Page 269 - Encyclopedia of Nursing Research

236 n HOMe HeAlTH clASSIFIcATION SySTeMS

patients’ health outcomes and families’ They increased faster than all other organized
desired quality of life. consumer demand providers in the health care industry because
H and technological advances will continue, Medicare primarily addressed the health care
one hopes, with nursing research verifying needs of the aging population. As this popula-
theoretical frameworks that guide effective tion grew, more health services were required,
home and informatics technology. resulting in an increase of health care costs that
required cost containment. As a result, health
Carol E. Smith care began to shift from acute short-term hospi-
tal care to community home-based and chronic
long-term care. patients began to be discharged
HoMe HealtH “sicker and quicker” and required more health
care services in the home.
ClassifiCation systeMs Home health systems were initially
introduced as management information sys-
tems designed to manage the flow of infor-
Home health systems are computer-based mation in the proper time frame and to
information systems designed to support assist in the decision-making process. The
care of the sick in the home. Home health early home health systems were introduced
systems primarily support home health and in large VNAs and other nonprofit HHAs
hospice programs provided by home health as billing and financial systems. They were
agencies (HHAs). Home health is more than developed for the sole purpose of improving
“care in the home.” Home care practitioners cash flow, holding down costs, and address-
offer continuity of care from the hospital to ing the federal regulatory requirements for
the community. They also use public health HHAs. They were designed to furnish the
concepts of disease prevention and health information necessary to obtain reimburse-
promotion and coordinate the services of ment for services from Medicare, Medicaid,
multiple providers, vendors, and community and other third-party payers.
agencies that may be involved in the care of Home health systems generally were
an individual or family. developed by commercial vendors who
Home care is the oldest form of health obtained the computer system hardware and
care and yet the newest. Home health nursing, developed the software to process the services
previously called care of the sick in the home, data provided by the HHAs. The computer
is one of the earliest developments in the field vendors owned the home health system and
of public and community health. care of the were responsible for maintaining and updat-
sick at home traditionally has been provided ing them. Home health computer vendors
by voluntary nonprofit agencies, such as vis- were usually contracted by the HHAs to pro-
iting nurse associations (VNAs). These agen- vide billing services and financial manage-
cies were organized to provide out-of-hospital ment, without the HHAs having to develop
services primarily to those who were sick their own system. With the introduction of
and poor. In 1885, the first VNA in the United the microcomputer and online communica-
States opened its doors in Buffalo, New york tion systems, local area networks and wide
(Maurer & Smith, 2009). area networks were introduced, designed to
In 1966, with the introduction of Medicare advance and enhance the home health sys-
and Medicaid legislation, home health pro- tems. They were used to link state and local
grams emerged from hospitals, ambulatory care units, to share hardware and software, and
facilities, and health maintenance organiza- to integrate data (Saba & Mccormick, 1996).
tions as stand-alone businesses. The programs Over time, home health systems have
and providers increased in number and size. been designed not only to collect and process