Bringing the Hospital, and the Lab, Home

The home health industry had already been growing steadily for years before COVID-19 came along; but the pandemic, and the need for virtual, “socially distanced” health services that came with it, have exponentially accelerated that growth. It not only increased demand for home health services, but also prompted the U.S. to propose changes to government funding of home- and community-based services (HCBS).

At the time of this writing, members of the United States Congress are debating an infrastructure funding package that could include as much as $400 billion for home and community-based services (HCBS). 1 (Globally, U.S spending on HCBS is much lower than that of nearly all other developed countries.1) If that funding is approved, we will likely see much bigger investments in home health programs from both payors and provider agencies. But we may also see changes to policies on reimbursement for home health services that would require agencies to show evidence of improved health outcomes for their patients.

As a result, many home health agencies and hospital systems may need to invest in new tools and resources that will help them deliver high-quality care to the rapidly growing and changing population of home-based patients.

The Picture of Home Health

Many people still think of home health as an option that is only for people who have been discharged from a hospital or nursing home. But today, many home health service providers are tasked not only with helping patients who have left a hospital setting, but also preventing patients from being admitted to a hospital or nursing home

So, who are today’s home health patients? First, according to recent Medicare data, only one-third of patients were assigned to home health care after a hospital or nursing home stay. Two-thirds are referred to home health from the community. 2

Home health patients also tend to be people who need help managing complex comorbidities. Nearly 50 percent of them have five or more chronic conditions, such as asthma, arthritis, diabetes, or heart disease. Only 22.4% of all Medicare beneficiaries must manage that many conditions all at once.2

What Will Today’s Home Health Providers Need to Succeed?

To be most effective in serving the growing complexity of their patient population, home health providers must build a comprehensive system that includes not only hands-on care, but also remote patient monitoring, lab work, radiology, and medication delivery. And, to make the system work, they will need to find ways to enhance their ability to communicate and collaborate with all the members of a patient’s care team.3 Some experts also think that home health agencies may need to become more specialized, with specific programs dedicated to heart disease, diabetes, respiratory health and more. And, as they expand to offer these services and more, home health agencies will want to consider how to best improve quality of care while reducing costs. 3

One health outcome measurement that both government payors (Medicare) and private payers will likely track is hospital admissions and readmissions. There is already some evidence that home-based primary care can reduce ER visits, hospitalizations, and 30-day readmissions for homebound patients. Early results of a 5-year Medicare program called Independence at Home showed not only these reductions in hospitalizations, but also an average annual cost savings of $2,700 per beneficiary.3

How Can Point-of-Care Testing Help?

Some healthcare providers have expressed reluctance over a broad shift to home health. One of the reasons often cited is that patients may not be continuously monitored at home in the same ways they are in a hospital, skilled nursing facility, or nursing home. They worry that subtle but significant changes in a patient’s vital signs or biometric measurements might be missed, and along with it, the chance to adjust treatment in a way that could improve and prolong the patient’s life.

But advancements in remote patient monitoring, medical records sharing, and rapid biometric testing can help ensure that a patient’s health status can be closely tracked at home, and that any necessary adjustments to the patient’s treatment plan based on those on changes can be quickly communicated to the home care team and the patient.

One example is in tracking lipid panel and A1C results for home-based patients with heart disease and diabetes. Regularly tracking these two metrics in addition to other vital signs and biometric measurements may help providers identify which patients are at the highest risk for eventual hospitalizations due to less-than-optimal management of their conditions.

Some studies have shown that reducing cholesterol levels that are too high can lessen the risk of heart attack or heart-disease related death4, and optimal control of blood glucose can make a difference in reducing diabetes complications.5 Furthermore, some evidence shows that poor glycemic control in patients with diabetes is associated with an increase hospitalization due to heart disease or any other cause.6

The ability for home health providers to gather accurate lipid panel and A1C results at the patient’s home in minutes, instead of the usual days or weeks it can take to get test results from a lab can make a difference in two ways:

– It can improve overall workflow efficiency, resulting in a related reduction in staff time and costs.

– It gives providers the opportunity to get same-visit feedback on their progress and setback in terms of their glucose and cholesterol control. Prompt feedback can help make new information “stick” and can help motivate patients to act on new knowledge they have gained. 7

When you combine these added efficiencies with better informed and more engaged patients, and with highly-skilled healthcare providers, you have a winning formula for high-value/low-cost service—something that both patients and payors like to see.

While the finer details of home health care policies in the U.S. are not yet certain, there is little doubt that demand for home-based care will continue to grow, and along with it, the need for home-health-friendly tools and services.

If you have any questions about the benefits of point of care testing in home health settings, please reach out to us. We are happy to help in any way we can. Start by visiting ptsdiagnostics.com/contact-us.

Sources

1 https://homehealthcarenews.com/2021/06/senators-advocates-tout-once-in-a-generation-opportunity-for-funding-hcbs/

2 https://homehealthcarenews.com/2021/01/top-home-health-trends-for-2021/

3 https://hbr.org/2019/10/5-obstacles-to-home-based-health-care-and-how-to-overcome-them

4 https://www.webmd.com/heart-disease/guide/heart-disease-lower-cholesterol-risk#1-3

5 https://spectrum.diabetesjournals.org/content/16/4/217 

6 https://link.springer.com/article/10.1007/s11892-018-0989-1

7 https://edume.com/blog/role-of-feedback-in-improving-learning

Q2 Graduation Photos

pts
pulse Q2

Congratulations
to our family of
2021 Graduates!

No More Telemedicine Tradeoffs: Get A1C Test Results for Virtual Appointments

For many people with diabetes, regular, personal interaction with healthcare providers is key to helping them successfully manage their disease. The opportunity to ask questions, share concerns, and receive support and encouragement from their providers is highly valued by many patients, and can have a real impact on their health outcomes. 1

But what happens when a global pandemic forces most face-to-face appointments to go virtual? And what happens to the quality of virtual appointments in cases where providers need lab quality results to confidently assess a patient’s condition?

Integrating self-testing options with a telemedicine program may be just the thing patients and providers need to enjoy the flexibility of telemedicine without sacrificing the quality of care.

Bridging the Telemedicine Lab Test Gap

Although virtual appointments have increased by 35% since COVID-19 took hold, there are many patients and providers who are reluctant to try virtual appointments due in part to a perceived decrease in the quality of care when it is conducted virtually.2

One reason for that perception is that the kinds of lab tests healthcare providers would typically use to assess the efficacy of their patient’s treatment cannot be performed virtually.2 Since the recent switch to virtual appointments was so sudden, many telemedicine programs have not yet caught up to the world of at-home, self-collection blood tests available on the market today, forcing providers and patients to do without the information they usually rely on to provide the highest quality care.

Patients and providers don’t have to miss out on the valuable insights lab tests can provide when they switch to virtual appointments. For example, people with diabetes can perform A1C tests at home with the A1CNow® Self Check test system. It is easy to use and has been shown to produce results that are as accurate as those from traditional laboratories.3 That means that both patients and providers can trust that they are receiving the same quality results they would likely receive from an office-run or lab-run test.

Personalizing Diabetes Management Through Self-Tests

Even before COVID-19, many patients with chronic conditions like diabetes and hypertension struggled to keep up with the number of appointments they needed to attend for help in managing their condition. Bringing the ability to perform simple lab tests and attend appointments from their homes may be a game changer for those who haven’t had full access to care due to time or money constraints. Though many will benefit for the flexibility of telemedicine and at-home testing, patients should ask their healthcare providers whether self-testing and virtual appointments are appropriate options for them based on their own health risks and goals. And, it’s important not to make any decisions about your health based on the results of an at-home test without first consulting a physician. More information on the A1CNow Self Check system is available at https://ptsdiagnostics.com/a1cnow-self-check/.

Bringing Clarity to Wellness Data with Onsite Health Diagnostics

We recently asked our partners at Onsite Health Diagnostics to answer a few questions about how they integrate PTS Diagnostics test systems into their business model.

Please tell us a little bit about your company’s mission.

At Onsite Health Diagnostics, we are independent auditors of wellness progress. While most health screening companies also offer behavior change services (telephonic coaching, lifestyle management, etc.) WE DON’T.

Precisely, this allows us to remove the conflict of interest in the traditional wellness value chain and objectively arm consultants with information about which wellness services work, and which don’t. Steeped in statistical science, our analyses answer 80% of corporate wellness questions using biometric screening data alone, allowing policy and reward program decisions to be made 6 months before claims data from the current year is available.

To support our efforts, over the past 5 years OHD has invested heavily in technology resulting in the industry’s leading Employee Registration Portal Application with Interactive, Online Reporting.  Additionally, we have aligned ourselves with cutting edge companies like PTS Diagnostics.

Ultimately our mission as an organization is to lead others to experience health and wellness clarity with the best people, service, data, and technology.

How long have you been using PTS Diagnostics products?

We have been using PTS Diagnostics products for over 4 years now. Watching PTS’s diligence in always improving and innovating has been impressive to witness. They never have any hesitation in trying to exceed our expectations as a client.

How would you describe your relationship with PTS Diagnostics?

I would describe it as a true partnership versus the typical customer/vendor relationship. PTS has been willing to explore new ideas and strategies to strengthen connections with current OHD clients and has helped us add new customers. It continues to be a consultative association where PTS’s and OHD’s goals are aligned.

How do PTS Diagnostics products make a difference for your customers and your operations?

PTS products make a difference for OHD and our clients by being accurate and economical with less restrictive handling and storage requirements than other products on the market. With the introduction of the Bluetooth iOS compatible adapters integrated with OHD’s connectivity technology, there are no comparable solutions from other point-of-care competitors.

Overcome COVID-19s Doctor Visit Dilemma with Telemedicine and Self Tests

Most people with diabetes are used to making careful decisions about their health.
Together with their healthcare providers, they plan what to eat, how much to exercise, how often to test their blood glucose and A1C, and whether they need changes in their care plan.

Prior to the COVID-19 pandemic, patients likely visited their healthcare provider’s office in-person on a regular basis. Unfortunately, people with diabetes are at greater risk of suffering severe complications from COVID-19,1 which has left many patients and their physicians stuck in a bit of a catch-22:

Attend face-to-face appointments and risk contracting COVID-19?

Or

Skip in-person appointments and risk the complications that can develop when diabetes is not well-monitored and managed?

Luckily, there is another option.

A1C Testing and Telemedicine

Most patients with diabetes are accustomed to running their own blood glucose tests at home—often multiple times a day. But, when it comes to A1C testing, they can often expect to get lab orders from their physician, show up for another appointment, and wait for results.

Before COVID-19, this approach to A1C testing was inconvenient, at best. But, in the new post-COVID world, it’s more than inconvenient— it’s a potential risk to a patient’s health.1

At-home tests (like A1CNow® Self Check) can be purchased online or at national pharmacy chains. These at-home A1C tests require only a fingerstick—much like blood glucose tests—and are easy to use. Studies have also shown them to be as accurate as lab tests.2

And there are many ways an at-home A1C test can be used in conjunction with a virtual doctor’s appointment. Here are just a couple of examples:

 

A1C Anywhere

The quick shift to telemedicine during the pandemic has been challenging, but it has also opened new possibilities for meeting patients right where they are. The flexibility of at-home testing can help patients overcome other common hurdles—like financial, time, or transportation constraints—to attending in-office lab appointments.

Now, patients can more easily work with their healthcare providers to design a diabetes management plan that fits their lifestyle—whether that means face-to-face appointments, virtual appointments, or a combination of the two.

If you are a person living with diabetes, please talk to your healthcare provider to find out if at-home A1C testing is the right option for you.

To learn more, please contact us.

Sources

1 American Diabetes Association. (2021, January 26). Frequently asked questions: Covid-19 and diabetes. Retrieved February 08, 2021, from https://www.diabetes.org/coronavirus-covid-19/how-coronavirus-impacts-people-with-diabetes

2 Jiang, F., Hou, X., Lu, J., Zhou, J., Lu, F., Kan, K., . . . Jia, W. (2014, June 1). Assessment of the performance Of A1CNOW(+) and development of an ERROR GRID ANALYSIS graph for comparative hemoglobin A1c measurements. Retrieved March 01, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4029042/