A Data-driven Approach to Support Effective Case Management of the High Risk Home Health Patient
- Room: Potomac D
- Session Number: 802
Tuesday, October 17, 2023: 3:45 PM - 4:45 PM
Speaker(s)
Description
VNA of Ohio is a member of the VNA Health Group, a large non-profit provider of home-based services with just under 42,000 home health admissions in 2022. Innovation is imbedded in our mission statement. In 2015 we created the Connected Health Institute. Early projects focused on data collection, aggregation, and reporting. In 2016, we created specialty programs to care for specific populations. From there, the need to operationalize data from flat reporting into actionable information was apparent and we created a web-based application to organize and present information from multiple sources. Multiple times a day we mine Homecare Homebase to surface assessment findings that provide critical pieces of information about a patient and their individual risk factors, including social determinants and confidence in their ability to manage their condition(s). We have since expanded to wider patient populations with an evolving set of risk models and alerts, including sepsis risk.
Topic(s)
Methodology
Course Level: Intermediate; 1.2 Accounting CPEs (NASBA/BMO) 1 Nursing CNEs contact hours, 1 Nursing Home/Asst. Living Adm. CEs (NAB/NCERS)
Handout(s)
Additional Info
Learning Objective 1:
Discuss three broad categories of risk factors that home health patients often present with.
Learning Objective 2:
Cite at least one remote case management intervention for use when social determinants of health become a social need for an individual patient by the end of the session.
Learning Objective 3:
Name the three most prevalent factors associated with the need to amend the care plan during episode monitoring.
Primary Target Audience:
Home Health