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1 Page 1 of 5 SEARCH RESULTS August 04, 2004 On the Road with Mobile Tech A nursing group saves time and money by better integrating software and mobile technology. By Beckie Kelly Schuerenberg, Senior Editor HOME MAGAZINE Current Issue Read the August issue Past Issues Access previous editions Subscribe Sign up for free trial Change Address Redirect subscription Editorial Calendar Obtain story guide Contact Editor Letters, questions Editorial Staff Bios and links (August 2004) Caregivers at the Visiting Nurses Association, Western Pennsylvania are accustomed to using mobile technology. The Butler-based organization s nurses have been using notebook computers since the mid-90s to collect and transmit data while providing care at patient homes. But familiarity didn t necessarily breed mobile success for the VNA. The overriding problem was that the association s home health care software wasn t designed to provide remote access to patient information. This complicated the job of nurses in myriad ways. For instance, because they couldn t remotely access financial and clinical applications, they had to travel each morning to a VNA branch office to download demographic data on each patient. Further, the software wasn t integrated across the VNA s four locations. So the information nurses sent to the databases at one facility could not be accessed by or shared with the others. The lack of integration made it difficult for the association to manage patient information as well as produce and analyze enterprisewide data reports, says Kristy Wright, CEO.

2 Page 2 of 5 E-Newsletter Free HDM Week signup NEWS PORTALS HIPAA Vendor News New Products Government Trends Mobile Tech Even though we had been using mobile technology at the point of care for so long, we never did a good job of integrating that technology into our everyday duties, she says. We couldn t get access to the information we needed because we didn t have it in a single database. So the VNA tackled its integration problems. In 1999 it began implementation of an integrated suite of clinical and financial applications specifically designed for home health care organizations. It finished that task in At the same time, it enhanced the mobile capabilities of its nurses by installing a point-of-care application that enables them to synch their notebooks with the integrated applications and transmit and access patient data during an encounter. The data integration and improved workflow has enabled the association to save hundreds of thousands of dollars, Wright says. The integrated system and the point-of-care application has enabled us to access data in a more real-time fashion so we can make better decisions, she says. It s had a huge impact on care and more than paid for what we invested in it. Enhancing mobility The VNA uses the HomeWorks home health care system from Overland Park, Kan.-based BeyondNow Technologies, now a subsidiary of Cerner Corp., Kansas City, Mo. The RoadNotes point-of-care module provides access to clinical applications and enables nurses to transmit data to the association s integrated database. RoadNotes uses mobile technology from ianywhere Solutions Inc., Dublin, Calif. The vendor s SQL Anywhere Studio offers bi-directional synchronization to an integrated database from desktop or remote network connections. The association spent a total of $400,000 on the

3 Page 3 of 5 applications, which include 130 licenses for the RoadNotes application and 101 for the HomeWorks system. The VNA installed the HomeWorks software on servers at each of its locations and installed the RoadNotes application onto new notebook computers it purchased for each of its 120 nurses. Calling in The mobile software offers access to each of the clinical applications within the HomeWorks system. HomeWorks also features remote management capabilities, which enabled the VNA to set up passwordprotected access to the RoadNotes software on each notebook, says Cindy Clark, director of information systems at the VNA. Nurses now use Toughbook CE-T2 notebooks from Panasonic Computer Solutions Co., Secaucus, N.J. The notebooks have touch screen capabilities, which enable nurses to enter data into the RoadNotes application faster, says Kathy Rogerson, R.N. VNA purchased the notebooks for about $2,000 each. The mobile software and hardware have enabled nurses to access and enter information such as charts, care plans, medications and other data into the HomeWorks system during encounters at patient homes. Nurses then use password-protected, dial-up connections to synchronize their notebooks with the HomeWorks integrated database and transmit information. Everything I would need is right on my notebook, Rogerson says. As long as I synch up, I can have the most up-to-date information on my patients. VNA nurses, however, aren t the only ones who have reaped benefits from the organization s new technologies. VNA administrators, for example, now have access to realtime, enterprisewide data reports because patient

4 Page 4 of 5 information is integrated as it is downloaded into the system. The real-time reporting functions have enabled executives to have better oversight of the organization and therefore make better business decisions, says Liz Powell, COO. The increased efficiencies VNA has achieved through better data transmission, integration and access has enabled it to eliminate five full-time employee positions and get back into the black financially, Powell says. At the end of 1999 when the VNA began implementing the system the organization was on target to lose $1.5 million. Since then, it has been able to eliminate five fulltime employee positions. The three positions in its medical records department were cut because the integrated software helped the organization automate data previously stored on paper, Powell says. The organization also eliminated two nursing positions that were responsible for contacting managed care organizations about patient eligibility. The duties have been designated to branch office administrators because they now have access to eligibility request information via the integrated database. Additionally, the elimination of its medical records department helped VNA save enough space in its main facility to move one of its branch locations there, which resulted in further cost savings. Back in black Thanks in part to the staff cuts and reduced rent payments, the organization broke even 2002 and posted a profit in 2003, Powell says. Like the VNA, other home health care organizations have an opportunity to significantly cut costs by increasing the functionality of their mobile services, says Gregg Malkary, managing director at Spyglass Consulting, Menlo Park, Calif.

5 Page 5 of 5 Using I.T. can give home health care organizations a phenomenal ROI, he says. It can help diminish the costs resulting from delays of getting new information into their systems. But it s not just about implementing new hardware and software. It s about redesigning the clinician workflow. And there are other emerging technologies that could provide even more benefits for Visiting Nurses Association, Western Pennsylvania and other home health organizations, Malkary adds. For example, they could offer nurses Tablet PCs to use in the field, he contends. The mobile hardware offers handwriting recognition, which could give nurses another method for data entry, he adds. The organization also could offer nurses faster, real-time access to the HomeWorks software from mobile hardware if they began using mobile phone network technology rather than a dial-up connection to access and transfer patient data, he adds. Contact the Editor Contact the Webmaster Guest Book Customer Service Advertising Information 2004 The Thomson Corporation and Health Data Management. All rights reserved. Use, duplication, or sale of this service, or data contained herein, is strictly prohibited.