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JAMA Viewpoint on Home Health Strikes a Chord

Posted 10/2/2013 Categories: healthcare reform, primary care, EMR, research, chronic care

A highly regarded colleague of mine, Dr. Steven Landers, who is the Visiting Nurse Association Health Group President & CEO, published a piece in the Journal of the American Medical Association (JAMA) last week that struck a chord with me, and I need to address three key points he made that I believe are critical to improving the healthcare system in America.

  1. The quantity and quality of research regarding Medicare’s home health program are limited.
  2. To further improve coordination, health information technology policy should address integration of home health records with medical records.
  3. Advanced practice nurses and physician assistants have made important contributions to primary care, and these professionals should be permitted to certify and oversee home health.

First, while it is true that research regarding Medicare’s home health program are limited, I don’t believe we should wait for CMS to conduct it. The leaders in our industry, Amedisys included, must begin to support objective research into the program’s efficacy and areas for improvement. Only then will we be able to prove the value of the skilled care we provide to millions of Americans each day. The Alliance for Home Health Quality and Innovation’s research initiatives are a positive step in that direction – we must continue to build a body of research that is valid and constructive.

Second, Dr. Landers could not be more right -- the lack of integration between EMRs and home health records poses a significant challenge. Our hospital partners are looking to us to help them transition their patients safely home after receiving acute care, but without a clean way to exchange information in real-time, improvements will lag behind. There must be a clear roadmap for how to do it and an incentive to make it work.

Last, but not least, as a physician who has practiced medicine for more than 30 years, I believe strongly that well-trained and qualified advanced practice nurses and physicians assistants are needed now, more than ever to join us in the care for the chronically ill at home. There is a shortage of primary care physicians that care for these elderly patients with chronic diseases. Working alongside these physicians, advanced practice nurses and physician assistants can help improve the communication, quality of care and outcomes of our shared patients if they were allowed to play a more meaningful role.

The time to prove the value of home healthcare is now. The time to make sure we’re a connected healthcare system that can exchange real-time information throughout the continuum is now. The time for collaboration across the spectrum of clinicians to make a difference in caring for our chronically ill population is now.

Well said, Dr. Landers. Thank you for your leadership on these issues. We hope your perspectives also hit home with the key regulators and policy makers we need on board to press forward.

About the Author

Michael Fleming, MD, FAAFP is the Chief Medical Officer for Amedisys, and Past President of the American Academy of Family Physicians and the Louisiana Academy of Family Physicians. Dr. Fleming has served as Speaker of the Congress of Delegates of the AAFP and as Board Chair of the AAFP Board of Directors. He serves as an assistant clinical professor in the Department of Family Medicine at the LSU Health Science Center and in the Department of Family and Community Medicine at Tulane University Medical School.
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Bring Health Care Home

Posted 12/8/2011 Categories: healthcare reform, home health, independence at home, chronic care

In his New York Times opinion article, Bring Health Care Home, Dr. Jack Resnick makes a compelling case for bringing health care home, where a network of coordinated care givers serve patients in a familiar, comfortable setting.

Care of chronic conditions is more often effectively managed in the home setting rather than in a hospital. The coordinated home health care models of today, which feature a broad network of highly-skilled clinicians ranging from physical therapists to physicians, work with the latest communication technologies to offer the best of old and new forms of medical treatment.

A home based primary care program introduced by the Veteran’s Administration more than 30 years ago has reduced hospital stays by 62 percent and led to a 24 percent drop in overall medical costs. The home health care industry can help produce better patient outcomes if more people, especially doctors, are more informed about health care at home options.

About the Author

Michael Fleming, MD, FAAFP is the Chief Medical Officer for Amedisys, and Past President of the American Academy of Family Physicians and the Louisiana Academy of Family Physicians. Dr. Fleming has served as Speaker of the Congress of Delegates of the AAFP and as Board Chair of the AAFP Board of Directors. He serves as an assistant clinical professor in the Department of Family Medicine at the LSU Health Science Center and in the Department of Family and Community Medicine at Tulane University Medical School.
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