Understanding the risks and potential returns on technology investments will be key for hospices’ sustainability alongside rising demand, workforce and economic pressures and cybersecurity risks.
Hospices nationwide have contended with increasing costs to deliver care, with many turning to technology to spread limited staffing resources across much needed underserved regions.
The financial lift and care model considerations are only part of the challenges hospices address when ramping up technology efforts, according to Catherine Harris, home health director at UVA Health. The Virginia-based health system provides hospice, palliative, pediatric, primary and emergency care, as well as bereavement support, among other services.
“[‘It’s] about how much of our future is high tech, high touch — it’s that balance between the two,” Harris said at the National Association for Home Care & Hospice (NAHC) Financial Management Conference in Las Vegas. “In terms of staffing … we’ve tried to use our systems as communication tools, and we’ve tried to reduce those barriers [by] listening to our staff and hearing what their problems are, and then focusing on them as the limited resource they are. We give data to our clinicians [and] try to hand them the information that they need to make the decisions when they’re providing care in the home.”
Cybersecurity and technology operating issues represent significant concerns, Harris stated. A recent global IT outage has helped illustrate the potential vulnerabilities in technology systems that can have massive impacts on health care delivery, she said.
Earlier in July the U.S. cybersecurity company CrowdStrike’s software update caused widespread outages to Microsoft Windows’ operating systems used by industries worldwide. The outage challenged health care delivery in several regions across the United States.
Technology disruptions such as these can impact timely access to hospice care, Harris indicated. Some hospices may have experienced challenges accessing patient electronic medical records, making clinical documentation, performing back-office administration and patient admission processes, as well as communicating with referral sources.
Having proactive policies and strategic response plans in place is increasingly important to sustainable technology advancements in end-of-life care, according to Harris.
“My team went on downtime procedures [on July 19], and at the end of the day, they could do everything they needed to do,” she said. “It’s important to focus on what they’re doing every day and that everything we do around that is to support that moment.”
Technology has played an increasingly important role in providers’ end-of-life care approaches, according to RJ Gagnon, CFO and COO of Andwell Health Partners. Formerly Androscoggin Home Healthcare and Hospice, the Maine-based company recently rebranded to better reflect its suite of behavioral health, palliative, hospice and home care services.
Leveraging technology has been pivotal to expanding patient reach, building operational efficiencies and ensuring interdisciplinary teams’ safety, Gagnon stated. An important consideration with technology investments is weighing whether they support a hospice’s unique service needs and boost staff satisfaction and retention, he added.
“We’re putting clinicians in vulnerable places all over the place, and are we giving them the right technology around safety?” Gagnon said at the conference. “There are technologies out there that are helping with that experience and giving them the feeling that organization leadership is investing. We have quite a bit of strategic focus on technology. We have to be really spot-on with understanding what technology we are putting into place, because it has to drive the overall value.”
Predictive analytics technology can help hospice clinicians determine which patients have the greatest needs, according to Gagnon. Some systems can also help identify root causes of downward margin trends and where a hospices’ biggest financial headwinds may exist, he added.
Hospices must ensure that their technology investments align with their data needs, such as measuring quality, outcomes and length of stay, providing insight around total cost of care and timely admissions, Gagnon indicated.
A significant challenge is that technology often takes time to fully mature before hospices begin seeing the potential benefits, according to Matt Chadwick, CFO, Well Care Home Health, which offers hospice and home health in North and South Carolina.
Hospices need a long onramp for integration and staff training when they scale a technology, keeping operational and financial aspects in mind, Chadwick stated.
An important consideration of technology evolutions in the hospice landscape is whether they drive clinical efficiencies, quality, compliance and help providers meet rising demand, he added.
“We had two options, which really were to push forward or retreat. We decided to push forward [but] it came with a lot of challenges,” Chadwick said during the conference. “It’s really helped our clinicians focus more on the patient in the home and gives us more data analytics on the back end that really helped us invest in moving forward. It’s really setting ourselves up to scale up.”
The financial components can make or break a hospices’ bottom line in some cases, said Sarani Doshi, vice president of corporate financial planning and analysis at VNS Health. The New York-based nonprofit provides home health, hospice and palliative care, as well as behavioral health and personal care/private duty services.
Technology can come with high price tags and heavy operational lifts, Doshi indicated. Hospices need to strike a balance in deploying their dollars and their staff toward potentially fruitful and sustainable technology growth, she said.
A hospice’s greatest return on a technology investment comes from having a cautious, analytical approach that continuously gauges the potential pitfalls around operations and quality, according to Doshi.
“We’ve been working with technology the past 10 to15 years, and our tools have slowly been added on top of one another,” Doshi said. “Taking a step back, what is your inventory, and what tools are you using? [It’s] assessing if you still need this. How is it being helpful to the value that you’re trying to add? Where do you need to build more? Where do you have those capabilities? Where do you need to draw back? We all have limited resources and understanding on the technology side, where are your resources going and where is the ROI?”
