Telemedicine for home infusion is made easier
Telemedicine for home infusion is made easier
Data collection via telephone
If the whole purpose of computerizing your field staff is to collect clinical data, why not go with something that could be just as efficient yet cheaper and more reliable? That’s what Tele-Document, a Cincinnati-based corporation, had in mind when it developed Dial-n-Document, a product that allows field staff to enter patient data over the phone.
The company, which was created in 1996 and followed in the summer of 1997 with the beta-testing of Dial-n-Document, now handles more than 500,000 annual visits from home care providers across the country. According to Don O’Rourke, Tele-Document’s president, one of the biggest benefits is ease of use.
"The training is minimal," he says. "We are seeing that the training for aides is less than half a day. It is not much different than if you do banking by telephone. It uses voice prompts, and everyone is comfortable using the phone."
Progress takes time
Debra Tadgett, RN, BS, director of home care services for Upper Valley Medical Center Home Care Services in Troy, OH, says the training time is miniscule compared to that typically required when moving to automation.
"We have already trained our entire staff to use the system," she says. "It takes about an hour to train nurses’ aides and staff to use the telephone documentation. One of the big benefits is that it does not take a lot of training time to learn how to enter information through the telephone."
However, having switched to the system from a totally paper-based documentation system is requiring some time.
"Our primary reason for using the product is that we were looking for a more cost-effective way to provide documentation and be able to build a database to use information that we needed from our patients’ records," says Tadgett. "Being so new, we haven’t had the opportunity to glean information from the system yet. We started with a third of our patient population and started inputting all of that data. We’ve been converting new patients and recertifications into the system. I think we’ve just about gotten to the point where we have our whole caseload and demographics in the system."
According to Tadgett, it took about four hours to train nurses and therapists how to use the system so they could enter all the necessary patient information into their computers.
O’Rourke notes that the product has a very specific use.
"This is used to collect data for home care," he says. "It is not a time and attendance product, but it is a fairly robust clinical data collection product that enters the information into a database."
The process to collect data is simple. A clinician or aide can call from any phone and enter her PIN number, followed by the patient’s ID number.
"The clinician is then asked if they want to document in English or another language," says O’Rourke. Right now, the company has two languages available and is letting users decide what languages become available in the future.
"Right now, we have English and Russian available because a provider had a high percentage of Russian-speaking patients and staff," he says. "We may go to Vietnamese next, but we are letting the customers dictate where we go."
The clinician then enters the mileage, supplies used, and several patient vital signs.
"Then it takes you through the processes and procedures you performed, ranging from an aide providing a bath and going grocery shopping to a nurse providing infusion therapy," says O’Rourke. "The nurse simply enters the appropriate code."
About $1 a call
After the documentation phase, the nurse is allowed to dictate a message that will be transcribed into the patient’s data. After the clinician reviews the information provided, she enters the data and ends the call.
In addition to ease of use, O’Rourke adds that the upfront cost is but a fraction of the typical cost associated with computerizing staff.
"We set this up as a service rather than a licensing of software," he says. "They pay per documented visit — what we call per click,’ or hang-up." Although a number of variables come into play in terms of cost, it averages out to just over $1 per call.
"And the servers reside at the customer site," he adds. "If they are of the requisite size, they don’t have to pay for that service. From then on they can view their data in any number of formats that are Windows-compatible and report it."
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