For long-term care and skilled nursing facility operators, wound care plays a significant role in everything from staff efficiencies to outcomes to reimbursement. It’s also an important factor in the growing push for the industry to expand adoption of value-based care initiatives.
The reason is clear. More than 25% of elderly patients have at least one wound upon admission to the hospital. Many of those patients originate from, or end up in, LTC or SNF units – about 2 million annually in nursing homes alone.
To deliver quality care to these patients — and demonstrate results in the data-driven, value-based payment world — providers and their healthcare partners need advanced wound care technology.
Shift to value-based payment programs
To improve healthcare quality and outcomes, the federal government and payers are advancing the use of value-based purchasing programs. The Patient-Driven Payment Model shifts payments from volume to value. Under PDPM, pressure injuries and wounds are one condition qualifying a patient for the clinically complex category, underscoring the need for vigilance in this area.
In September, The Centers for Medicare & Medicaid Services announced the new Skilled Nursing Facility Healthcare-Associated Infections Requiring Hospitalizations Measure. The goal is to track the rate of nursing home stays that result in acquired infections, such as wounds.
Such value-based programs put further pressure on SNFs and LTC facilities to continue optimizing their care for wound care patients. Having the proper tools to drive accurate documentation and best outcomes is therefore essential.
Technology is the bridge
A key complaint of value-based programs is that even good facilities can be penalized. For example, if a patient’s existing pressure ulcer was not properly documented upon admission, a SNF could still be penalized, even though the wound didn’t start in that facility. The ongoing quest is to prove that we are doing our jobs — and doing them well.
That’s a task that can be difficult in and of itself. Wound care has historically been challenging for the industry for many reasons, including the complexity involved in treating wounds, the fact that patients may have multiple comorbidities and difficulties with adherence and compliance.
However, new cost-efficient and simple-to-use apps are providing an accessible entry point for many providers. These apps don’t take the “art” out of medicine; they help to diagnose based on probabilities, improve the efficiency of assessments and drive the most up-to-date, evidence-based treatments available. In effect, advanced wound care technology can be the bridge SNFs and LTC facilities need to more widely adopt VBP.
Five ways wound care tech helps
Wound care technology enables SNF and LTC facilities to optimize their participation in value-based programs while improving outcomes and securing appropriate reimbursements in five important ways.
- Wound care tech proves the value of what the facility is doing for wound care. Objective data that proves a facility is performing to standards is critical. It provides quantifiable proof that an organization is assessing properly, meeting best practices, billing to code, etc. That data then provides the information needed to avoid penalties and secure optimal reimbursement.
- Technology helps ensure quality care. Yes, we do need to “prove” the quality of care in today’s healthcare ecosystem, but we should also ensure that quality care is readily provided. Wound care technology provides valuable insights that lead to optimal care. For example, 3-D imaging provides more accurate wound measurement, enabling more informed wound treatments.
- The wound status of patients coming to/from the hospital is confirmed. Because of penalties and the importance of prompt treatment, we should make the process of evaluating wounds upon admission as quick and simple as possible. Typically, advanced wound care tools are only available to members of the wound care team. Technology and mobile apps can make wound care diagnosis accurate, safe and quick for any member of a clinical team, helping to speed admission and treatment.
- Providers get the data needed to stage necessary interventions and changes to treatment. Objectivity, precision and consistency are needed to show a reliable trend in all things medical. It’s how clinicians make the most of their clinical decisions. If any subjectivity or variability are introduced, the ability to make the best decision is diminished. Conversely, objective data helps ensure that optimal care is provided uniformly to all patients.
- Wound care tech allows greater focus on patient engagement. It creates efficiencies that allow staff to spend less time filling in EMR boxes and more time on one-on-one, personalized care.
It’s time to embrace VBP
Adoption of technology remains problematic for some LTC operators and SNFs. Many still do not have fully integrated electronic medical records or updated systems. Often a patient’s wound information is in a silo, requiring either faxed medical records or paper records on admission. IT staff at healthcare systems work hard to create a communication channel between foreign medical record systems of varying sizes at different venues. To support those efforts, third-party vendors can provide technology to bridge those different venues, allowing for a single source of truth that facilitates the efficient and accurate hand-off from hospital to SNF.
With an EMR system in the SNF that “talks” to the hospital system, the facilities’ EMR can be populated, and staff can promptly get information on the patient’s condition, allergies, comorbidities, and of course, wounds. While more interoperability is needed, there are EMR systems that do communicate without adding the need to re-input data or go back and forth between systems. SNF and LTC operators should look for technology that is cost-effective and supports seamless sharing of data.
There are other benefits to wider use of wound-care technology, from mobile apps to EMRs. For example, health plans and payers (government and private) are always looking for ways to gather more data to assist with programs to improve outcomes and reimbursement. LTC and SNF providers that offer those capabilities will be viewed as key partners in new data research initiatives.
Value-based care will continue to expand into long-term care and skilled nursing. It does not need to be feared; it should be embraced. If we accept the challenge that the goal of value-based care is not to penalize, but to prove that clinicians are good at what they do, fewer of us would have issues with the initiatives. Concerns would further decrease if we had the technology to make such proof accessible to all, thus ensuring accountability for all. The right approach and technology can make the transition to VBP seamless for facilities and ensure that the potential of advanced wound care technologies are used to benefit all stakeholders.
JD Tyler is a physician and the former CMO for Tissue Analytics, a Net Health company. He has a broad range of health IT experience including serving as chief medical information officer for a regional health system.
