A six-month pilot test of a program designed to help home care providers identify and manage acute clinical changes shows potential for improving care and reducing avoidable hospitalizations.

Twenty-two offices of a national home care company participated in the pilot. Caregivers used telephone-based software to check in at the start and end of their shift and report changes in the client’s condition through an automated checklist. The care manager in the office was automatically notified when changes were reported and then decided on subsequent actions. 

The data analyzed comprised 273,278 caregiver shifts. Changes—mostly in behavior, skin condition, eating/drinking, and the ability to stand/walk—were reported in 2 percent of the shifts. 

Among the program’s reported benefits were improved quality of care, timelier receipt of care, improved relationships with care recipients’ families, prevention of unnecessary hospitalizations and increased client retention following hospital discharge.

A randomized trial is underway to further evaluate the program.

The preliminary analysis appeared online Aug. 10 ahead of print in the Journal of the American Geriatrics Society.

Our Take: A lot of people have been awaiting the results of this trial. The preliminary results are worth reading, if anything because it details best practices of how simple technology can be deployed in the home.

Private duty home care has largely been excluded from the value-based care conversation, in large part because it has earned, rightly or not, the unfortunate labels “non-medical” and “unskilled.” This nationwide effort has the potential to prove that private duty care can make a difference in quality outcomes, and that so-called unskilled personnel can successfully identify changes in a patient’s condition—and successfully use technology to improve patient care.

If this proves to be the case when their findings are released in 2017, expect ACOs, post-acute providers and health systems to take notice.

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