Tag Archives: LVM Systems

Care Management and the Contact Center


LVM Systems

Traci Haynes, MSN, RN, BA, CEN, CCCTM

The need for care management continues to grow exponentially in the United States. The ever-increasing number of chronic conditions in both adults and children has placed greater demand on healthcare resources and services. US healthcare spending reached an all-time high of 3.81 trillion dollars in 2019, with a predicted growth to 4.01 trillion dollars this year. 

In a report from the Centers for Medicare & Medicaid Services (CMS) Office of the Actuary, healthcare spending is expected to grow by 5.4 percent from 2019 to 2028. This prediction will result in healthcare spending at 6.19 trillion dollars and will account for 19.7 percent of the gross domestic product (GDP), up from 17.7 percent in 2018.

The Center for Disease Control and Prevention’s (CDC) National Center for Chronic Disease Prevention and Health Promotion indicates that six in ten adults in the US have a chronic disease and four in ten adults have two or more. The CDC also estimates that about 25 percent of children in the US, ages two to eight, have a chronic health condition. They report that a concise list of risk behaviors causes many chronic diseases. These include tobacco use and exposure to secondhand smoke; poor nutrition, including diets low in fruits and vegetables and high in sodium and saturated fats; lack of physical activity; and excessive alcohol use.

Care Management

Many of the complications of the most common and costly chronic conditions such as heart disease, stroke, diabetes, COPD, obesity, and asthma could be prevented or better controlled. Also, many individuals who struggle with multiple conditions often have combined social complexities. Even the most clinically astute patients find it difficult to navigate complex and fragmented healthcare systems, especially when the responsibility falls to the individual alone without adequate support or partnering. This difficulty in navigating healthcare systems often results in inefficiencies, increased costs, and poor outcomes.

The contact center can play a vital role in managing and improving the patient’s condition Click To Tweet

The Agency for Healthcare Research and Quality (AHRQ) states that “Care management is a promising team-based, patient-centered approach designed to assist patients and their support systems in managing medical conditions more effectively. It also encompasses those care coordination activities needed to help manage chronic illness.

In 2012, The American Nurses Association (ANA) stated that “Patient-centered care coordination is a core professional standard and competency for all nurses, and should be the foundation for all care coordination programs.” They also said, “Nurses need to position themselves within the interprofessional team to perform this core nursing process and contribute to better patient outcomes.”

Doing this involves systematic, organized teamwork, including the patient and family, and requires communication among all participants.

Currently, care coordination is one of the National Quality Strategies of the National Quality Agenda. A coordinated effort involving an interprofessional team with the patient and their family can help achieve the Institute of Healthcare Improvement’s Triple Aim goals of better care, better health, and reduced costs.

As part of their triple aim interventions, the AHRQ supports identifying populations with modifiable risks, aligning care management services to the needs of the population, and identifying, preparing, and integrating appropriate personnel to deliver the needed services.

Contact Center Support

The contact center can play a vital role in managing and improving the patient’s condition. By routinely checking on the patient at predetermined intervals and monitoring the individual’s plan of care, the contact center can communicate with the interprofessional team providing a picture of the patient’s current and recent status at that particular point in time. 

Using telecommunications can provide invaluable connectivity to monitor patients and provide a meaningful 24/7 service for clinical assessment capability and episodic care and interventions, should the need arise. And now more than ever during these unpredictable times, individuals both with and without chronic conditions, are avoiding or delaying preventative and needed care.

Nurses provide invaluable expertise in coaching, educating, and improving an individual’s self-management skills, thereby increasing the quality of care, resulting in better outcomes. They are also able to provide an assessment of symptoms and recommend interventions, often decreasing exacerbations.

The ANA, the American Academy of Nursing (AAN), the American Academy of Ambulatory Care Nursing (AAACN), and the American Organization of Nurse Executives (AONE) each contribute resources for care coordination in the form of position statements, white papers, frameworks, policy briefs, core curriculum, and courses. There are also effective models and tools, along with hospital and community-initiated programs.

Conclusion

Contact center care management is a win-win-win. It’s a win for healthcare systems, the providers (interprofessional team), and most importantly, patients.

LVM Systems logo

Traci Haynes, MSN, RN, BA, CEN, CCCTM is director, clinical services at LVM Systems.

Telehealth in Uncertain Times


LVM Systems

By Traci Haynes

The COVID-19 pandemic has placed telehealth at the forefront in providing healthcare services. It has forced changes in the environments in which clinicians typically practice. Individuals who, under non-COVID-19 conditions, would seek access in an emergency department (ED), urgent care, or healthcare providers’ office are now avoiding these settings. And with community spread, the Centers for Disease Control and Prevention (CDC) recommends alternatives to face-to-face triage and visits in an office setting if screening can take place via telehealth (that is over the phone, through patient portals, or online self-assessment tools). A recent report from Frost and Sullivan suggests that telehealth will increase by over 64 percent nationwide this year and continue to increase in the years ahead.

The Agency for Healthcare Research and Quality (AHRQ) defines telehealth as “the use of telecommunications technologies to deliver health-related services and information that support patient care, administrative activities, and health education.” It typically consists of a two-way, real-time interaction over distance between a patient and a clinician using audio or visual technology. 

Telehealth or Telemedicine?

Telehealth can help communicate with and coordinate care for individuals with chronic condition. Click To Tweet

Many consider the terms telehealth and telemedicine synonymous and interchangeable. However, telemedicine can describe a more limited set of remote clinical services such as diagnosis and monitoring.

In recent years, telehealth has become more recognized, especially in the aftermath of natural disasters (such as hurricanes, tornados, earthquakes, floods, and blizzards), when seeking routine care can be dangerous for both clinicians and patients. There was a tremendous uptick in telehealth interactions following Hurricanes Irma, Maria, and Harvey in 2017. Crises tend to increase the urgency of telehealth needs. 

Using telehealth in rural communities to bridge the healthcare gap delivering routine care or providing access to specialists that typically exist in more urban areas is well known. Telehealth also makes services more readily available or convenient for individuals with limited mobility, time restrictions, or transportation issues. Furthermore, telehealth can help communicate with and coordinate care for individuals with chronic conditions in supporting self-management as well as assist with earlier interventions in the face of impending exacerbations. 

Social Distancing

The critical need for the recent social distancing between providers and patients has driven increased demand for telehealth. In response to the pandemic, the Trump administration has expanded access, albeit temporary, with changes to telehealth reimbursement policies. 

Beginning March 30, 2020, the Centers for Medicare and Medicaid Services (CMS) allowed more than 80 additional services through telehealth. Clinicians can bill immediately for dates of service on or after March 6, 2020. According to CMS, it will now pay for telehealth services under the Physician Fee Schedule at the same amount as in-person services. 

Healthcare providers, including physicians, nurse practitioners, clinical psychologists, and licensed clinical social workers, are now able to offer telehealth to Medicare beneficiaries, including standard office visits, mental health counseling, and preventive health screenings. Medicare often is the early adopter for changes in reimbursement, with other health plans following their lead. 

A May 9, 2020 report in Modern Healthcare, said that Providence went from 700 video visits a month to 70,000 a week. New figures from Blue Cross Blue Shield of MA reported that daily claims for telehealth grew from approximately 200 to more than 38,000 in May. A May 26, 2020 article in FierceHealthcare reported experts predicting 1 billion telehealth visits by 2021, and currently almost half of practicing physicians are now using telehealth appointments. 

With this shift in practice, healthcare providers will increase their use of telemonitoring devices to measure blood pressure, pulse oximetry, heart rate, temperature, and weight readings. Telemonitoring also will assess EKG tracings and views of the retina and tympanic membrane, as well as other data to diagnose patients.

Emergency Department

There is growing concern about the decreased number of ED visits for emergent situations such as acute myocardial infarctions, cerebrovascular accidents, and other life-threatening situations. Recent statistics, as reflected in emergency medical system calls, offer evidence of increased deaths at home. EDs also report that patients are waiting too long to seek care, and as a result, have often suffered irreversible damage. 

An article in HealthDay News on May 20, 2020 reported that U.S. EDs are seeing about half as many heart attack patients as usual. The data from Kaiser Permanente Northern California included 4.4 million patients. In looking at records from January 1 through April 14, they found that the weekly rate of hospitalizations for heart attacks decreased 48 percent. Moreover, fewer individuals with pre-existing cardiac conditions went to the ED from March 4 through April 14, when compared to pre-COVID-19 timeframes from the year before.

Telehealth Nursing Practice 

Telehealth, in support of the Institute for Healthcare Improvement’s (IHI) triple aim has shown improved access, quality, and cost-efficiency of healthcare delivery and has resulted in an increased demand for telehealth nursing practice (TNP). 

A medical call center with TNP registered nurses (RNs) using decision-support tools provide recommendations for care at home or accessing a higher level of care based on the caller’s symptoms. RNs do not give a diagnosis, nor do they prescribe medications, although in certain situations, RNs can provide refills or e-prescribe medications based on physicians’ orders. 

The breadth and scope of TNP have advanced throughout the years. It has had a major presence in the United States since the 1960s, in Canada since the 1970s, and the UK beginning in the 1990s. 

In the last half of the 70s, health maintenance organizations (HMOs) began using telephone triage and advice services as a gatekeeper to control consumer access to care. In the 80s, hospital marketing departments used telephone triage as well as physician and service referrals, class registration, and health education and information services to attract and keep their market share. Once again, in the early to mid-90s, managed care organizations further expanded telehealth services for demand management, recertification, and referral authorization due to the ever-increasing incidence of chronic illness and multi-morbidities as well as the associated rise in healthcare costs. 

Present-day, the COVID-19 pandemic, has led to the role of telehealth nurses providing triage, surveillance, and monitoring for disease management, care management, case management, care coordination, and clinical prevention programs.

Conclusion

The use of telehealth has grown exponentially during this pandemic. It has filled a much-needed void in providing qualified medical care by clinicians without the necessity of commuting to a higher level of care. It has proven positive outcomes and high degrees of satisfaction. Telehealth is convenient and accessible, and while an option for many medical situations, it is especially important to know of its reliability during a public health emergency.

Traci Haynes, MSN, RN, BA, CEN, CCCTM is director, clinical services at LVM Systems.

Coronavirus and the Healthcare Call Center


LVM Systems

By Mark Dwyer

Healthcare call centers face unprecedented challenges in response to the Coronavirus (COVID-19) pandemic. At a time when efficient call processing is even more critical than usual, due to increased call volumes, call times have lengthened. Much is attributable to the plethora of misinformation individuals have readily available to them over the internet, via the media, and from family and friends. Now, not only do call center nurses need to calm the caller, they must correct the caller’s misunderstandings.

Add to this the pace at which medically valid updates occur. Triage call centers must keep up with the weekly, and sometimes daily, changes to the guidelines for handling possible COVID-19 calls.

COVID-19 has generated tremendous activity related to telehealth as a method of triaging and treating those who are infected. Given that COVID-19 symptoms can vary from very mild to severe and that the virus spreads through close contact, telehealth can be a powerful tool in combating the crisis.

Health center providers may now deliver in-scope services via telehealth to individuals who have not previously presented for care at a health center site and who are not current patients of the health center for the duration of this public health emergency. These include triage services with or without initial consultations. Some of the specific changes include:

  • Continuation of zero member liability (such as copays and cost-sharing) for care that is delivered via telehealth.
  • Any services provided virtually will be eligible for telehealth coverage.
  • All prior authorization requirements for telehealth services will be lifted for dates of service from March 17, 2020, through June 30, 2020.
  • Telehealth services may be delivered by providers with any connection technology to ensure patient access to care.
COVID-19 has forced healthcare to look at all aspects of its care delivery system. Click To Tweet

New Telehealth Policies Expand Coverage for Healthcare Services

Numerous states have taken steps to waive their requirement that a physician is licensed in the state to provide care to patients through their declarations of statewide emergency. More states are sure to follow.

According to Gregory A. Hood, MD, an internist in Lexington, Kentucky, who is on the advisory board of Medscape Business of Medicine, “The waiving of state licensure requirements should help ease a number of stress points of the current crisis in ways that benefit society.”

Healthcare providers, supported by states and payers, can leverage telehealth in ways not possible in previous epidemics to triage, diagnose, and treat patients while effectively protecting healthcare workers and reducing the spread of the disease. States that have broad authority as payers can play a crucial role in driving the use of telehealth as a method of treatment by implementing reimbursement policies that enable providers to offer virtual care services to patients.

Like many other aspects of the United States’ healthcare industry, when COVID-19 ends, the healthcare call center will never be the same. We will work smarter, more efficiently, schedule more creatively, and support more remote staff. We will embrace telehealth, tele-triage, and telemedicine with video calls, chat, and online physician consults.

More insurance companies will reimburse for online physician visits enticing more to participate. Triage call centers may also have more opportunities to work with EMS and police stations to help triage patients. Finally, data sharing will increase to the patient’s PCP into their EMR records or other approved endpoints. Data aggregation and reporting will enable call centers to analyze better yearly trends leading to heightened prediction and prevention of disease. 

COVID-19 has forced healthcare to look at all aspects of its care delivery system. May we all be the better for it. 

LVM Systems logo

Mark Dwyer is a veteran of the healthcare call center industry and serves as COO of LVM Systems.

Vendor Spotlight on LVM


LVM Systems

LVM has served the healthcare call center industry for over thirty years. During that time, they have worked with many prestigious health systems, stand-alone hospitals, and other healthcare organizations. Throughout the years, they engaged their clients, learned what they wanted, and developed specific enhancements to address their needs. 

Today, their clients are asking them to develop solutions that place a high focus on integrated access to high quality, patient-centric care. Healthcare organizations, communities, and medical professionals face the challenging task of communicating patient care across all stakeholders while focused on the patient’s continuum of care.

LVM’s current healthcare call center system provides software solutions to support both clinical and marketing functions. Clinically, their software supports nurse triage, pediatric and adult guidelines, disease management, behavioral health, hospital/patient transfer, health information, and surveys.

On the marketing side, numerous clients utilize the physician referral, answering service, class registration, marketing outreach, web-based messaging, complaint management, and other components of the software. Some client hospitals use both the clinical and marketing capabilities.  

All these components exist within the same software, enabling clients to use them throughout their healthcare organizations. Clients utilizing LVM’s N-Centaurus software receive quality support upon which LVM has built their reputation. N-Centaurus remains a strong solution to meet numerous client needs. It will continue to do so for many years to come. 

Organizations looking for a fully integrated system that takes their current functionality and builds upon it, can look for LVM’s upcoming product release. Creating such a product has been their mission over the past three years, with the goal to produce an interoperable solution to meet the needs of LVM clients and their patients. LVM listened to the industry and their clients. Their new product reflects that effort. 

LVM rolls out its next-generation product that will take their clients’ organizations to the next level. Click To Tweet

Spring is the perfect time of year for new beginnings and refreshing new ideas. This spring will be especially notable for the industry as LVM rolls out their next-generation product. Although they can’t share the specifics quite yet (and spoil the product launch), know that this product will take their clients’ organizations to the next level. Users, however, need not worry. The functions and features they have come to depend on will still be there—just in a more integrated, system-wide way. 

Also, LVM has expanded the functionality of their existing software to increase its value. Clients will be able to relieve many of the stress points their patients experience when interacting with the client’s organization. No longer will patients feel lost in the myriad of touchpoints they must navigate to access an organization and receive services. No longer will they feel frustrated from not knowing simple things like where to park, where to register, or where to find the lab or radiology building. Simplified follow-up communications will enable patients to remember appointments, fill their prescriptions, and among other things, check their vitals.

As LVM looks toward the next thirty years, they see tremendous opportunities to assist clients in greatly improving the health of the country. LVM looks forward to sharing this experience with their clients. Although there will be changes, some things—like the ability to customize LVM’s hospital call center solutions and their high level of quality support services—will never change. 

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Learn more about LVM.

Vendor Spotlight: LVM Systems


LVM Systems


In 1988, Les Mortensen had the foresight to create a product to help hospitals help the patients they serve. Since then, hundreds of hospitals, thousands of users and millions of patients have benefitted.

LVM is now one of the industry’s largest providers of hospital-based healthcare call center solutions. It celebrated another successful year in 2018, marking its thirtieth year serving the healthcare industry.

When reflecting upon how LVM has continued to grow throughout its 30-year history, three critical components come to mind: providing comprehensive, efficient software; using recognized, quality clinical content; and building positive relationships with clients across all company departments.

At LVM, past accomplishments drive ongoing improvements and the development of additional functionality to increase the success of its clients. What keeps LVM the logical choice when selecting a healthcare call center partner is its practice of constantly adding increased functionality, greater usability, and enhanced call handling efficiency to its products. Client input assists the LVM development team to assure the products and services LVM delivers address the industry’s greatest needs.

Some recent enhancements include:

Chat Messages

The chat product is a web-based function that is setup on the client’s website to allow a patient to engage and start a chat with the contact center.

Hospital Transfer

An alternate, streamlined hospital transfer module provides clients a more efficient method to process the initial call’s data capture and needed sending information, track a working diagnosis, and record the data necessary to complete acceptance tracking. This simplifies the process while still collecting all the pertinent information.

Quick Entry Screen

A reformatted quick entry screen optimizes data entry and ease-of-use.

Auto Merge Data on Save

A new view records option appears on the data conflicts screen. Selecting this option allows the user to evaluate the record in conflict for changes when saving.

Protected Fields

The following fields are marked “protect this field” by default: myLVM password, SMTP password, credit card user password, and PDF owner password. Data stored in these fields is not viewable during a call.

Read Only Fields

Fields can be set as read only giving the user the ability to see the information displayed in the field, but they will be unable to make changes. The field will be grayed out on the screen.

Login Screen

The updated sign on screen alerts the user that their password is going to expire by the changing background color. The color changes when the password is going to expire in less than ten days. 

Security Settings

The optimized and updated security settings provide for more finite control and consistent security measures. The following are some recent changes regarding password security set-up and use rules designed to make using the product more secure:

  • Heightened Login Security: When a user exceeds the number of failed login attempts, their record is locked. It requires a user with manager authorization to unlock the record.
  • Inactive Accounts Expire in x days: Sets the number of days until the password automatically disables inactive user accounts. Inactive user accounts are marked “Don’t Use” when disabled.
  • Login Attempts Before Account Lock: Designates the number of consecutive failed login attempts required before locking a user’s account. Once locked, a manager can unlock the account, or the user must wait the designated time before it will unlock.Account Lock Will Expire in x minutes: Designates the number of minutes before a user’s account will unlock and they can try to login again. This field works in conjunction with “login attempts before account lock.”
  • Password History Entries: Choose how many previous passwords are kept to prevent re-use. The user will be prevented from using these passwords when creating a new one.
  • Password Minimum Special: Choose the minimum number of special characters required to be in the password.

LVM’s team of industry experts constantly study changes in healthcare to stay abreast of significant changes affecting healthcare call centers. These efforts distinguish LVM from other companies whose sole focus is software development.

At LVM, healthcare organizations have a partner to provide ongoing updates to its pediatric and adult nurse triage functionality, CRM database segmentation and marketing capabilities, physician referral, class/membership management, service referral, patient transfer, behavioral health input, and many other functions. LVM also offers a comprehensive co-morbidity care management program (CCMP) for individuals with chronic disease(s). CCMP focuses on educating and engaging individuals, earlier interventions, coordinating care, and managing transitions across the continuum.

LVM Systems logoFor more information or a demonstration of LVM’s call center solutions contact Carol Zeek, regional VP, sales, at 480-633-8200 x279 or Leann Delaney, regional VP, sales at 480-633-8200 x286.

Mark Dwyer is a 32-year veteran of the healthcare call center industry. He joined LVM Systems in 2003 and currently serves as COO.

Why, after 30 Years, I Still Look Forward to Going to Work


LVM Systems


By Mark Dwyer

With the holidays upon us, and the New Year fast approaching, now seems the perfect time to reflect on why we do what we do. I have been in the healthcare call center industry for over thirty years, nearly half my life. I did not start out expecting to work with call centers, or even in healthcare, for that matter. Back in 1986, I had never even heard of a healthcare call center—probably because, back then, they hardly existed.

The how of my entering the healthcare call center world, although interesting, is not nearly as important as why I have remained it in for most of my adult life. Anyone who works in a healthcare call center or for a healthcare call center software vendor will likely relate to what ultimately keeps me excited about my job, even years later. Although the money I have earned during my career has certainly played a motivating role, when asked why, my answer always takes a broader perspective.

Reflecting on the past thirty plus years, I remain motivated knowing my efforts have positively affected millions of peoples’ lives worldwide. This is also true of many of you. Let me explain by sharing my personal experience.

In 1986, I joined National Health Enhancement Systems (NHES), a fledgling start-up associated with the Arizona Heart Institute. During my thirteen years at NHES (later to be acquired by HBOC and then McKesson), I helped grow the company from six employees when I joined, to over 300 (with their own call center) before they sold. I then joined three former colleagues in supporting healthcare call centers through business strategy and call center process efficiency consulting services.Remember just how significant what you do each day is to the lives of the people you touch. Click To Tweet

I returned to the software vendor side in 2003 when I joined LVM Systems. At that time, LVM was still a small, sixteen-employee organization. Over the past fifteen years, I have had the pleasure of assisting in LVM’s growth to over seventy employees and to a position of prominence among healthcare call center software vendors.

This brings us to today and the reason I remain excited about my job. It is the influence afforded me to positively affect the lives of millions of people around the world. Let me explain. I have had the pleasure of helping grow two healthcare call center software companies into positions of leadership in the industry.

During that time, the numerous families of the employees at these companies have had the resources to put food on their tables, a roof over their heads, and clothes on their backs, not to mention money for little league and club sports, braces, music lessons, private schools, college tuition, and many Happy Christmases with presents under the tree.

It does not stop with just these 370 plus employees and their families. That is just the beginning. Each healthcare call center nurse, resource representative, and manager working in a healthcare call center using the products developed by NHES, McKesson, and LVM have jobs due in part to the efforts of these companies. These individuals again benefit from the wages they earn allowing them to provide for their family’s needs.

If we expand this even further, the real impact of the work I do, the work we all do, is significantly more far-reaching. Our efforts affect the lives of millions of callers helped by the healthcare call center software we use. Knowing that I have played even the smallest part in helping call center representatives in marketing call centers that facilitate enrolling callers in appropriate programs or referring them to needed physicians or services feels good.

And when I think about how nurses, in triage call centers across the country, daily avert deadly heart attacks or assist new moms in caring for their inconsolably crying infants, I know what I do is important. This is what keeps me coming to work each day, knowing that my efforts to grow and maintain viable software providers and products enables you to successfully help people.

It is this greater world-view that keeps me gladly doing my job. So, if you ever wake up and question why you go to work each day, look at the big picture and remember just how significant what you do each day is to the lives of the people you touch. Even if it is just one.

Merry Christmas and Happy New Year!

LVM Systems logoMark Dwyer is the chief operations officer of LVM Systems.

LVM Systems Turns 30

LVM Systems logoIn 2018, LVM Systems, Inc. will complete its thirtieth year of serving the healthcare call center industry. To commemorate the occasion, LVM will release a new version of its flagship call center software, N-Centaurus.

In addition, LVM will celebrate with its clients and staff throughout the year. Special events, parties, gift drawings, and other activities will culminate in its 2018 Users’ Conference next fall.

LVM Systems develops and markets software and internet products exclusively in the healthcare call center industry. Their primary niche is solutions that support nurse triage, disease management, and referral and marketing services. For more information, email info@lvmsystems.com.

Moving From “Sick Care” to “Health Care”


LVM Systems


By Mark Dwyer

In 2012 our government enacted legislature that mandated U.S. hospitals reduce re-admissions by emergency departments (ED) admits for the first thirty days post discharge. To force this change in behavior, rather than waiting for hospitals to choose to proactively address the overall health of their communities, the government began penalizing hospitals who had higher than average readmission rates through a deduction in their reimbursed Medicare payments.

This was a radical change in American healthcare as it put the onus of keeping patients well on the hospitals and providers who treated them. No longer could hospitals simply wait for individuals to require hospital care, rather it became their responsibility to proactively manage ED admitted patients for at least the first thirty days post discharge. If they were unsuccessful in providing the patient with the tools and help needed to keep them from re-admitting, they bore the weight of a financial penalty.

Initially, the penalty amounted to 1 percent of the hospital’s total annual Medicare reimbursement. It was tied to three specific DRGs (diagnosis related groups): acute myocardial infarction (AMI), heart failure (HF), and pneumonia. Each hospital was scored against its neighboring hospitals to determine which ones had readmission rates in the highest twenty-fifth percentile of their surrounding hospitals. If a patient who had been admitted via the ED due to one of these three DRGs required readmission within thirty days post discharge, and the hospital’s readmission rate was in the highest twenty-fifth percentile of hospitals in the area, the hospital’s overall annual Medicare reimbursement was reduced by 1 percent. Although 1 percent may not seem like a lot, when it was applied against the hospital’s entire Medicare reimbursement dollars it was significant—especially for hospitals operating with only 2-3 percent profit margins.

But the government didn’t stop there. In year two of the program, the percentage of Medicare reduction was increased to 2 percent of the hospital’s total annual Medicare reimbursement amount. Then in year three, not only was the percentage again increased to 3 percent of the hospital’s overall Medicare reimbursement, but three additional DRGs were added: elective knee replacement, elective hip replacement, and chronic obstructive pulmonary disease (COPD).

At this point many hospitals began paying attention, especially when over 2,200 U.S. hospitals were penalized for failing to reduce their readmission rates. To address this ever-increasing reimbursement reduction, hospitals had to implement programs to manage Medicare patients post discharge for at least the first thirty days. To do so, many home grown programs were introduced with varying success.Healthcare software vendors have programs to help educate and manage the patients post discharge. Click To Tweet

A number of healthcare software vendors also began developing and marketing programs to help educate and manage the patients post discharge. Some of these programs involved on-site care management visits, phone calls, reminder texts, and emails. Some also involved extensive motivational programs designed to not only assist the patient in remaining proactive in their care but also the patient’s caregiver. Too often the Medicare patient’s primary caregiver is their elderly spouse who is also battling a litany of health issues. Assisting them and other familial caregivers was determined to play a critical role in the process.

But what about the many patients who suffer from more than one chronic disease? Some vendors realized that many Medicare patients suffer from co-morbidities. It is not unlikely for an individual with diabetes to also be obese or someone with HF to have been admitted with an AMI DRG. Initially, since these various disease states were defined as separate care plans, patients suffering from co-morbidities experienced multiple interactions post discharge to manage all conditions that could possibly result in a costly readmission.

To motivate patients and their caregivers to follow post-discharge instructions regarding medications, to make and attend post-discharge provider appointments, and to integrate with the hospital’s care management or medical call centers, vendors have begun collaborating with leading content developers. By adding patient educational and motivational training content to their software programs, post-discharge programs can enable the nurse or care coordinator conducting follow-up calls to select the specific information needed to address each of the patient’s multiple issues. This co-morbidity program approach eliminates the need for redundant calls to address each of the patient’s healthcare issues. Instead it enables the nurse or care coordinator to select the content, surveys, motivational scripts, and other resources needed to meet all of the patient’s unique needs across a wide array of health conditions.

Future thinking hospitals and providers who see the need for follow-up beyond the initial thirty days post discharge are beginning to take a stand for long-term health management by using customizable co-morbidity programs. This is a real step in the direction of healthcare management. Imagine a future where healthcare generates greater revenues from having empty beds, keeping area residents healthy and at home.

LVM Systems logoMark Dwyer is the COO of LVM Systems, Inc. For more information about LVM’s Co-morbidity Care Management Program (CCMP), contact LVM Systems sales at 480-633-8200 x223 or info@lvmsystems.com.

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LVM Systems Announces Poly Plan Health Coaching Program

LVM Systems has developed the Poly Plan – Health Coaching program to enable RN care coordinators to manage the health of multi-morbidity patients. Poly Plan helps identify the appropriate surveys to complete with the patient, the information to send, the health statistics to gather, and the goals to set – all within one call.

There are two primary plan frequencies: The comprehensive plan is designed to follow-up with the patient on a less frequent basis, such as quarterly. The high frequency plan involves contacting the patient weekly or monthly. Based on updated standards of care, care coordinators use surveys to gather data on the HEDIS and disease-specific medical care standards, as recommended by the corresponding accrediting organizations and authorities. The system also includes the Zung Depression survey and Diabetes Distress Screening (DDS17).

Once the appropriate data is gathered, the care coordinator accesses Poly Plan’s Health Information library as needed. This information is shared with the patient using email, text, or paper.

Key reporting tools assist with patient assessment and streamlined call processing. The at-a-glance report gives care coordinators a quick way to view the patient’s health history, lab values, appointments, and goals. Supporting the at-a-glance report is the adherence score card report to alert care coordinators to any behaviors that need to be addressed during the contact. Key components of Poly Plan include tools for patient engagement, self-management, patient goals, behavior change, improved outcomes, and reporting.

LVM Systems logo

LVM Systems’ Poly Plan – Health Coaching program provides the infrastructure to effectively improve care, education, and behavior modification. The result is a program that can provide healthier outcomes for patients, increase customer loyalty, and positively affect an organization’s bottom line.

For more information email Heather Jacobs or call 480-633-8200 x333.

[Posted by Peter Lyle DeHaan, PhD for AnswerStat magazine, a medical healthcare publication from Peter DeHaan Publishing Inc.]

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LVM Systems Introduces iCentaurus Reporting

LVM Systems released iCentaurus reporting to enable a call center’s remote partners to access data and print reports from authorized databases within the call center’s environment. With this remote reporting tool, healthcare call centers can allow their off-site partners to print patient charts, class rosters, membership lists, and management reports.

Now, when a revenue tracking report is due for a 6:00 a.m. meeting, it will be available with the click of a button, complete with up-to-date data. According to Cheryl Baker, manager of client services for LVM Systems, “Many of our clients have been asking for this functionality. Providing controlled remote access to data and reporting will greatly strengthen our clients’ relationships with the entities they serve.”

Mark Dwyer, COO at LVM added, “Our clients are constantly being asked to do more with less. ICentaurus reporting allows them to leverage their staff, while continuing to meet and exceed the reporting needs of their partners. Doing more with less is what it is all about today.”

LVM Systems logoICentaurus reporting is locally hosted at the healthcare call center site and shared with partners outside the call center through a secured web connection. Once rights to specific databases are granted, and access to specific reports are authorized, remote partners can login and generate their defined reports as agreed to by the host organization.

[Posted by Peter Lyle DeHaan, PhD for AnswerStat magazine, a medical healthcare publication from Peter DeHaan Publishing Inc.]