Technology, Collaboration Pivotal to Speedy Hospice Admissions

Rising demand and prolific workforce shortages have strained timely access to hospice among dying patients nationwide. Hospices moving the needle toward improvement have leveraged multifaceted approaches that blend interdisciplinary care support with technology integration.

Hospices have limited windows of opportunity and time to reach patients upstream in today’s current health care climate, according to Dr. Tracy Romanello, medical director at Catholic Hospice and Catholic Palliative Care Services.

Patients are often referred to hospice very late in their illness trajectories, which leaves little time to address their full range of needs, Romanello said at the Hospice News ELEVATE conference. Having effective admission processes involves strong communication between referring providers and interdisciplinary hospice care teams, she indicated.

“What does a seamless admissions process look like? I have speed at the top of my list,” Romanello told Hospice News during the conference. “If you don’t get there quickly, that’s an unmet need. You have to be fast. As people are making the decision for hospice, generally, [it’s] because they have uncontrolled symptoms. And for a patient, you have to expedite meeting their needs. You have to coordinate care. Speed is super important.”

Hospice News photo by Merz Photography

Care collaboration has played a pivotal role in the ability for Catholic Hospice to improve and streamline its admissions, according to Romanello. The hospice provider is part of Catholic Health Services, which serves south Florida. Established more than 40 years ago, the health system is a ministry of the Archdiocese of Miami and offers assisted living services, home health, hospice and palliative care, among other services.

Reaching patients upstream is crucial to timely initiation of care, Romanello stated. Strong care coordination and communication is needed between hospice teams and referral sources. Also important is having systems in place to help identify patients in potential decline, which can result in reduced emergency and urgent care utilization, lower costs and improved quality at the end of life, she said.

Improving timely hospice access involves a strong focus on accuracy, particularly around patient eligibility and documentation, said Ernesto Lopez, CEO of the health care artificial intelligence company 1520ai.

Hospices need ways to ensure they avoid documentation errors such as incorrect dates, Lopez said. Having a record of improper documentation can be a referral red flag and potentially dampen a hospices’ reputation for quality.

Challenging hospices’ ability for speed and accuracy are issues such as high demand, workforce shortages and greater patient acuity, according to Lopez. These issues have some hospices doing more with fewer resources, he indicated.

“You have to have all those elements … those technical components of admission that are necessary need to be in place,” Lopez told Hospice News at the conference. “You have to get it right. It’s the impact that this team can make in getting there first. And you have to make sure that you’re effective. To be able to do that consistently, to close this admission process – for a lot of programs they struggle. It’s a challenge.”

More hospices are turning to technology to help strengthen their admission processes in recent years, said Transcend Strategy Group COO Courtney Penn. Among providers’ tactics is leveraging data to identify challenging trends among referral sources, such as high rehospitalization rates among medically complex or seriously ill patient populations, Penn indicated.

Transcend Strategy Group consulting company helps health care providers with change management and strategic growth plans, sales and marketing performance and staffing retention. The company also focuses on research on the varied outreach strategies among hospice and home-based care providers seeking to improve outcomes and grow their census.

Data-driven artificial intelligence (AI) has also become a bigger part of hospices’ sales and marketing efforts, she stated. Staff have mined community and geographically-based data trends to identify the greatest areas of unmet need among underserved patients, Penn stated. However, having a balance between human oversight and data-driven technology is key.

“What we’ve learned from working with hospice organizations across the country is that best in class admissions [aren’t] about working harder at what providers are currently doing,” Penn told Hospice News at ELEVATE. “It’s building systems that are smarter and designed to work with your unique organization’s referral patterns, needs and market demands. Before the AI adoption can start, before the [electronic medical record (EMR)] integration … an effective admissions process starts with that very first phone call. It really is about an interconnectedness of all of those pieces working together.”