Home Healthcare Organization Streamlines Processes and Improves Patient Care

Microsoft Office Customer Solution Case Study

Customer Profile The Visiting Nurse Service of New York has 2,500 clinicians who provide nursing, rehabilitation therapy, mental health services, and home health aide supportive care to 24,000 patients each day. Business Situation The organization wanted to increase its efficiency and improve patient care by streamlining workflow processes and reducing paperwork. Solution The Visiting Nurse Service of New York deployed 2,500 Tablet PCs running Microsoft® Windows® XP Tablet PC Edition to its field clinicians, who use the PCs to record and share patient information Benefits Better information access for better patient care Increased productivity and flexibility Ability to analyze information Cost savings through integration Foundation for program expansion

"VNSNY has always taken the Microsoft approach…. With Windows XP Tablet PC Edition, we have it all built into a single operating system that was designed to work with the device. Tablet PCs are so easy to use and Microsoft technology so reliable that we have a lot fewer headaches."
— Rick Stazesky, Director of Information Systems, Visiting Nurse Service of New York

The 2,500 clinicians of the Visiting Nurse Service of New York (VNSNY) visit patients’ homes to provide nursing and other physical and mental healthcare. The organization needed a way to record and share patient information quickly, reducing the time between a patient visit and the updating of that patient’s record in the organization’s record–keeping system. Additionally, VNSNY wanted to shorten clinicians’ long days and reduce their paperwork loads. An early adopter of pen-based technology, VNSNY recently implemented a solution using 2,500 Tablet PCs that run Microsoft® Windows® XP Tablet PC Edition. Tablet PCs enable field clinicians to quickly and accurately complete their work on–site. With consistent formats for its patient records and integration between applications, VNSNY now can manipulate and analyze information to make improvements in the way in which it delivers care.

Situation

Since 1893, the Visiting Nurse Service of New York (VNSNY) has been providing home healthcare to patients in New York City. Today, the organization’s 2,500 clinicians deliver home healthcare services ranging from pediatric to elder care, psychiatric assessments to AIDS treatment, and short–term interventions to long–term management. VNSNY clinicians visit patients throughout New York City’s five boroughs, Westchester County, and Nassau County on Long Island. VNSNY is the largest home healthcare organization in the United States; in a typical year, its clinicians make more than 2 million visits to more than 100,000 patients.

One of the organization’s strengths is its drive to develop innovative ways of using technology to improve patient outcomes. VNSNY leads the way when it comes to testing and implementing new methods of delivering patient care, enhancing communications with its physician and hospital partners, and promoting operational efficiency

Regulatory agencies require healthcare organizations to complete a substantial amount of documentation for each home visit; the paperwork is intended to capture clinical data as well as information related to billing and insurance.

Clinicians used to record notes by hand during their daily patient rounds and also attempt to fill out forms while attending to patients. At the end of the workday, clinicians would then call or visit one of five regional VNSNY offices to update each patient’s file in the main VNSNY system. The company wanted to give its clinicians a way to record information electronically while still at a patient’s home to reduce the number of hours in a typical clinician’s workday. Being able to enter data while on–site would also increase the information’s accuracy because clinicians would not skip the data entry while with the patient and try to record it later from memory.

Additionally, there used to be a delay of up to five days between a patient visit and when information from that visit was accessible in VNSNY’s computer system. The delays meant that the medical information available was frequently outdated, so subsequent clinicians were visiting patients without the most recent, relevant information about a patient’s treatment. "Our clinicians were basically operating in isolation, which just didn’t make sense because one patient often is served by several of our clinicians, who all share responsibility for the patient’s well–being," says Rick Stazesky, Director of Information Systems for the Visiting Nurse Service of New York. "Our organization strives to have each visit build on the last, promoting better patient care, but we had no systematic way for our clinicians to pass on information regarding patients unless they left handwritten notes for one another at the patients’ homes."

Delays in the availability of information also hindered VNSNY’s ability to promptly send invoices. "Healthcare is a low–margin industry, so we also were looking for a way to have our invoices follow treatment as closely as possible," says Stazesky.

Another significant deficiency of the paper–based system was that it did not allow VNSNY to gather information consistently from its 2,500 clinicians. Most patient information was written down in narrative form, rendering it useless for any sort of analysis. One of VNSNY’s goals was to compile an electronic medical patient record. "We had this wealth of patient documentation that we couldn’t take advantage of because it was in narrative form, some of it largely illegible," says Stazesky. "We wanted to use that information as a strategic tool for developing best practices for treatment and directing the course of our organization."

Since the mid–1990s, VNSNY has been working to eliminate its clinicians’ use of paper forms. The organization wanted to help its clinicians spend their days more efficiently, with a greater proportion of time devoted to patient care, rather than paperwork.

Solution

VNSNY decided to investigate mobile technology to meet its clinical and administrative needs. "Mobile technology is useful for the Visiting Nurse Service of New York because we are a (...)