1. Four Pressures
Shaping Post-Acute
Care Technology
Understanding Technology
in the Context of Pressure Relief
Pressure – although uncomfortable in the moment – shapes progress.
Pressure creates diamonds out of coal and transforms semiconductors
into technology marvels. In healthcare, pressure to prove outcomes,
contain costs and increase patient satisfaction (while serving a growing,
aging population) is fueling IT evolution and investment. It’s also fueling
confusion among providers looking to future-proof their organizations.
Putting IT solutions in the context of the pressures they alleviate can
help prioritize investments and manage expectations. This whitepaper
examines four pressures shaping the future of post-acute care and the
related IT advancements that address them. It concludes with three steps
post-acute care providers can take as they plan their IT strategies.
WHITE PAPER
Serve patients
Avoid readmissions
Remove friction
Prove value
1
2
3
4

2. 1. THE PRESSURE TO SERVE PATIENTS IN THE LOWEST-COST
APPROPRIATE SETTING
The pressure to serve patients in the most economic settings is fueling
opportunities for telemedicine (using remote technologies placed in a home
or other non-acute care setting for clinical evaluation, diagnosis, consultation
and treatment), telehealth (remote health status monitoring for compliance,
wellness and education) and mobile healthcare technology.
Managing patient care plans across a variety of care givers not confined to
the four walls of a single facility necessitates mobile-enabled automation built
on best practices and evidence-based protocols. Mobile care teams need
“anytime, anywhere” access to care plans, schedules and other information.
Mobile cloud-based solutions deliver this capability cost-effectively and
securely, and also can collect data from home medical equipment and
monitoring devices to track compliance and trigger alerts when intervention is
needed.
Mobile apps that engage consumers in managing their health will accelerate
data collection and tracking, and facilitate better care coordination. Juniper
Research’s September 2013 Mobile Health and Fitness Report forecasts
that by 2018 96 million people will use app-enabled mobile health and
mobile fitness hardware devices, up from 15 million in 2013. Post-acute care
providers will leverage mobile technologies to access evidence-based content
at the patient bedside to provide the right care at the right time, to capture
new data, and to modify care plans according to current circumstances.
Patients will increasingly use online portals to schedule appointments, get test
results and communicate with care givers. For example, patients with chronic
conditions such as diabetes or hypertension will use home-based devices
that measure blood levels and blood pressure and automatically transmit that
information to care providers.
2. THE PRESSURE TO AVOID READMISSIONS
The pressure to avoid hospital readmissions and the associated financial
penalties is intensifying the focus on patient compliance with discharge
instructions and recommended therapy.
For home medical equipment providers, automating orders and
communication between physicians to ensure any equipment in the home
meets the patient’s lifestyle needs, and automating re-supply are worthy
investments. For example, recommending lightweight, portable equipment
for active patients who need oxygen during the day improves the likelihood of
compliance with treatment protocols because use of the equipment doesn’t
interfere with the patient’s daily activities. Automating oxygen re-supply
NUMBER OF PEOPLE
USING MOBILE
HEALTH & FITNESS
TECHNOLOGY
Source: Juniper Research,
September 2013,
Mobile Health & Fitness Report
“We’re closely
tracking our patient
re-hospitalization
rates as part of our
evidence-based
practice.”
Homecare Company
in North Carolina
page 2 Four Pressures Shaping Post-Acute Care Technology
Mobile technology
offers opportunities
for post-acute care
providers to leverage
evidence-based content

3. further advances compliance, as does automating data capture from home
medical equipment and triggering alerts to care givers when behaviors don’t
align with care plans. Equipping referring physicians with detailed analysis on
how patients achieve and maintain compliance not only reduces the risk of
readmission and additional diseases, but also helps physicians improve care
and strengthens referral relationships.
Also for home health care providers, monitoring and treating patients
with conditions prone to higher rates for readmission is key to keeping
readmission rates down. An example is a recent study of home health care
agencies that followed the Depression CAREPATH protocol, developed by
Weill Cornell Medical College, and were able to show reduction in depression
symptoms by 60% and reduction in re-hospitalization by 40% vs. patients not
treated with the protocol. These types of quality outcomes can help home
health providers demonstrate their value to the hospitals in their community.
3. THE PRESSURE TO REMOVE FRICTION FROM DATA, DOCUMENT &
WORKFLOW EXCHANGE
Post-acute care providers who can’t interoperate – meaning smoothly and
electronically exchange data, documents and tasks across all of a patient’s
care givers – simply won’t survive over the long term.
Systematic and uniform data capture, reporting and analysis is a “must-have”
that manual systems can’t deliver. Data aggregation and data access are
fundamental technology changes required to improve patient outcomes,
streamline productivity and reduce costs. Including post-acute care in
interoperability strategies enables healthcare organizations to connect critical
patient information across all care settings to reveal more detailed patient
pictures for more specific treatment plans and improved patient care.
Technology that frees documents, clinical images, diagnostic images and
information from silos so that it can be easily captured, stored and exchanged
among systems and care givers is at the center of healthcare transformation.
Web-based, software-as-a-service (SaaS) solutions excel at communicating
with multiple and disparate systems and data warehouses that are essential
to collaborative care.
4. THE PRESSURE TO PROVE VALUE
As healthcare shifts from a volume-based model to a value-based model,
more care is being provided outside the four walls of a hospital or doctor’s
office, expanding the scope and relevance of post-acute care. Providers must
go beyond delivering quality care at reasonable costs; they need to irrefutably
demonstrate that they are.
page 3 Four Pressures Shaping Post-Acute Care Technology
“For a large
organization like
ours, the flow of
information that
Brightree provides
is vital to our ability
to provide better
care and stay in
compliance.”
Albemarle
Homecare & Hospice

4. www.brightree.com
Benchmarking agencies against best-practices and others providing similar
services is becoming increasingly important. Agencies are using this data to
market their services to Accountable Care Organizations (ACOs) and physician
groups, and to see their performance in a larger context that reveals where
they need to improve.
Public reporting of outcomes through services such as Home Health Compare
for home health agencies, and soon a comparison for hospice organizations
with the new mandated Hospice Item Set reporting, enable consumers to
exercise their right to make their own informed post-acute care choices
rather than simply accept recommendations from physicians or acute care
personnel. This evolution heightens the need for post-acute care agencies to
leverage software systems that monitor and empirically prove outcomes.
Three Steps Post-Acute Care Providers
Should Take
To ensure ongoing viability as healthcare industry pressures mount, post-
acute care providers must invest in technology that helps them prove they
are efficient, high-performing, and able to easily interoperate with providers
across the care continuum. Here are three steps that can help:
Identify current challenges in collaborating across post-acute care settings,
and with acute and ambulatory providers. Where is the friction? Where are
balls dropped? Where are costs too high?
Do a reality check on change. Understand that some challenges will involve
technology, and some will involve culture. Consider hiring a consultant to help
you through both.
Embrace pressures as opportunities. There is a Chinese proverb that
observes, “When the winds of change blow, some build walls while others
build windmills.” Those who invest in technologies that harness data,
workflows, document exchange, mobile access and other elements to create
more seamless and accountable care across settings will not only survive, but
thrive as the winds of healthcare change continue to blow.
Four Pressures Shaping Post-Acute Care Technology
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