Maxwell Healthcare CEO: Hospice EMR interoperability is coming


In a changing payments and regulatory environment, hospices are focusing on factors such as data collection, effective revenue cycle management, and electronic medical records (EMRs) interoperability. According to Jennifer Maxwell, CEO and co-founder of Maxwell Healthcare Associates and strategic advisor for home care technology company Medalogix, providers who leverage technology to achieve these goals must implement these systems carefully, including training. Staff.

Medalogix is ​​a holding company of private equity firm The Visstria Group. The provider of palliative and home care solutions merged with Muse Healthcare earlier this year under the Medalogix brand.

Maxwell told Hospice News that she and her co-founder Tom Maxwell launched their consulting firm in 2016 in response to growing competition in the hospice and home health industries and a regulatory and payment model environment. evolving.

Maxwell recently spoke with Hospice News to discuss the challenges ahead for the adoption and optimization of hospice technology, and how vendors can stay ahead of the curve.

What are some of the most important things hospices need to put in place to provide the right care at the right time? Can you tell us more about this issue and what you consider to be common concerns?

It’s really about delivering the right care to the right patient with the right resources. Healthcare is going to be a continual change in regulations, finances and patient demographics. I’ve been in the home health and hospice industry for so long in business development and counseling, and I knew there was a niche need for this care, but I didn’t know how to explain that need until. ‘We start to dig deeper into what really is is a three-pronged approach. It’s the people, the processes and the technology for the future of healthcare. If you don’t have all three, then it’s like the three legs of a stool – it won’t stand on its own.

Your technology needs to be configured appropriately as a sort of foundation for business operations. Working with home care agencies and hospices that report these kinds of issues, it’s often that they saw a technological solution, that they thought it was really great, but they didn’t. really looked at what their operations are today and what it will look like differently with new technology in place. You can’t just put the technology in place to solve the problem. You need to make sure that it is mapped correctly, that it feeds into the organization’s goals, and that it is efficient, so that from field staff to the back office, it is easy to use for everyone. The technology itself is obviously expensive, but if you don’t have buy-in from your end users, the technology is worthless to your organization. You need to change the people involved in the process and have change management to be able to implement the technology appropriately.

What do you think are the biggest challenges palliative care providers face in optimizing and leveraging technology?

Referrals, patient admission and admission, planning and eligibility are four key elements that can break up a hospice patient’s care and create chaos for the organization. This is to ensure that these four elements are streamlined, managed and understood.

The billing element has received intense regulatory scrutiny as it covers all of the required documentation. The packaging of the documents for the reimbursement is enormous. Ultimately, patients will not be seen on time if you are not able to bill them on time, which diminishes your source of income.

We see a lot of things upstream with high staff turnover. Recruitment and retention right now is a big challenge. Regardless of the overall optimization, we find that many agencies struggle with clinical staff and have to turn down referrals. It is heartbreaking to have to turn down a patient in need of care. How can we make life efficient for end users of technology within a hospice organization, and how can we help them recruit better?

When you think about interoperability and other technologies that can integrate with their EMR, there are some great tools and elements that can help with the redundant tasks and workflows needed by agencies to see patients, bill. patients and stay in compliance.

What would be your biggest tip for hospices in terms of key data to monitor and analyze? How can they shape operational best practices around this information?

I would say staffing levels and patient count levels are important.

With the census, it’s all about knowing your credentials and your conversion rates. How do you get referrals? What are their visits per benefit period? If you have a lot of patients and they have very short stays, you have capitation issues for which you are only paid a certain amount per patient per year. If you maintain this churn rate, you will not get the full benefit of this patient’s stay. You could dive into your cost per visit by discipline and then look at your count, your length of stay, your conversion rate. There is a lot of scrutiny in the documentation of patient stay over the past seven days, to make sure the documentation is really good, monitor your cap liability, and then leverage the technology for you. help do more with less.

Automating robotic processes is huge business, and there is a lot to come. Plus, know the criticality of your patients through the use of a monitoring tool that can store and stack your least important needs down to your most critical patient. Manage patients using technology and optimize all technologies, not only the EMR, but also ensure that it provides data to clinicians, medical directors and all staff to know exactly where to locate the needs of this patient today, tomorrow and trends.

The use of artificial intelligence functions to continuously learn from the patient improves the success of these agencies. Adopting technology for the future is really the way to go in order to be able to care for more patients with less resources and to do so with the highest level of quality possible.

What are the biggest hurdles on the horizon that technology could alleviate for vendors?

You can use predictive analytics beyond patient care to see how your staff are performing. If you see their behavior changing over time, what could you do differently to support them? Data can help determine what their needs are.

Employee satisfaction is going to be huge so that the agencies are also sustainable in their budgets. If you think about the cost, some agencies have a turnover rate of over 100% in certain areas and that’s a high cost to incur. It’s also really a competition issue between the agencies, because they offer sign-up bonuses and things like that to keep these clinicians and their staff while the next agency does something a little different. At the end of the day, when I talk to clinicians and end users who are in the field or in the back office, I make sure that you have the right technology for them and that you make it easy to use. Pay attention to the technology you are implementing, so that you have happy employees who can be at the bedside and provide the care patients need.

Also, it’s about having a systematic approach to how you get on board, train, and teach the why of technology. It’s a continuous cycle, you don’t do it once and assume everyone understands it. This is continuous quality improvement to make sure you are meeting the needs of your employees.

How do you see the hospice space evolving in terms of interoperability?

I see we’re going to tip the needle here over the next couple of years, and we’ll see movement on all kinds of new laws and ideas. The pandemic has created innovation beyond what we normally did. Sad to say, there is a great opportunity to see new and bigger things happening, and even to improve the quality of care patients receive at home.

You have patients who love the technology in their homes that helps them be continually independent, but that’s another cost burden on the provider. There is still work to be done when it comes to telehealth and what we do with it and what remote patient monitoring and artificial intelligence devices we put in place. There are a lot of companies out there that are really trying to get creative right now.

Interoperability is coming and we are seeing more than just tech companies partnering with all EMRs. We’re also seeing vendors working and learning more about how to get upstream from risky entities. They want to monitor the patient’s journey before they hit home health or hospice and get data back and forth.


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