic network instead of building multiple connections, or using traditional unsecure paper methods.