Have you heard about telemonitoring, otherwise known as telehealth? It sounds very cyber age, but it is actually quite basic and easy. For those patients who qualify, a monitor is placed in the home. The patient and/or family member is instructed in the operation of the equipment which consists of a blood pressure cuff, a finger oximeter, and a scale. Each day at a designated time, the patient is instructed to check their vital signs using this equipment. In addition, there are 10 customized questions asked by the monitor regarding how the patient feels today, changes in symptoms, etc. This information is transmitted through the phone to a central station in our office where it is analyzed and follow-up conducted as necessary. Your doctor can be notified of your monitored results at any time. By using the telemonitor, you can hopefully avoid hospitalizations, prevent a problem, or seek medical attention that could affect your health. If you want more information, please contact us and we will be glad to tell you more about telehealth.
OASIS-C
In 2008, there were over 9000 Medicare certified home health agencies throughout the United States. In 2006, over 3 million beneficiaries were served, and 103,931,188 visits made.Home health is covered under the Part A Medicare benefit. It consists of part-time, medically necessary skilled care (nursing, physical therapy, occupational therapy, and speech-language therapy) that is ordered by a physician.Quality health care for people with Medicare is a high priority for the Department of Health and Human Services, and the Centers for Medicare & Medicaid Services (CMS).CMS has adopted the mission of The Institute of Medicine (IOM) who has defined quality as having the following properties or domains: Effectiveness, Efficiency, Equity, Patient Centeredness, Safety and TimelinessThe instrument/data collection tool used to collect and report performance data by home health agencies is called the Outcome and Assessment Information Set (OASIS). Since fall 2003, CMS has posted on www.medicare.gov a subset of OASIS-based quality performance information showing how well home health agencies assist their patients in regaining or maintaining their ability to function. Based on the 2005 National Quality Forum (NQF) endorsement, as of 12/2007 12 of these measures have been posted to Home Health Compare. The measures (all collected via the OASIS data set) are:
- Improvement in Ambulation/Locomotion
- Improvement in Bathing
- Improvement in Transferring
- Improvement in Management of Oral Medication
- Improvement in Pain Interring with Activity
- Acute Care Hospitalization
- Emergent Care
- Discharge to Community
- Improvement in Dyspnea (Shortness of Breath)
- Improvement in Urinary Incontinence
- Improvement in Surgical Wound Status, and
- Emergent Care for Wound Deterioration
In collaboration with NQF, CMS has developed new home health measures and in particular process measures for immunization, medication management, pain management, fall prevention, depression screening/intervention, care coordination, risk assessment, heart failure, and diabetes. These measures have been incorporated in the revised OASIS tool (OASIS C) which will be implemented January 1, 2010.NQF also will look to harmonize the home health measures with similar NQF-endorsed TM measures in other care settings (e.g., ambulatory, hospital, and nursing homes). NQF will work in partnership with the Agency for Healthcare Research and Quality (AHRQ) and CMS, the accrediting entities, alliances, and representatives from major stakeholder groups to establish priorities and identify a set of national goals, measures corresponding to each goal and a framework for accountability.In the future home health care will be subject to Pay-for-Performance which will link reimbursement to evidence-based practices and systems (in the form of process measures that will be collected at the agency level) - to promote use of such practices.
