Care Coordination and Technology

Care Coordinationand

TechnologyRita Kobb MS, MN, GNPLead Care Coordinator

Tech Care Coordination Programrita.kobb@med.va.gov

VA InitiativeCommunity Care

Coordination Service

Implemented April 2000Served over 2000 veteransHome is site of careRight care, right place, right timeCoordination not care provisionPatient not problem focused

Why Use Technology?

Increases access to care Improves communication Promotes healthier behaviors Promotes self-care Reduces healthcare consumption Reduces healthcare crises

Types of Technology

Disease management tools Messaging devices Real time video monitors Computers with chat rooms Instamatic cameras

Technology Devices

Risk Management Software

Case Study 1-Telemonitor77 y/o WW II VeteranLung Disease from Smoking

12 mos Pre-enrollment– 9 admissions– 97 days in hospital– 48 ER visits– unable to leave home

12 mos Post- enrollment

– 2 admissions– 7 days in hospital– 5 ER visits– Army reunion

Case Study 2-In-home messaging80 y/o WW II VeteranHeart Failure

12 mos Pre-enrollment– 10 admissions– 113 days in hospital– 37 ER visits– no activity– wife at home

– 0 admissions– 0 days in hospital– 2 ER visits– gardening– wife out shopping

Case Study 3-Camera64 y/o Korean War VeteranDiabetes

12 mos Pre-enrollment– 5 admissions– 36 days in hospital– 12 ER visits– wound for 16 mos– on surgery schedule

– 0 admissions– 0 days in hospital– 0 ER visits– wound healed 6 wks– no surgery

Lessons Learned

• Patients embrace technology• Patient needs/coordination not

technology drive care Always include caregiversDon’t use the word computer to explain what technology is

Where Do We Go From Here?

• 5 Networks (14 states) active• 6 more to begin this Fall• Final 10 Networks Fall 2004• National training center to teach

staff how to use technology and do care coordination opens 2004

Care Coordination and Technology

Documents

Care Coordination for California’s Children and Youth with ... · Care coordination under the CCS program is done by medical professionals while care coordination under managed

Making Connections: Strategies for Strengthening Care ... · Making Connections: Strengthening Care Coordination for Children & Adolescents 1 Introducing Care Coordination Strategies

Technology Essentials for ACO's and Care Coordination

HL7 Coordination of Care Service Functional ModelHL7 PCWG Coordination of Care Service Functional Model Page 4 HL7 Service Functional Model; Coordination of Care Service (CCS), STU

Patient Care Coordination Variance Reports Template€¦ · Web viewSection 4.8.2 Implement–Patient Care Coordination Variance Reports Template - 1 Patient Care Coordination Variance

Care Coordination Program

Nursing Facility Care Coordination Guidelines Facility Care Coordination ... NURSING HOME PRODUCT CHANGE: ... hospice care plans and/or home care agency’s care plans, etc)

WS Technology - Service Coordination

Improving Care With an Integrated Care Coordination Program

Improved care coordination · Improved care coordination – background, vision, solution and ... + patient services by it self an integration + Solution based on Intersystems technology

Community Care Coordination Systems: Technology …...Community Care Coordination Systems: Technology Supports 1 Executive Summary The health care system is transforming to deliver

Care Coordination Delegation Guidelines for Community Members · Care Coordination Delegation Guidelines for Blue Plus MSHO Community Members 1 | P a g e Care Coordination Delegation

Care Coordination - Welcome to SCAN Health Plan! · 2018-04-13 · Care Coordination . Improving the Patient Experience . Office Staff Training . Introduction \爀屲Care Coordination

Paying for Care Coordination

SDS Care Coordination Guide

1 Care Coordination Through the Use of Home TeleHealth Technologies VHA Care Coordination Program VHA Care Coordination Program VA Healthcare Network of

Behavioral Health Care Coordination

Appendix LL: Guide to Care Coordination Forms Important Points€¦ · Appendix LL: Guide to Care Coordination Forms . Important Points • Use the most recently revised Care Coordination

Care Coordination: Executive Summary

Care Coordination Powerpoint