5 Questions for Tracey Moorhead, President, VNAA

As populations age around the world, home healthcare will become a more vital part of caring for senior patients. To learn more about this growing trend, and how technology can play a role, we sat down with Tracey Moorhead, president and CEO of the Visiting Nurse Associations of America (VNAA), which represents non-profit providers of home health, hospice, and palliative care services and has more than 150 agency members in communities across the country.

Intel: How has technology impacted the visiting nurse profession?

Moorhead: Technology has impacted the profession of home care providers, particularly, by expanding the reach of our various agencies. It allows our agencies to cover greater territories. I have a member in Iowa who covers 24,000 square miles and they utilize a variety of technologies to provide services to patients in communities that are located quite distantly from the agencies themselves. It has also impacted the individual providers by helping them communicate more quickly back to the home office and to the nurses making decisions about the course of care for the individual patients.

The devices that our members and their nurses are utilizing are increasingly tablet-based. We do have some agencies who are utilizing smartphones, but for the most part the applications, the forms and checklists that our nurses utilize in home based care are better suited for a tablet-based app.

Intel: What is the biggest challenge your members face?

Moorhead: One of the biggest challenges that we have in terms of better utilizing technology in the home based care industry is interoperability; not only of devices but also of platforms on the devices. An example is interoperability of electronic health records. Our individual agencies may be collaborating with two or more hospital systems, who may have two or more electronic health records in utilization. Combine that with different physician groups or practice models with different applications within each of those groups and you have a recipe for chaos in terms of interoperability and the rapid sharing and care coordination for these various patients out in the field. The challenges of interoperability are quite significant: they prevent effective handoffs, they cause great challenges in effective and rapid care coordination among providers, and they really continue to maintain this fragmentation of healthcare that we’ve seen.

Intel: What value are patients seeing with the integration of technology in care?

Moorhead: Patients and family caregivers have responded so positively to the integration of these new technologies and apps. Not only does technology allow for our nurses to communicate with family members and caregivers to help them understand how to best care for and support their loved ones, but it also allows the patients to have regular communication with their nurse care providers when they’re not in the home. Our patients are able to contact the home health agency or their nurse on days when there may not be a scheduled visit.

I visited a family in New Jersey with one of our agencies and they were so excited that it was visit day. When the nurse arrived not only was the wife there, but the two daughters, the daughter-in-law and also the son were there to greet the nurse and to talk with the nurse at length about the progress of the father and the challenges that they were having caring for him. That experience for me really brought home the person-centered, patient-centered, family-centered care that our patients provide and the technologies that were being utilized in that home not only when the nurse was there but the technologies that the nurse had provided with the family, including a tablet with an app to allow them to contact the home health agency, really made the family feel like they had the support that they needed to best care for their father and husband.

Intel: How are the next generation of home care providers adapting to technology?

Moorhead: The next generation of nurses, the younger nurses who are just entering the field and deciding to devote themselves to the home based care delivery system, are very accustomed to utilizing technologies, whether on their tablets or their mobile phones, and have integrated this quite rapidly into their care delivery models and processes. Many of them report to us that they feel it provides them a significant degree of freedom and support for the care delivery to their patients in the home.

Intel: Where will the home care profession be in five years from now?

Moorhead: I see significant change coming in our industry in the next five years. We are, right now, in the midst of a cataclysm of evolution for the home based care provider industry and I see only significant opportunities going forward. It’s certainly true that we have significant challenges, particularly on the regulatory and administrative burden side, but the opportunities in new care delivery models are particularly exciting for us. We see the quality improvement goals, the patient-centered goals and the cost reduction goals of care delivery models such as accountable care organizations and patient-centered medical homes as requiring the integration of home based care providers. Those organizations simply will not be able to achieve the outcomes or the quality improvement goals without moving care into the community and into the home. And so, I see a rapid expansion and increased valuation of home based care providers.

The technologies that we see implemented today will only continue to enhance the ability to care for these patients, to coordinate care and to communicate back to those nascent health delivery models, such as ACOs and PCMHs.