The Keys to Preventing Home Health Care Documentation Downfalls

What are the workflow and software practices that raise your home health agency’s success?

In an era where the use of paper in healthcare is nearly obsolete, home health agencies face challenges with best practices to refine the use of their home care software system. Technology in home healthcare is meant to be the vehicle driving staff to successfully perform their work with goals to improve efficiency, avoid payment delays, seamlessly comply with regulations and ultimately allow staff to prioritize their attention on providing outstanding care. How does your agency fare in today’s digital era?

Common Concerns for Agencies

With tight budgets, home health agency leaders cannot afford to purchase a program with too many bells and whistles that are not being used on a day-to-day basis. Although there can be a variety of complaints specific to each home health software program, there is common ground amongst users. Persistent complaints surrounding technology in healthcare include:

• a steep learning curve which can make patients feel second to electronic devices and increase workplace stress amongst staff,
• a lack in input from patients and clinicians in program design leading to barriers in usability and reduced product engagement from staff,
• lacking or lagging customer service to support staff which increases the chance of care breakdown and negative patient outcomes, especially during critical point of care moments,
• a cumbersome process to integrate which involves disruptions to staffing and a loss of income at least during transition phases,
• regulatory compliance is outdated, which leads to a survey scramble and the discovery of inadequate documentation,
• fragmentated EHRs leading to nurse burnout and turnover related to workplace frustration.

Evaluating Current Practices

Agencies need a software program that checks many of their needs boxes to support them today and with future growth. The use of multiple platforms create not only duplication but also sets the stage for mistakes due to human error factors in needing to remember how each program is utilized.

An all-in-one solutions with documents that can unify the EHR, flowsheets, progress notes, plan of care, billing, and outside records in one centralized home health software system will bode the best for team communication, efficiency and workflow. Overall, the right product will ease burdens associated with documentation and improve accuracy and workflow.

The best home health agency technology will:

• automatically maintain currency with regulations,
• focus on documenting the essential details thereby reducing time spent by staff on a device, improving the ability of staff to identify the most critical information easily and increase the amount of time available for direct care,
• provide initial transition support and have representatives available for reliable service to users with ongoing use of the product,
• allow for easy communication between staff to discuss roles, responsibilities and follow up needs.

Research from The Journal of Applied Clinical Informatics emphasize the need for technology to be carefully selected for application within the home health context and unique constraints.

Recommendations include:

• Utilize portable or mobile technology that simultaneously allows the user to be compliant with the standards of patient privacy and infection control while still allowing efficient data entry.
• Have a system that is developed to integrate into an already established workflow. Staff can adapt and change, yet better compliance is found when technology supports current processes and adds few new steps versus an overhaul of an entire workflow.

Each department should be reviewed for potential improvements, getting insight from the team on the biggest roadblocks to perform their job the best. It is also important to gather staff input on potential solutions, in an effort to consistently improve home health care agency processes and workflows.

For example, staff that are used to checking boxes for administration of medications and treatments want to be able to click through simple, readable and readily available EHRs. In addition, staff need to be able to easily modify or update changes to medications during start of care or routine visits or it may not be done. Staff performing repetitive tasks that need to document progress notes and assessments desire to have the most used findings and notes pre-programmed as choice clicks with an automatic move from one section to another without further navigation. This also supports a reduction of unnecessary information in narrative text for a clearer message in the chart. Having documentation processes that are modified to be more efficient helps organizations maintain compliant with policies more easily.

Optimal workflows also include having technology tailored to support the home health agency’s population. For example, if the agency exclusively works with a pediatric population, remove unnecessary documentation relating to adults and include items that are pediatric specific such as the use of diapers, fontanel status, the FLACC (face, legs, activity, cry, consoling) tool, bottle/breast feeding and more in the correct sections. If your agency provides intravenous therapy, an avatar with the availability to find the line type and site visually is more helpful than digging through multiple documents. Today’s patients, or parents of patients, are busy and more technologically savvy. They may prefer a text message visit confirmation through a secure chat instead of playing phone tag when they are busy with work or other siblings.

Effective use of software within home health agencies is foundational to the product of organizational success. Empower the entire team to evaluate current practices for ways to improve workflow and find solutions that deliver what your agency needs. If options aren’t available with current technologies, consider a change in software. The right product is sure to provide a return on investment and move the organization forward.

Additional reading:

1. Technology and home health care
2. AI in home health care documentation
3. How to choose the best home health software
4. What’s coming in the future of home health care?