Citizens
Memorial Healthcare Smooths Processes with
Maestro
One of the biggest challenges
for today's home care agencies is finding
ways to obtain maximum reimbursement for
their services. Citizens Memorial Healthcare,
a hospital-based home care agency in Bolivar,
Missouri, is turning to information
technology to meet those needs, most recently
through a migration from PtCT's legacy
clinical system Home Care Manager to Maestro.
"Maestro helps us manage our episodes of
care, while still providing quality care,"
says Jennifer Earl, IS specialist at Citizens.
"It also improves our documentation
skills, which will allow us to get better
reimbursement from Medicare."
After working with the staff at PtCT to
ensure a smooth migration, Citizens soon
began realizing the benefits of the new
system. "PtCT had the implementation
well mapped out for us, and everything flowed
perfectly," says Valerie Noblitt, RNBC,
director home care services at Citizens.
"They kept everything on track with a
thorough timeline."
Clinicians Experience
Benefits of e-Signature and Improved
Documentation
By moving to a groundbreaking technology,
Citizens now has automated processes and a
system which guides the workflow of home care
clinicians, including the ability to sign
electronically and document at the patient's
home. Prior to Maestro, Citizens created
workarounds in Home Care Manager to automate
certain processes, such as the electronic
signature feature for physicians.
"Our biggest benefit to date is that we
no longer have a workaround for physician e-signature,"
says Noblitt. "With the workaround, our
clinicians had to enter information in twice;
now we enter it only once, and then all of
the orders and 485s flow into the sign queue
to be signed."
Another benefit of using an intuitive,
process-based system like Maestro is the
ability to document at the point of care.
Maestro ensures processes are done in the
proper order, are completed in a timely
manner, and lets nothing slip between the
cracks.
"Clinicians are less likely to forget to
add a plan of care or document a treatment,"
says Earl. "We have more accurate
documentation and the information is going to
be readily available for the next clinician
caring for the patient."
Saving Time, Smoother
Processes
Prior to Maestro, Citizens chose to bill
through its hospital's billing system, which
pushed billing data into Home Care Manager
but it did not flow into the Medicare payment
system.
"It took a large amount of time to
manually enter all our billing information
into the Medicare system," says Noblitt.
"We are now electronically filing
everything through Maestro, which has made it
tremendously easier and less time consuming."
Additionally, Citizens does not have to rely
on an interface because all the charges and
tasks are in Maestro. "We do not have to
go into another system to get our charges and
ensure everything flowed correctly through
the interface," adds Noblitt. "It's
made a big difference."
Citizens' billing process runs more
efficiently with Maestro, and in turn the
reimbursement turnaround has improved due to
the e-signature feature.
"The orders and plan of treatment are
signed more quickly with e-signature, because
they don't wait on a desk to be signed or
received," says Noblitt. "When they
are ready to be signed, they go into the sign
queue and stay there until signed. Prior to
this process, we faxed orders and plan of
treatment back and forth. The two potential
problems with a faxed order or plan of
treatment is it gets lost in the fax, and we
have to resend, or the physicians lay the
order or plan of treatment down on their desk
and forget about it."
Achieving Excellence
In 2008, Citizens was awarded with OCS
HomeCare Elite, which is given to the top 25%
of Medicare-certified home care agencies in
the U.S. The award recognizes those agencies
whose performance measures in quality
outcomes, quality improvement, and financial
performance are the best. Stemming off this
accomplishment, Citizens has set out to be in
the top 20% in patient outcomes in all the
indicators reported by Medicare on its Web
site.
"We are well-positioned in our pay for
performance (P4P) initiatives," says
Noblitt. "We have three indicators in
top 20% right now, and three to five others
are in 2-3% of being within the top 20%. By
implementing Maestro to improve our
documentation and quality care, we're on the
right track to achieve this goal very soon."