Active Archive Supports Expansion of Home Health Care Market

Summary

More and more medical care is happening outside the walls of our nation’s hospitals and physician offices. While the shift to more home-based care initially was sparked by the need to clear hospital beds for COVID-19 patients, other benefits emerged, and now new Medicare waivers cover a multitude of treatments and services. To ensure quality care is delivered at home, it is important that nurses, occupational therapists, respiratory therapists and others who deliver the care have secure and reliable access to the comprehensive patient record that also must be retained for at least seven to 10 years from the date of service. An active archive is an important solution to keep the flow of information moving at the point of care, wherever that may be.

Home health care worker and an elderly couple

While we saw many shifts in healthcare over the past year, the growth in home health care is expected to continue over the years to come. In one report, 97% of 76 health plan executives surveyed in Nov. 2020 said they believe more care at home is better for both their organizations and their members. And, about the same high percentage said they believe treating members at home is more cost effective than facility-based care.

Beyond shifting care delivery due to COVID-19, growth in the home health segment is fueled by an aging population (the number of people 65 and older is projected to double to 1.5 billion by 2050), the rising incidence of chronic disease and increased patient preferences. The home health market size was valued at $281.8 billion in 2019 and is expected to grow at a compound annual growth rate (CAGR) of 7.9% through 2027.

Prior to the pandemic, typical types of home health care included:

  • Therapeutic – home respiratory, insulin delivery devices, home dialysis equipment
  • Diagnostic – Diabetic care unit, BP monitors, heart rate meters
  • Mobility Assist – wheelchair, home medical furniture, walking assist devices
  • Services – skilled homecare, PT, OT, speech therapy, nutritional support, hospice and palliative care

However, after realizing the success of more home-based services, new Medicare and Medicaid waivers granted in late 2020 offer a much greater level of flexibility for patient care taking place in a home setting. These waivers are similar to the agency’s recent telehealth allowances that also are expected to continue. The expanded services now cover a wider list of acute care, such as asthma, pneumonia, and chronic obstructive pulmonary disease (COPD) that can be treated through home-based services. And, new protocols are being established to assist with shifting care delivery to a home setting. This move is significant as Medicare is the largest single payer for home healthcare services representing about 40% of all home health services.

Keeping up with Home Health Care Medical Record Requirements

There are numerous regulatory compliance requirements for home health agencies including meeting the rules for the state health department as well as the federal Center for Medicare Services, which requires reporting of outcome and assessment quality data by home health agencies every 60 days.

In general, CMS documentation requirements include:

Evaluation – Includes overall exam and also a thorough evaluation of the patient’s entire health status. The evaluation serves as the benchmark for tracking treatment progress over the 60 day reporting period.

Plan of Care – Each clinician is required to develop a thorough plan of care with goals, treatment and measurement.

Progress – Nurses and therapists must document the care and how it relates to the patient’s overall treatment goals. All charting has to be specific, for example: the patient will regain 75% leg strength and be able to stand without assistance for 2 minutes.

The Role of Interoperability in Home Health Care Success

Interoperability is key to home health records that often need to be shared among multiple clinicians including physical and occupational therapists, visiting nurses and the primary care physician. Recently, CMS developed clinical templates to assist providers and EHR developers with data collection and medical record documentation to support coverage of selected items and services for home health care. The information gathered and recorded in the templates would become part of the patient’s overall medical record.

Medical Record Retention Guidelines for Home Health

Record retention laws and guidance can vary state to state, but in general CMS regulations require that home health patient records are kept for a minimum of seven years of the date of service. However, the National Association for Home Care & Hospice recommends that agencies maintain patient records for at least 10 years to accommodate the requirements in the regulations and the statute of limitations in the Federal False Claims Act.

There are numerous Home Health EMRs, including: AxisCare, Alora, EpicCare Dorothy, Homecare Homebase, MatrixCare, Meditech Home Health EHR, PointClickCare, WellSky and others.

Active Archives Deliver Access to the Complete Medical Record at the Point of Care

As the push for data consolidation continues, and mergers and acquisitions proceed, electronic health record (EHR) systems will be replaced. Often, cost and technology constraints mean it doesn’t make business sense to migrate all the older records into the new system. However, the need to comply with record retention, and to maintain easy access to what could be imperative legacy data still exists.

Our team has award-winning experience in extracting, migrating and archiving data and images from over 500 software brands. Ranked #1 in the 2020 Best in KLAS Software & Services Report as a Category Leader in Data Archiving, we can help your team retain your home health records, and all records, in a discrete and secure active archive. The complete medical record becomes available with just a few clicks and a single sign-on from the active EMR.

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Feb 04 2021

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