Homecare: The Future of Health Care

by Marie Ruhland, RN, BSN

Marie began her homecare career in 1987 at Hilo Medical Center Home Care, and has been there ever since. She started as a staff nurse, moved up to clinical supervisor, and now serves as director. Here’s how technology had an impact on Marie and her agency:

I love homecare, and I love to teach and learn with my patients. I believe homecare is the health care of the future. One of my biggest accomplishments has been establishing our agency as one of the top agencies in the state of Hawaii. We were one of the first agencies to go “point of care” with our documentation, and the first agency in Hawaii to implement telemonitors. Our outcome-based quality improvement rates for acute care hospitalization (ACH) have been lower than the national risk-adjusted rate, and we are one of the lowest in the state for ACH. I feel that our agency, although small, is very competitive and continues to be on the cutting edge due to our adoption of technology.

* * *

Marie is Director at Hilo Medical Center Home Care in Hilo, Hawaii, a Standard member of the Beacon Institute™. Hilo Medical Center is the largest facility in the Hawaii Health Systems Corporation.
--------------

by Pam Ireland, RN, BA

In August 1983, Pam began working for a rural public health department that offered homecare services. Looking back now, she sees the major benefits of technology.

Before they had the CMS-485, we had to complete our own form and send it in for payment. After the 485 came along, there was one year when they changed the 485 three times and we had to reorder forms each time! The 485, 486, and 487 were extremely cumbersome since we did a lot of chronic-type patients. Documentation was somewhat sparse compared to what we have to do now. Our state Blue Cross was the intermediary and they denied a lot. We gave IV medications and billed wound care supplies, and a lot of the patients with routine labs were kept on service as they also needed custodial care. Even training was more difficult. When HIV hit the front page, we had to do a lot of quick training, and anxiety was pretty high. A lot of agencies were just getting into regulation management and there were things we didn’t know we should’ve been doing differently. There are so many great stories and I’ve seen so many changes. But we keep going.

* * *

Pam is Director of Homecare at Mt. Carmel Home Health Care in Pittsburg, Kansas. They offer nursing care, social services, homecare aides, and therapy. Mt. Carmel is part of the Via Christi Health System and is a Premium member of the Beacon Institute.