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Home Health Plans & Doctors

New Studies Point Towards U.S Doctors Widely Ignoring Review of Details in Their Patient’s Home Health Plans


Home Health Plans & Doctors

June, 2018 

Recent studies indicate physicians approve  treatment plans Involving Skilled Home Health care after spending barely a minute to examine the details and treatment

Surprising statistics emerged from a recent study of American physicians currently practicing nationwide. In doctors who were empowered with the responsibility of treatment plan approval involving patients receiving skilled home health care services, most only glanced at the details of the plans for 60 seconds or less.

With over one thousand doctors running the gamut of specializations including geriatrics, general practitioners, family medicine, hospice and palliative care, more than 70 percent indicated they had signed off on a minimum of at least one plan for skilled home health care in the previous year. These patients had plans that were covered under Medicare. Among these doctors who certified and endorsed the plans, nearly 5 spent less than one minute reviewing the paperwork before applying their signature. According to the recent report cited in the Annals of Internal Medicine, roughly 20 percent of the surveyed physicians stated they spent more than 2 minutes studying the patient plans.

An independent researcher from John Hopkins University in Baltimore, Maryland cited that the official process whereby the patient plan of care is certified and acknowledged between the skilled home health caregiver/nurse, often entered into the agency’s home health software, and then endorsed either electronically or via paper, was flawed. The original process was designed only for regulation and payment by (Medicare), falling drastically short of fostering a true communication and system of checks and balances between doctors and clinicians, nurses or therapists who actually perform the care plan in patient homes.

Further exacerbating the situation is the fact that a good percentage of care plans are hard for the physician to read due to many variables such as font size, layout, and the format of the report. Additionally, many of the plans fail to properly emphasize the most pertinent information to delivering the appropriate care to the patient.

As a possible solution, some in the industry have suggested that instead of expecting doctors to spend more time studying and deciphering care plans, more innovative communication measures need to be taken to link the skilled home care agencies and their nurses/caregivers with doctors, in the interest of what is best for patients. Tools such as homecare software stocked with features like a physician’s portal, integrated faxing, and offline charting could certainly ease some of the burden; however in the end, physicians and to some extent, their attention to detail, are still the gatekeepers to a patient receiving the quality care they need.

Skilled home health care services can be recommended by doctors for homebound patients who require support from their nurses, caregivers, and physical & occupational therapists to manage the daily tasks that can facilitate recovery from injury or illness.

Given the $17.7 billion dollars plus spent annually over the last few years on skilled home health care services for more than 3 million beneficiaries, some consider it alarming that more than one third of Medicare patients do not get physician evaluation or care plan management services during their skilled home health care regimens. The findings did confirm that many physicians ordinarily interacted with multiple skilled home health care agencies using email or faxing. More than 80 percent of physicians reported that they had never or very rarely altered an order for skilled home health care services. Most reportedly simply signed off on whatever came across their desk. About the same proportion of doctors stated that they never (or rarely) contacted the skilled home health care teams and agencies of their patients to discuss their care plans.

The lion’s share of physicians surveyed stated that care plans could be improved by the addition of a brief, easy to read “need to know” section, complete with important clinical information. Many reported that if there were an easier way to contact skilled home health care agencies, that would also be very helpful.

Studies such as this have been generally forged as controlled experiments meant to prove or disprove how little or how much time doctors spend reviewing the plan of care, and further to draw a correlation to influencing the quality and length of patient care. Statistically speaking, many are still alarmed at the findings that such a large percentage of doctors are signing off on care plans they have spent little or no time even reading.

Family involvement in serving as the go-between involving patients, nurses, and physicians is always suggested to ensure that patients are receiving the proper medicines, care, and attention. A family member speaking up about how the patient is doing, can go far in rectifying things that may go overlooked.

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