Over the past few years, we’ve shared our approach to developing solutions for our hospice and palliative care customers. Applying digital transformation methodologies, we create solutions that leverage the latest benefits of technology. During recent visits to current and potential customers, we saw the advantages of this approach.
The digital environment allows a full range of access to information and functionality. The importance of this was highlighted as we discussed the process of obtaining hospice admissions documentation and processing revisions from patients and caregivers. We were shown firsthand the difference, in real settings, between simply overlaying digital tools on a paper-centric process and fully embracing the digital approach.
Replicating paper Process
In the paper-centric process, an admission nurse visits and walks patients and families through the documentation, explaining benefits and manually checking the information. If revisions or corrections are required, the nurse revisited the patient and caregivers to obtain the changes and re-sign the documents.
While some facilities have moved to “digital,” it is typically in PDFs or systems based on the paper process. Each form/PDF is independent of the others, meaning the same information is entered on multiple forms. The process still requires a nurse to visit the patient and caregivers for the admissions and any corrections/revisions. By simply overlaying digital tools in an existing process, facilities fail to leverage the digital environment fully; They are still using a “paper-centric” process.
For facility staff to access information, this process does provide some improvement. PDFs, or scanned documents, reside on the server and are accessible to those with the proper permissions. From an administrative perspective, this is clearly a benefit, as once collected, the information is available to the staff.
However, by simply overlaying digital tools on a paper-centric process, all the effort necessary to obtain and correct the patient information remains. Failing to adopt a truly digital-centric approach leaves many ‘solutions’ falling short. Here are a few ways this manifests in the hospice administration process.
Failure to Leverage Mobile
Mobile technology adoption is high among seniors, their caregivers, and families. The importance of mobile adoption and its implications for care facilities cannot be overestimated. By providing a true mobile-first solution, facilities reduce the time required of staff while providing better service to patients and caregivers.
Unfortunately, for most “solutions,” mobile is an afterthought. This leaves staff in the field with limited functionality, as well as patients and caregivers with limited access. In most cases, visiting providers can only access what they bring with them or have limited access to information on the servers.
How does a mobile-first, fully digital approach look vs a paper-centric approach?
The paper-centric approach, even when utilizing technology like PDFs and CRMs, heavily relies on in-person activity to facilitate education, information gathering, and consent/approvals. A mobile-first approach alleviates much of the burden.
Explanation of Benefits (EOB).
The paper-centric approach requires an admissions nurse to visit the patient and caregivers, walk them through the documents, and explain what it all means. This obviously takes time for the nurse but also requires resources for coordination and scheduling, not to mention no-shows or missed appointments.
With a mobile-first, digital approach, a set of explanatory videos and user-friendly “walk-throughs” provide patients and families with the full explanation. Additionally, should they need to revisit information, it and the explanations are always accessible. Of course, with email, chat, and phone, patients have access to professionals whenever needed. The core to this is taking a truly fresh look at how EOB can work in a mobile environment, not just giving access to documents.
This also eliminates the need for coordinating the schedule of multiple family members and caregivers along with the patient. With stakeholders geographically spread out, the digital approach provides the best way to share information, including EOBs.
By recognizing the mass adoption of mobile by seniors, a new set of tools opens up to allow facilities to provide service and information much more efficiently. People are familiar with the mobile environment and comfortable obtaining and sharing information using their phones, even welcoming the opportunity.
Gathering information and Obtaining Signatures
Perhaps the biggest challenge during the admissions process is collecting information and getting the appropriate signatures.
In the paper-centric process, without going into the minutia of the information itself, much time is spent by the admissions staff collecting and verifying it. Once collected and confirmed, an admissions nurse must be on-site to gather the required signatures. If there are any corrections to be made, the nurse must then revisit the patient or family to have them re-sign the documents, even a PDF version.
With a digital-centric process, information is gathered electronically, using the phone to photograph/scan paper, information is collected through easy-to-use forms, and people with access from virtually anywhere can provide the necessary information.
Within an application, tracking what has been collected and what is still required is easy and, more importantly, visible to both patients/caregivers and facility staff. Everyone is aware of the status. Admissions staff can proactively reach out with specific requests based on what has yet to be provided.
Signatures can be received electronically without the presence of an admissions nurse.
In the event of a correction to the information, the re-signing is also gathered electronically. However, these issues are reduced in a digital process because the information that is entered digitally can be compared to that on other forms or even applied automatically. Any discrepancies can be dealt with early on, reducing admissions time.
Challenges in migrating to a fully digital environment
We see facilities face a few common challenges to digital migration.
- A concern is that patients and families will be uncomfortable with a mobile-first digital process. By developing a mobile process that breaks down admissions into small, easy-to-do steps, it actually makes it easier for patients and families. A truly reimagined process removes much of the intimidating forms and information overload, reducing them to easy-to-consume segments. Our experience is that families prefer this approach.
- Perceived control. Physically having documents and watching a person sign forms provides admission staff with a sense of controlling the process. Even if it requires much more work, some individuals would rather retain a paper-centric process than rely on a digital platform. Ironically, with a properly implemented digital solution, admissions teams have greater visibility and control of the process.
- Inertia hinders adoption. Our instinct is to stick with what we know, even when something else may prove to be better. Good leadership is necessary for a successful transition to a digital process. Once done, people are more efficient and happier system-wide.
Transitioning to a Digital Process
Moving to fully digital admissions is easier with a partner who has helped organizations adopt the process. Having concrete examples of how problems were addressed and obstacles overcome builds confidence in the process among the stakeholders. With leadership’s support and experienced partners, organizations can make the transition from a paper-centric process to a digital.
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