"Home healthcare needs tools & protocols to support a higher degree of post-acute care in the home * Clinical supervisors complete the assessment in their EHR while video conferencing with the client/patient"

2. Our
Presenters
Adrian Schauer
Founder & CEO | AlayaCare
Laurie Neander
RN MS President | Bassett
Healthcare Network: At
Home Care
Bob Holly
Moderator | Home Health
Care News

3. Outcomes for the Audience
1. Get out our crystal ball and muse on how COVID-19 will
change the delivery of care during the pandemic, and
after it has passed
2. Help providers understand the eligibility criteria to provide
this mode of care + introduction to a telehealth resource
centre
3. Laurie’s experience implementing Telehealth, tips and
tricks on what to focus on for better outcomes
4. Demonstrate how easy and simple one or more of the use
cases are to deploy
5. Q&A

4. Tele-touch
(Telephonic
"phone
call")
Defining Virtual Care:
Will also depend on who is providing care: Physician, Nurse, Aide, Social Worker,
etc.
Video
Content
(Recorded)
E-Visit
Delegated
Act
Video Visit/
Conference
RPM
IOT/
Wearable
Persistent

5. As though Value Based Reim
bursement was
not enough…
Crisis as a Driver
of Innovation

6. This is Your Health System
Acute Care
Primary Care
Non-Medical Home Care
Skilled Home Health
Skilled Nursing Facility
Residential LTC
Hospice
Community Care
Family
Caregivers

7. This is Your Health System on COVID-19
Acute Care
Primary Care
Non-Medical Home Care
Hospice
Skilled Home Health
Residential LTC
Skilled Nursing Facility
Community Care
Family
Caregivers

8. Therefore…
We need to rapidly figure out what types of home healthcare
interventions can effectively be delivered virtually
For interventions that need to be delivered in person, how do we
ensure the safety both for patients and care givers?
How can we effectively combine the proximity of the family caregiver
and the expertise of the formal home healthcare provider?
What forms of re-imbursement should we be counting on (or lobbying
for) to allow us to run our businesses and support our clients and
caregivers in the time of COVID-19?
1
2
3
4

9. Will the world go back to how it was?
• This crisis has forced 10 years of progress in Telehealth to
happen in 10 days
• Once the crisis is past, what is likely to stay in place? And
what will be rolled back?
? Virtual Supervisory visits
? Virtual Assessments and Self-Screeners (Employees, Family
Clients)
? PCW delegated tasks from RN electronically
? Virtual Rehab exercises
? Virtual Care Navigation and Triage
? Assistance with ADLs
? Engagement with Family Caregivers
? Other

10. Specific Use Cases for
Provider Types

11. Assessments &
Supervisory Visits
• Most assessments can be
performed without being face-to-
face
• The client/patient needs to be able
to hold a device (usually a
smartphone) and answer
questions
• Clinical supervisors can easily
complete the assessment form in
their EHR while video
conferencing with the client/patient

12. Chronic Disease
Management
• Whereas the incentive to keep
chronically ill patients out of hospital
always existed, the risk of contracting
COVID-19 during a hospital visit is now
a mortal concern
• We need to step-up all available efforts
to reduce preventable re-admissions
with the polychronics are the highest
risk group for dying of COVID-19

13. Post-Acute Episodic Care
• Hospitals are all hustling to discharge patients
quickly to free up hospital beds for COVID-19
care
• Clearing hospital beds of ALC patients is
again a mortal question for health systems
• Discharge to home is MUCH safer than
discharge to facility-based care
• The home healthcare industry needs the tools
and protocols to support a higher degree of
post-acute care in the home

14. Wound Care &
Enterostomal Therapy
• Given extreme shortages of ETs
even before the pandemic, we have
seen the model of a careworker with
the patient consulting virtually with an
ET.
• Pictures (asynchronous) or video
(synchronous) can be used to
facilitate or enhance this experience.
• Shortfalls of course extend to senses
that are not as easily virtualized:
can't smell the wound or detect
coloration perfectly but may reduce
risk for an at-risk client.

15. Rehab or Other
Therapies
• PT – Physical Therapy
• Using video for range of motion
• Safe or appropriate use of
• OT – Occupational Therapy
• Less clear how this would work
modifications
• Example: Dysphasia – some help
provided virtually to family
• ST - Speech Therapy
• Can be virtualized quite

16. Palliative Care
COVID+
• One of the greatest
disease is that many
dying alone in ICUs
to say goodbye to their
COVID-
• Hospice in the home for
cases needs to be a
• Recall that in the average
Americans die. This puts
numbers in perspective

17. Complex Pediatric
Care
• Although the stats show that young people rarely die
from COVID-19, that is not necessarily true for
immunocompromised youth
• We need to implement the tools and methodologies to
keep the complex pediatric cases out of the hospital
• Given the shut down, Family Caregivers are more
available than ever, so we need the tools and protocols
to allow the families to provide the care (with our
assistance) that used to happen in home
• Would you give family members log ins to your EMR’s
mobile app?

18. Frail Elderly – Assistance
with Activities of Daily
Living
• Many Activities of Daily Living cannot be assisted
virtually
• Some check-in calls will now be funded, but
consider how EVV will play into this
• Benefits of using an integrated video/voice
app where the call log exists as part of the
visit
• In other cases where someone needs to be there
in person, being able to screen the patient/client
and the caregiver is key
• Some needs can be handled without entering the
home: food, prescriptions, social engagement

19. Screener
Resources
Check with your local health authority
for screener guidelines

20. Poll Question #1

21. Family Caregiver
Distress
• The current respite model may be
unavailable in the pandemic context
with social distancing
• Adult Day Centers closed
• Friendly Visiting
• Virtual visit as a stress relief
• Care Navigation and healthcare
advisement
• Social worker or HCA that they have
a relationship with can continue that
relationship virtually

22. Treatment of COVID-19
• Standard care plans for treating
COVID-19 patients are
emerging
• Most (80%+) of those infected
will stay home
• In the context of overrun acute
care facilities, determining when
a hospitalization is required will
be essential
• Monitoring biometrics like sp02
and temperature will be key
indicators
• 24/7 Capability to be available to
this population

23. Reimbursement
Overview of some changes we’re already seeing and changes that we
expect to see

24. Historically,
Telehealth
has not been
a line on the
cost report
LAURIE

25. The Value of Remote Monitoring –
Bending the Healthcare Cost Curve
An acute RN shortage impacts quality outcomes
Increase census without added staff
Address an aging population, social isolation and “family everywhere”
Reduce risk of employee exposure to infectious disease… and,
exposure to the patients served
1
2
3
4
Actively participate in value-based and bundling system initiatives5

26. https://www.alayacare.co
m/virtual-care-guide
Telehealth &
Virtual Care:
A Regional Guide

27. Stratify risk
Match the right
technology for the
right patient at the
right time

28. Poll Question #2

29. Tools to Enable
Virtual Care: Demo

31. The time is NOW to capitalize on the value
of tele-healthcare - document the
evidence
Clinical Decision Support
Safe Interventions during the pandemic / lock down
Data – Demonstrate the value
Recognize tele-healthcare as the foundation of care delivery in the home
1
2
3
4

32. Will the world go back to how it was?
 Here is what we think will happen….
 Once the crisis is passed, what is likely to stay in place? And what will be
rolled back?
 Virtual Supervisory visits and Virtual Assessments
 Self-Screeners (Employees, Family Care Giver and Clients)
 PCW delegated tasks from RN electronically
 Virtual Rehab exercises
 Virtual Care Navigation and Triage
? Assistance with ADLs
? Engagement with Family Caregivers
? Complex Pediatrics
? Wound Care
? Palliative Care

33. Poll Question #3

34. Open Discussion

35. We are driven to enable the care
we would want our loved ones to
receive in the place they call home.
Purpose

36. Questions?
www.alayacare.com/virtual-care