Page 270 - Encyclopedia of Nursing Research

HOMe HeAlTH clASSIFIcATION SySTeMS n 237

home health data required by governmental focused, with authors presenting their expe-
and private third-party payers for reimburse- riences and lessons learned. crossen-Sills,
ment for patient services but also for the effi- Toomey, and Doherty (2009) recount the H
cient management of the HHA. Billing and transformation of a nearly century old VNA
financial applications include general ledger, into a technological leader. Their successful
accounts receivable, accounts payable, billing, journey with home health systems imple-
reimbursement management, and cash man- mentation was guided by attention to the
agement. Operations management applica- mission of the organization as well as benefits
tions, such as scheduling, patient census, visit to their home health patients. Home health
tracking, cost statistics, utilization reports, systems integration has been addressed by
accounting statements, and discharge sum- hospital- and health system–based HHAs.
maries have been developed and refined. Inpatient electronic patient care information
Newer home health systems have systems include home health applications for
emerged that are designed to focus on the seamless integration of patient care records
patient encounter and visit during an epi- and collaborative care among health care
sode of care. They include clinical applica- professionals from home health, inpatient,
tions used to assess and document the care and ambulatory care settings.
process, to generate care plans, and to pre- The U.S. Department of Veterans Affairs,
pare critical pathways or protocols that out- a recognized leader in technology and patient
line critical events. These newer systems care systems, has turned its attention to home
have the capacity to communicate patient health systems. recognition of the needs of
information for continuity of care from hos- the aging veteran population has resulted in
pital to the home, to the community, and back an increasing focus on home health care and
to the hospital. The systems also offer other associated technologies. The Veterans Affairs’
applications that focus on decision support, computerized patient record system offers a
evaluation of care, and measurement of out- well-integrated system for care coordination
comes across settings, time, and geographic and conferences for home care staff and other
locations. The systems are considered part of health care providers. Their community care
the lifelong longitudinal record containing coordination Service (Kobb, Hilsen, & ryan,
patient-specific health-related data. 2003) uses multiple technologies to maximize
Stolee, Steeves, Glenny, and Filsinger care coordination and patient satisfaction as
(2010) researched facilitators and barriers well as to identify best practices for veterans
to use of home health systems. limited with chronic health conditions. One element
research about home health systems of community care coordination Service,
inspired their effort. In conducting their home telehealth, also has gained widespread
research, they noted lack of clarity about acceptance among home health patients and
definitions and use of terminology for the providers in a variety of settings, especially
many forms of electronic systems now rural locales.
being used in HHAs. The most commonly Home health systems are expected
identified facilitators of home health sys- to enjoy growing recognition and utili-
tems were portability of technology, oppor- zation in the future. These increasingly
tunity for improved data entry accuracy, sophisticated systems will be refined and
management support, and incentives for improved as the population of the United
users. Barriers to successful implementa- States ages, the needs for home health care
tion of home health systems centered on swell, and the health care system contin-
cost and training requirements. ues to evolve.
The literature about home care systems
tends to be more discussion- than data-base Sandra Sojka