Sending equipment kits home with patients versus completing individual in-home installments has proven to be a successful and effective model. Since switching to kit installations, the COTN team is able to utilize their time more efficiently. This method ensures that in the future, as enrollment rises, they will be able to accommodate larger numbers of patients, keeping up on readings and ensuring adequate communication with patients and providers.
The only drawback to this strategy thus far is a decrease in the level of personal connection between the COTN team and the patients whose health they monitor. Meeting the patients in their home environment provided an opportunity for the team to get to know the patients better and learn more about their lifestyle. Though still more efficient, it is now sometimes necessary to spend a little more time examining patient charts, or speaking on the phone with patients in order to create a clear picture of what is happening for them health-wise, the effectiveness of their medications, and what habits or activities may contribute to the state of their health.
The COTN program RNCC states that since switching to the kit method, the level of care provided to patients remains comprehensive, though the level of personal connection is not the same.
Wednesday, November 5, 2014
Patient Enrollment at Mosaic Redmond
Since the rollout to the Redmond clinic in late August, 2014, a total of thirteen patients have been enrolled. In order to promote Telehealth and encourage provider buy-in, the COTN team followed up the rollout meeting by with welcome and thank you letters. In the future, all rollouts will be followed up in this manner in order to create camaraderie between the COTN team and program, and all providers within the network.
Form Translation
Although progress has been made regarding the translation of written materials into Spanish, challenges persist.
The onsite translator at Mosaic Medical has created Spanish versions of the Inventory and Consent and Welcome letters. However, the survey that measures the effects of the program on patient self-management ability, the PAM Scores questionnaire, was created by Insignia, and worded in such a way as to produce specific desired information. Mosaic’s translator is unable to translate the questionnaire, as a direct interpretation would not yield the same meaning. This form is available in Spanish by Insignia, but has not yet been made available to COTN.
The onsite translator at Mosaic Medical has created Spanish versions of the Inventory and Consent and Welcome letters. However, the survey that measures the effects of the program on patient self-management ability, the PAM Scores questionnaire, was created by Insignia, and worded in such a way as to produce specific desired information. Mosaic’s translator is unable to translate the questionnaire, as a direct interpretation would not yield the same meaning. This form is available in Spanish by Insignia, but has not yet been made available to COTN.
Equipment Retrieval Challenge
With enrollment numbers on the rise, it is increasingly important that Telehealth equipment be returned promptly when one’s participation in the program ends. Although patients are given explicit instructions to do so, the equipment is not always returned.
In an attempt to encourage timely return of the equipment, the COTN coordinators at the Prineville Clinic are keeping a list of patients with items checked out. There are notes in two areas of these patients’ charts in EPIC, viewable by the front and back office staff at the clinics. Reminder notes are also attached to upcoming appointment notices. The COTN staff has also sent out letters and made regular phone calls to patients, requesting them to return the equipment.
COTN’s RNCC has recently created a new letter, which will inform the patients of the cost of the equipment, which they will be responsible for if it is not returned. The next step, if all of the above steps have failed, will be to send an invoice to the patients, billing them for the cost of the equipment.
In an attempt to encourage timely return of the equipment, the COTN coordinators at the Prineville Clinic are keeping a list of patients with items checked out. There are notes in two areas of these patients’ charts in EPIC, viewable by the front and back office staff at the clinics. Reminder notes are also attached to upcoming appointment notices. The COTN staff has also sent out letters and made regular phone calls to patients, requesting them to return the equipment.
COTN’s RNCC has recently created a new letter, which will inform the patients of the cost of the equipment, which they will be responsible for if it is not returned. The next step, if all of the above steps have failed, will be to send an invoice to the patients, billing them for the cost of the equipment.
PAM Scores
As per the HERSA grant which is funding the expansion of Telehealth into Central Oregon, patients are required to complete pre- and post- Patient Activation Measure scores.
One challenge with this process is that some patients are reluctant to complete the surveys. Others fail to return their completed surveys.
A second hurdle has been sorting out how to keep track of the scores. When COTN first launched Telehealth in Prineville in 2013, the process involved scanning the completed forms so that they were accessible electronically. Once scanned, the forms were saved in in “other orders” – this was prior to there being a specific place in EPIC for the forms to call home.
Heading forward, the scores will be saved in the “referral” section in EPIC, and pre- and post- scores will be entered into an Excel Spreadsheet as they are collected.
One challenge with this process is that some patients are reluctant to complete the surveys. Others fail to return their completed surveys.
A second hurdle has been sorting out how to keep track of the scores. When COTN first launched Telehealth in Prineville in 2013, the process involved scanning the completed forms so that they were accessible electronically. Once scanned, the forms were saved in in “other orders” – this was prior to there being a specific place in EPIC for the forms to call home.
Heading forward, the scores will be saved in the “referral” section in EPIC, and pre- and post- scores will be entered into an Excel Spreadsheet as they are collected.
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