io HealthTM GrandCare Health
Point-of-care Optimization Software Drives Home Health Documentation Costs Down 5.1% and Revenue up 9.1%
David Bell, Ph.D. and Tiffany Shubert, Ph.D. PT
EXECUTIVE SUMMARY: io AssistTM , a Point of Care (POS) OASIS documentation and virtual education tool was implemented and
evaluated over a four-month period in three Home Health agencies. We compared performance during the study period to the
prior year baseline and found significant improvements in accuracy and efficiency:
- Functional scores increased 7.8 points (+/- 1.9) for SOCs submitted by clinicians using Io Assist.
- Score changes led to a 9.1% ($243) higher revenue per episode.
- Visit plus documentation time decreased by 5.1% (5.7 minutes) +/- 2.6%.
- Clinicians satisfaction was neutral to positive.
- Results show a significant and continuing trend.
Ash Rahman
BACKGROUND
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BACKGROUND
The home health industry faces heavy documentation requirements and needs faster point of care data entry with better data accuracy. OASIS is a standardized data set required by the Centers for Medicare and Medicaid Services (CMS) for every covered home health patient. Hundreds of data points are collected for each patient, including their degree of independence in activities of daily living, diagnoses, medications, and demographics.
Home health agencies send this data to CMS, where it is used to determine reimbursement, star ratings and value-based purchasing scores.
Providing accurate OASIS data is challenging due to the complexity and large number of questions. OASIS documentation time, not including patient-facing time, ranges from about 45 to 90 minutes per patient, depending
on the complexity of the case. Current workflows to identify and correct any data entry errors are time consuming as they require clinicians to fix errors after the fact based on feedback from the office.
PRODUCT
io AssistTM was developed by home health industry veterans to make OASIS data collection faster and more accurate while complying with CMS and state regulations.
io AssistTMproduct was designed to help clinicians practice at the top of their license by providing basic data validation and education in real time. Io Assist uses information about the patient diagnoses and presentation to provide data validation in the context of their existing clinical workflow to minimize training time. For more information what io AssistTM is and how it works, see this short demo.
io AssistTM software runs on Android tablets and is deployable via a Mobile Device Management (MDM) system.
STUDY METHOD
We tested io AssistTM at GrandCare Health Services in January to April 2024 on approximately 600 patients per month. Starting in January of 2024 io AssistTM was rolled out to eight clinicians and to additional clinicians in February. By April, io AssistTM was rolled out to all 120 GrandCare clinicians.
We measured outcomes of clinician speed and accuracy from January to April, comparing those results to the baseline period of January – December 2023.
RESULTS
io AssistTM was adopted easily by clinicians. Training was approximately 5 minutes, and survey results indicated that clinician reaction ranged from neutral to positive. Clinicians commented that io AssistTM helped them work faster with greater confidence in their documentation. It was found to
be particularly helpful for novice home health clinicians.
Functional Scoring
io AssistTM initial implementation focuses on scoring patient function (M1033, GG and M1800s). Higher scores indicate greater patient complexity and result in higher reimbursements on average.
During the study period, functional scores as submitted by clinicians increased from 19.8 in 2023 to 29.7 in April, with a statistically significant increase every month. An unexpected result was that these increased passed through QA, so final scores also increased by around 10 points.
Documentation Time
io AssistTM helped clinicians complete documentation faster. During the study period, total visit plus documentation time decreased by 5.68 minutes (+/- 2.86). The savings was more significant for physical therapists than for nurses.
Reimbursement
More accurate functional scoring resulted in an increase in revenue per episode of 9.1% (+/- 1.6%).
DISCUSSION
The results strongly support io HealthTM is an effective tool to support clinical documentation efficiency and accuracy. Moreover, the trend is significant and continues throughout the study period, suggesting that clinicians have learned and changed behavior over the period. Preliminary reviews of the data suggest that results from other companies using io Assist are consistent with those observed at GrandCare.
During the coming months, io AssistTM will continue to implement new functionality that is expected to improve on the results reported here, particularly by reducing clinical documentation time.
