COMS Interactive has developed software to help nursing homes take a bite out of one of healthcare’s most persistent problems: hospital readmission of post-acute care patients.
Estimates vary on the rate of rehospitalization among patients released to nursing homes or assisted-living facilities, but there’s not much debate that it’s a serious problem. A 2010 report from the Robert Wood Johnson Foundation found that 25 percent of Medicare beneficiaries discharged from the hospital to a skilled nursing facility were readmitted to the hospital within 30 days.
Those rehospitalizations cost Medicare $4.34 billion in 2006.
More vexing is that it’s likely that a significant percentage of reshospitalizations shouldn’t happen: Some experts estimate that up to 40 percent could’ve been avoided with high-quality skilled nursing care, according to the Commonwealth Fund.
From nursing homes’ perspectives, rehospitalizations have an obvious cost, too: empty beds. When a patient has to return to the hospital, it’s a lost revenue opportunity for the nursing home operator.
And that’s where Cleveland-area COMS (the name stands for Clinical Outcomes Management Systems) comes in.
“If you engineer better care at the post-acute level, everybody benefits,” said CEO Ed Tromczynski. “Our whole focus is arming the post-acute entity with information and tools at the point of care to do that.”
By helping nursing homes better care for their patients, COMS Daylight IQ disease management software package can reduce nursing facilities rehospitalization rates by as much as 50 percent, Tromczynski said.
Daylight IQ’s backbone is a library of disease-based protocols and procedures that help nurses tailor their care to specific patients. For 24 “disease categories” that represent 85 percent of common disease affecting nursing homes residents — such as diabetes, cancer or congestive heart failure — the software provides lists of symptoms, treatment interventions and care tips.
That information combines with a “rules engine” and reporting tool that helps uncover any abnormal trends that could indicate a patient’s disease is worsening.
For example, if a patient suffering from chronic obstructive pulmonary disease (COPD) suddenly gains weight and begins wheezing, the software would alert a nurse that the patient’s body may be filling up with fluid because the disease is progressing. In this scenario, the software’s protocols and procedures would instruct the nurse on how to care for the patient and would possibly help the nurse detect the patient’s deteriorating condition faster than he otherwise would have.
With most nursing home patients suffering from one primary disease, but also eight secondary diseases that combine to exacerbate each other, the patients can be very challenging for nurses to manage, Tromczynski said.
COMS has about 30 customers and its software is being used at more than 300 facilities, Tromczynski said. In addition to nursing home operators, COMS sells to assisted living facilities and home healthcare companies.
Future plans include rolling out bolt-on modules to the software, such as a character-recognition tool that would capture medical records data from an online screen or form and pull it into Daylight IQ, Tromczynski said.