Since the advent of the Affordable Care Act in 2012, the accent has been on lessening hospital readmissions — and not without reason. The readmission rate within 30 days of discharge stands at 20 percent for those going from hospital to home, 25 percent for those transitioning from a hospital to a skilled nursing facility.
And the pricetag for those readmissions is a staggering $17 billion a year.
This issue — a considerable one, given the fact that one in every four Medicare patients hospitalized with an acute medical issue is discharged to a SNF — centers on interoperability. On making certain that the lines of communication between the two places remain open, thereby ensuring the best possible outcomes.
These concerns were best summarized in a 2017 study undertaken by the Yale Center for Healthcare Innovation, Redesign and Learning:
“At times, hospital and SNF providers seemed pitted against one another, as each institution remained primarily focused on addressing its own fiscal and performance metrics, with less consideration of the effectiveness or cost of the overall plan of care.”
The study anonymously quoted workers on both sides of the equation, with an SNF employee saying that hospitals overpromise outcomes and a hospital worker noting that readmissions sometimes occur when family members are unwilling to accept unfavorable diagnoses.
Other reports have concluded, as a result, that hospitals need to take a more active role in the discharge of patients — that they must be more diligent about providing SNFs with all the necessary information. As one of the SNF respondents to the Yale study said, it can be “almost embarrassing” when one has to ask a family member exactly what sort of care their loved one received in the hospital.
It has been further suggested that the two facilities would do well to collaborate on tailored care plans to ensure the best possible outcomes.
The patient’s family can take a more active role as well, by investigating SNFs and finding out what they have to offer. Too often families rely on a physician at the hospital to make the call as to where to send their loved one, and that has its drawbacks, as doctors tend to choose a facility based on a prior relationship, as opposed to performance data.
It falls upon the SNF, of course, to provide innovative, holistic care. The latter is the case at The Allure Group, a network of six such facilities in Brooklyn and Manhattan. There, our staff makes the best use of cutting-edge technology, in hopes of providing the best possible patient outcomes.
Key to our innovation is our focus on achieving interoperability. Interoperability affords SNFs the ability to facilitate a seamless transition from the acute setting to the post-acute setting by the sharing of critical patient information. Through our effort to connect with partner hospitals’ EMR systems, The Allure Group can obtain EMR records that are critical to the development of personalized patient care plans. Information such as Continuity of Care Documents (CCDs) and Discharge Summaries, provide a wealth of information on a patient which are vital to ensuring that the patient’s post-acute care is appropriate.
Another technology employed by The Allure Group is the EarlySense, a remote patient monitoring system that involves placing sensors under cushions or pillows to track residents’ vital signs and movements. Implemented at one of Allure’s facilities, the Bedford Center, in July 2017 (and later expanded to the other five), EarlySense demonstrated in its first six months results that correlated to those that had been seen elsewhere — a 45 percent reduction in patient falls, a 60 percent reduction in bedsores and an 80 percent reduction in code-blue events.
Allure’s 1,400 patients also reap the benefits of TeleHealth technology, which gives them constant access to medical care, even at those times when a doctor is not on-site. In addition, Allure employs ConstantCare tech, which enables us to transfer real-time vitals to electronic medical records. Various robotics are also available to aid in patients’ rehabilitation. They include:
- AlterG Anti-Gravity Treadmill: Helps those with all manner of lower-body issues — whether a top-notch athlete or a patient with a debilitating neurological disorder — rehabilitate without putting undue stress on the affected limb.
- Armeo Spring: Enables those with partial arm paralysis, whether the result of stroke, spinal cord injury or diseases like multiple sclerosis or Parkinson’s, to regain their motor skills.
- H200: Stimulates muscles and nerves in the hand or forearm through electrical stimulation, allowing patients afflicted by some of the same disorders listed above to achieve movements like reaching and grasping.
- Lokomat: Robotic exoskeleton that helps a patient, suspended in a harness over a treadmill, “relearn” how to walk.
- L300 GO: Electrical stimulation designed to improve the mobility of patients afflicted by maladies affecting the lower extremities.
But before a patient can take full advantage of such innovation, it is essential that
a foundation must be laid — that the lines of communication between a hospital and skilled nursing facility are open, and the patient’s needs are made abundantly clear.