Tech Reshaping Hospice Care

Technology is changing the ways hospice care is delivered. From the evolution of electronic medical records (EMR) to the advent of artificial intelligence (AI), hospice providers are leveraging new systems to create efficiencies, improve patient care, and make their organizations more attractive to investors.

Numerous organizations are discovering the value of predictive analytics, telemedicine, and emerging communications systems.

VITAS Healthcare is working with AT&T to develop therapies using 5G virtual relative systems to address chronic pain and anxiety among hospice patients. Health care technology companies like WellSky and Hospice Source have been partnering with hospice providers to integrate AI systems into work flows.

Providence St. Joseph Health’s TrinityKids Care, a large pediatric hospice provider, is using virtual reality technology to comfort terminally ill children, including scenarios in which they fly into space,  battle robots, and swim with whales.

“This is the most exciting time ever for technology and innovation in health care, and the opportunity to leverage technology in new ways to improve care has never been better,” Stephen Collens, CEO of MATTER, a Chicago-based startup incubator focused on innovation in the health care space, told Hospice News. “That’s why you see so much investment in digital health, and that’s why there is such a rapid rise in companies and entrepreneurs focusing on it.”

One key aspect of technology that is gaining ground in the hospice space is predictive analytics, systems that analyze patient data from EMRs to predict changes in a patient’s condition. This has been particularly beneficial in enhancing performance on key quality measures such as registered nurse (RN) and social worker visits during the patient’s last seven days of life.

In addition to being an important component of quality patient care, visits at the end of life have an impact on an organization’s publicly reported quality scores as well as their bottom lines. The U.S. Centers for Medicare & Medicaid Services service intensity add-on payment program provides additional payment to hospice providers for nurse and social worker visits during the patient’s final days.

“The advancement of analytics are helping us take the curtains off the picture that we want to see at the end of life. I think as we learn more and as machine learning evolves we are going to see clear patterns of what happens to a patients progression with their diagnosis or group of comorbidities, when they are nearing death,” said Cindy Campbell RN, BSN, MHA-Healthcare Informatics, director of operational consulting for Fazzi, Inc. “No one can predict death with certainty, but I think as analytics become more powerful and more accurate we can give our clinicians the tools they need to have flags on their EMR showing that end of life is likely approaching.”

These systems also represent a learning opportunity for clinicians to help them better perceive patterns in patient deterioration and recognize signs of decline, according to Catherine Dehlin, BSN, CHPN, CHCM, Fazzi, Inc.’s director of hospice services.

Hospices are also leveraging communications technology to create efficiencies and improve responsiveness to patient and family needs as well as care coordination. Clinicians can now communicate instantly rather than making a phone call that may sit in a colleagues voicemail for hours. Telemedicine technology also allows clinicians to consult instantaneously with specialists from the patient’s home, such as a wound care expert.

Telemedicine is becoming increasingly important in rural areas were clinicians may have to travel significant distances to reach the patient.

“We also appreciate other advancing technology, such as telehospice care. I have seen this effectively supporting on call, for example,” Campbell said. “Rather than immediately driving 40 miles in the middle of the night, hospices have been able to connect with caregivers via secure Skype-type devices, allowing us to intervene faster. We have seen great results from that.”

With all the benefits technology can bring, hospices and investors also encounter challenges. The usefulness of technology often depends on how well it is implemented and how well staff are trained to use it. Also, return on investment for the time being comes over the long term. It may be a number of years before companies recoup the outlay of funds.

“There has been a huge amount of capital invested in digital health generally. In 2010, health care companies invested $1.2 billion. Fast forward to 2018 and the amount was $15 billion. Then you look at the overall capital that is coming back to investors and so far it’s very little.” Collens said. “One factor is that health care tends to take longer and a lot of companies generally require more capital to advance than most do in some other industries so the investment potential hasn’t been realized yet, but it will be. That’s what happens with early stage investing generally.”

According to Collens, depending on the type of technology and type of business, technology can be a factor in making a company more attractive to investors or potential acquirrors.

“If you are talking about a company that is using really sophisticated machine learning to generate information that is going to inform care decisions, then the technology that they are sitting on and the tech capabilities of the people in the company are hugely important,” he said.

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