May 12, 2021
Healthcare is always changing, always evolving—and keeping pace can often seem like a daunting task. But with the right partner, solution and strategy, adopting new and innovative technologies can be easier than you think.
That’s the story with Amedisys, Inc. and their recent approach to successfully reducing hospitalization rates with Medalogix Touch. The strategy was shepherded by the organization’s corporate leaders in 2018, when they reviewed organizational-wide quality initiatives to:
- Prevent unnecessary hospitalizations
- Improve patient satisfaction
- Enhance care coordination
As a national in-home care provider with more than 500 centers across 39 states and the District of Columbia, Amedisys’ leaders wanted to focus on hospitalization reduction as the primary goal and do so in a way that would integrate any new programs into regional care centers, and workflows, without disrupting regular operations or creating new burdens for clinicians. And because Amedisys has experience with prior acute care hospitalization, or ACH, reduction efforts, the team knew what they needed to do, says Carolyn Erskine, AVP of Nursing Strategy, Innovation and Programs.
“Amedisys was looking for ways to provide outreach and touchpoints for high-risk patients in hopes of preventing unnecessary hospitalizations,” Erskine explains, adding that any solution would need to meet certain criteria, including:
- Put patient needs front and center
- Reduce the load for care centers
- Be scalable
A history with successful clinical programs such as those focused on COPD and heart-failure patients provided a roadmap for patient education that could lead to clinical intervention. But more was needed —specifically a program that could weave in additional communication and touch points for the larger, high-risk patient population. How could they better leverage a patient’s individual data collected by clinicians to predict, plan and, by extension, improve outcomes?
A predictive solution that leverages data and protects clinicians’ time
The answer was Medalogix Touch, predictive analytics solution built by using historical Outcome and Assessment Information Set (OASIS) and other patient medical record data to identify trends that are predictive of future outcomes. Since OASIS is collected at specific timepoints throughout an episode of care and tracks a patient’s improvement or decline, it can be used to identify trends indicative of future likelihood to experience a negative outcome, such as hospitalization.
Medalogix Touch uses data to rank patients by their relative risk for hospitalization. Automated touchpoints can then be applied to those at highest risk, by using an interactive voice response technology (IVR) which allows a computer to interact with patients via phone. A simple verbal or touch-tone indication by the patient triggers an alert that is triaged by home health agency staff. It’s a simple but powerful way to stay in touch with patients between visits, with the goal of identifying early signs of decline and prompting immediate response efforts before a hospitalization may occur.
Home health agencies such as Amedisys typically have programs in place to intervene with high-risk patients, but often struggle with needed clinician capacity to scale the programs. Amedisys’ interest in Medalogix Touch was led by the desire to innovate, centralize and expand their outreach to at-risk patients in a realistic, efficient and scalable way. The predictive engine that drives Medalogix Touch utilizes a statistical concept called “gain,” which in effect identifies the most at-risk patients, pinpointing the patients most likely to hospitalize at a significantly higher rate than if randomized or determined only by the clinician. Because the concept gain promotes efficiency and allows for a more targeted approach, Medalogix Touch would enable Amedisys to focus their efforts on the right patients at the right time.
Amedisys began implementing Medalogix Touch into some of its facilities in fall 2018, and after promising early results expanded its usage across its network. That included establishing a new, centralized national call center and the necessary staff, as well as new protocols to tie into existing policies and procedures.
During the first three months of the pilot, several benefits were noted:
- Early identification of urgent decline, which prompted clinician visits and physician communication to avoid emergency room visits and hospitalizations
- Recognized ability to pivot daily to ensure the right care was being delivered to the right patients, according to risk rather than subjective means
- Patient satisfaction increased
In mid-2020, an analysis was performed by Amedisys on the patients who participated in Amedisys’ Medalogix Touch program within the first seven days of start of care, yielding the following results:
- 20% lower Risk Adjusted 60-Day ACH rate than comparable (non-Touch) patients who have either not participated or not substantially participated in the program.
- The non-Touch patient group shared a comparable patient profile to the Touch patient group based on assessment type, 60-day ACH risk level and outlier exclusion criteria.
- The population studied was risk adjusted and resulted in a 60-day ACH rate absolute reduction of 3.4% (Study and control groups included only high-risk patients.)
Medalogix performed an additional analysis of the data, which substantiated the Amedisys results, affirming that patients in the treatment group experienced significant advantage in achieving hospitalization reduction.
In seeking innovative ways to keep patients safer at home, Amedisys has successfully implemented Medalogix Touch as an intervention that—coupled with ongoing process improvements and education—has proven to be a cost-effective, scalable solution in the effort to reduce ACH rates among their patient population.
“We are always looking for ways to keep our patients at home where they want to be. We constantly ask ourselves, what else can we do to drive down readmissions?” Erskine said. “But we’re convinced that this method is a good, cost-effective method to reducing hospitalization. We love what we’re doing, and we’re committed to moving forward.”
View the full case study here to learn more about how the Medalogix Touch solution can prevent hospitalizations, improve patient satisfaction and enable better care coordination without placing burden on clinical staff.