Loop­ing in home-based care­givers

Modern Healthcare - - Innovations - By Rachel Z. Arndt

Man­ag­ing a pa­tient on a care plan means not just keep­ing in touch with the pa­tient but also with care­givers at home. That can be tough, since pa­tient por­tals gen­er­ally don’t al­low mul­ti­ple re­cip­i­ents on the pa­tient side to re­ceive mes­sages. In­stead, care­givers and case man­agers of­ten end up re­sort­ing to phone calls— lots of them—to stay on the same page.

Those phone calls, plus time spent ac­tu­ally car­ing for pa­tients, can add up quickly. On av­er­age, fam­ily care­givers spend about 24 hours per week on care, ac­cord­ing to a 2015 AARP re­port.

“A lot of times, you end up leav­ing mes­sages over and over again, so you kind of feel that you’re stalk­ing some­one,” said Monique Fleu­rant, a nurse case man­ager with Rhode Is­land Pri­mary Care Physi­cians Corp.

The physi­cians group, which says it cares for over 150,000 pa­tients, re­cently sought to ease that com­mu­ni­ca­tion bur­den and turned to Se­nior­link, with which it partners. The com­pany’s Vela soft­ware, which com­plies with HIPAA, serves as a plat­form for ev­ery­one in­volved in a pa­tient’s care to send text mes­sages, im­ages, files, videos and other for­mats, keep­ing in touch when the pa­tient is not in a med­i­cal fa­cil­ity.

“Think of it as a vir­tual care room,” said Se­nior­link CEO Tom Ri­ley. Each per­son in­volved in a pa­tient’s care can have a dif­fer­ent set of per­mis­sions, al­low­ing them to view some or all of a pa­tient’s in­for­ma­tion, in­clud­ing ad­vanced di­rec­tives and med­i­ca­tion lists. Or, Ri­ley said, think of it like Slack, the work­place mes­sag­ing pro­gram. Like Slack, Vela lets users di­rectly mes­sage each other and send group mes­sages.

A few other plat­forms, such as Lua, of­fer sim­i­lar ca­pa­bil­i­ties. Oth­ers are more pa­tient-di­rected, such as Car­ingBridge, which lets pa­tients cre­ate web­sites to share up­dates with fam­ily and friends. And My Cir­cle, from Quest Di­ag­nos­tics, gives fam­ily mem­bers ac­cess to each other’s lab re­sults.

But in gen­eral, HIPAA-com­pli­ant com­mu­ni­ca­tion tools for care­givers who aren’t nec­es­sar­ily health­care pro­fes­sion­als are rare. Re­searchers found that just 15 out of 200,000 mo­bile health apps pro­vided com­mu­ni­ca­tion tools for fam­ily mem­bers.

Vela pro­vides a shared cal­en­dar that helps peo­ple in­volved stay on top of ap­point­ments. The mes­sag­ing plat­form also al­lows for a more ef­fi­cient and doc­u­mented way for a case man­ager to make sure a pa­tient is tak­ing the right med­i­ca­tions by in­form­ing the pa­tient’s en­tire care team and fam­ily.

And that in­cludes the pa­tient’s home care­givers, who might other­wise be left out of the com­mu­ni­ca­tion with the pa­tient’s med­i­cal care team. “No other ap­pli­ca­tion that we came across mean­ing­fully in­te­grated the care­giver as part of the care team,” said Noah Bene­dict, chief op­er­at­ing of­fi­cer of the Rhode Is­land physi­cians group, which is now a partner client of Se­nior­link. “It was al­ways a lo­gis­ti­cal hur­dle.”

By loop­ing in all care­givers, Vela al­lows them to share in­for­ma­tion and add value, Bene­dict added.

The suc­cess of plat­forms like Vela de- pends in large part on the care teams them­selves. “Tech­nol­ogy is never the tail that wags the dog,” Bene­dict said. “You have to have a solid care model and care team to pull some­thing like this off.”

And as these mod­els be­come more preva­lent, ven­dors would be smart to find ways to con­nect the dots be­tween all mem­bers of a care team, said Re­becca Alt­man, man­ag­ing di­rec­tor at Berke­ley Re­search Group.

“Be­ing able to care for pa­tients in a lower-cost set­ting, which is their home, is far more cost-ef­fec­tive than tak­ing care of them in an ED or hos­pi­tal,” she said.

Based on cur­rent re­sults, Se­nior­link is pro­jected to end the year with $150 mil­lion in an­nual revenue, Ri­ley said. Some of that revenue comes from risk-bear­ing health­care or­ga­ni­za­tions that pay to use Vela’s se­cure mes­sag­ing on a sub­scrip­tion ba­sis.

The com­pany also of­fers other care-man­age­ment ser­vices, in­clud­ing what Ri­ley calls a “vir­tual nurs­ing home bed,” which is now avail­able in seven states, with de­ploy­ments slated in a few more by year-end.

For that ser­vice, Se­nior­link charges a Med­i­caid pro­gram or at-risk man­aged care or­ga­ni­za­tion $80 a day for care co­or­di­na­tion and man­age­ment through Vela, tele­phone calls and home vis­its. “We’re sav­ing state Med­i­caid and man­aged-care or­ga­ni­za­tions 50 cents on the dol­lar,” Ri­ley said. ●

“Think of it as a vir­tual care room.”

Tom Ri­ley CEO Se­nior link

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