Patent Application
20170004263
Embodiments disclosed herein relate to and provide a method, system and application for the real-time monitoring of key performance indicators (“KPI” or “KPIs”) and providing KPI alerts and survey status alerts to users via push notifications (e.g., text messages).
The long term care industry has continued to be plagued with increased regulatory fines coupled with decreased reimbursement rates. Hospitals received “Meaningful Use” grants to outfit their facilities with the technology necessary to support electronic health records, while long term care facilities had sequestration reductions applied to their Medicare rates. This leaves operators of these facilities operating on the slimmest of margins.
Accordingly, there is a desire and need for these facilities to receive, monitor, react to and report key indicators impacting patient care and/or the efficiency of the services provided by the facilities.
In addition, long term care providers are subject to routine inspections (known as surveys) where deficiencies and/or other issues are reported by a state or other regulatory agency. The providers are required to fix these deficiencies/issues within a predetermined scheduled time. It is therefore desirable to ensure that facility receives the support it needs to fulfill survey requests on a timely basis and to predict and be alerted to subsequent visits.
The disclosed embodiments relate to and provide for the real-time monitoring of key performance indicators (“KPI” or “KPIs”) and providing KPI alerts and survey status alerts to users via push notifications (e.g., text messages). In addition, text based and/or graphical reports of the information monitored and analyzed by the disclosed embodiments and/or the raw data used that was monitored and analyzed may be pushed to client's, key personnel and/or other users of the disclosed method, system and application.
In one embodiment, a system and method can be implemented via a website (e.g., “ThinkAnew.com”) operated by a server accessible by the user over the Internet or other network. In another embodiment, a system and method can be implemented using an application that can be downloaded onto a mobile device (e.g., smartphone, PDA, tablet) and accessed by the user via the mobile device. The disclosed principles may be described herein or in the figures as a “Virtual Intelligence for Better Execution” (“VIBE”) program or application.
The method, system and application disclosed herein will supply operators with the proper tools and reporting necessary to e.g., monitor their census, hospital readmission rates, collection efforts and quality of care to their residents, to name a few. The disclosed embodiments also provide substantially real time data analysis and monitoring and push notifications that allow operators to make proactive decisions versus reactive decisions and make those decisions in a cost effective manner. Raw data and/or text based and/or graphical reports of the information monitored and analyzed by the disclosed embodiments may be pushed to client's, key personnel and/or other users of the disclosed method, system and application.
While the disclosed embodiments are described with reference to the health care industry (e.g., long term or senior care industries), it should be appreciated that the disclosed principles are not to be limited to any particular industry.
As will be appreciated, the disclosed embodiments are more than a reporting repository; instead, they provide an interactive business intelligence tool. It is desirable to have users at all levels of an organization use the disclosed reports and tools to enhance their workflow. The disclosed embodiments can provide alerts to pre-defined individuals when KPIs fall outside of their accepted thresholds. This can be accomplished without the pre-defined individuals being logged into the disclosed system. It should be appreciated that throughout this disclosure references to thresholds, good thresholds or acceptable thresholds could be thresholds set by the user, the system or a governing body and that what is a good/acceptable threshold should not limit the disclosed principles. In addition, the raw data and/or text based and/or graphical reports of the information monitored and analyzed by the disclosed embodiments may be pushed to client's, key personnel and/or other users of the disclosed method, system and application.
According to the disclosed principles, key performance indicators will measure benchmarks for e.g., census, labor, accounts receivable (“AR”) and clinical measures functions. Reports may be displayed in a graphical format so that performance is easy to ingest upon first glance. Moreover, each graph can be exported to multiple formats to that details can be analyzed offline or by another application, if desired.
The disclosed embodiments provide a “Survey Alerting” feature that will allow a facility to alert pre-defined personnel (e.g., internal and regional staff) when e.g., a state survey teams enters a facility. This is a separate feature than the alerts/push notifications generated based on KPIs. The Survey Alerting feature (also described and/or illustrated herein as a “survey status alert”) not only allows for the facility to receive the support it may need in order to fulfill the current survey requests on a timely basis, but will also record the visit's activity and allow the disclosed embodiments to build in predictability reporting for subsequent visits. Survey results will also be loaded into the disclosed embodiments, allowing real-time alerts to be triggered to e.g., the staff or managers; these alerts may report prior deficiencies and will be generated during an impending survey window (i.e., the window in which the next survey may occur).
The disclosed embodiments may allow for the LTC TrendTracker template to be pre-populated so that user can easily upload to TrendTracker for regional and national MDS/RUG reporting analysis. It is known that LTC Trend Tracker is a web based tool that is available free of charge with an ACHA membership. The LTC Trend Tracker tool allows users to benchmark quality measures against their peers. Moreover, and as discussed below, the disclosed embodiments will pull-in information and data from multiple sources and databases.
For example, for pre-existing cloud-based managed healthcare systems (e.g., PointClickCare, American HealthTech) customers, data will be sent from the healthcare systems to a secured ftp server via log files and the disclosed embodiments will pick up these log files and apply the data to a client specific data relay database hosted by the disclosed system. Once the log files are applied to the data relay, the disclosed embodiments will pull appropriate data elements out of the data relay and into the system's database (according to the timing from log files to data relay as well as the client's specific schedule). A refresh date/time will displayed to the user so that the user will know the last time the data displayed was last refreshed. In addition to, or alternatively, the disclosed embodiments can host the database for the healthcare system and pull information from this hosted database. The disclosed embodiments will use scheduled data feeds that may be established by the system or its users to offload download times. Moreover, for time and attendance functions, there can be a schedule and data feed established by the user and a time and attendance vendor, if desired. For payroll purposes, there can be a schedule and data feed from a payroll vendor, if desired.
In one embodiment, the disclosed system is implemented in software (i.e., computer instructions) that are stored in a computer readable memory and executed by a processor.
In one embodiment, the disclosed system and method can be implemented using an application program (e.g., the VIBE application) that can be downloaded onto a mobile device 30 (e.g., smartphone, PDA, tablet) and accessed by a user via the mobile device 30. The application program will cause the mobile device 30 to interact with the system server 20 to perform certain features of the method disclosed herein. In another embodiment, the disclosed system and method can be implemented via a website (e.g., “ThinkAnew.com” or “VIBE.com”) operated by a server accessible by a user device (e.g., smartphone, PDA, tablet, laptop, personal computer, etc.) or online application over the Internet or other network.
Once logged in, the user can access several different tabs depending upon the functionality/reporting desired. The selected tab brings up a corresponding web page. For example,
For the census versus budget report 152, the disclosed embodiments will categorize skilled population based on client preference, and report a census of “Skilled vs Budget” as a variance percentage—all other payers are reported as “Other vs Budget” also as a variance percentage. Report details will include values in addition to percentages. As can be appreciated, this report 152 enables the real time monitoring of census numbers versus budgeted numbers with skilled mix segregated.
For the labor hours PPD (Per Patient Day) trend report 154, the disclosed embodiments will pull labor hours in PPD format for all job codes selected by the client, and report those hours against budgeted PPD as well as a rolling average. As can be appreciated, this report provides real time monitoring of labor hours to better manage labor costs, and for comparison vs budget. Nursing PPD regulations are mandated under the Nursing Home Federal Requirements, F353 §483.30 Nursing Services. The facility must have sufficient nursing staff to provide nursing and related services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident, as determined by resident assessments and individual plans of care. The intent of §483.30 (and the disclosed embodiments) is to assure that sufficient qualified nursing staff are available on a daily basis to meet residents' needs for nursing care in a manner and in an environment which promotes each resident's physical, mental and psychosocial well-being, thus enhancing their quality of life.
For the MDS (Minimum Data Set—part of the U.S. federally mandated process for clinical assessment of all residents in Medicare or Medicaid certified nursing homes) average Medicare rate report 156, the disclosed embodiments will provide the trending of the average Medicare rate, based on MDS ARD dates within a selected time period. ARD is defined as the specific end point of look-back periods in the MDS assessment process. It allows for those who complete the MDS to refer to the same period of time when reporting the condition of the resident. For SNF PPS assessments, this date also determines payment. As can be appreciated, this report provides financial forecasting for the Medicare population.
For the AR goal collected report 158, the disclosed embodiments will calculate the goal for Medicaid and Medicaid pending as: prior month revenue+/−prior month adjustments/days in the month to get a daily rate. The daily rate is then multiplied by the days in the state's billing schedule to obtain the goal amount. For all other payers, the calculation will include the prior month's revenue+/−prior month adjustments. This report will pull the percentage of the cash goal collected by e.g., the 5th-10th and 15th day of the current month. As can be appreciated, this report measures collections activity to determine the amount of funds in AR that gets calculated based against the goals of the company.
A key and unique feature of the disclosed embodiment is the survey status alert feature 160. This utility will reside on the dashboard and allows a staff member or other user to trigger an alert both internally and to e.g., a corporate/regional team when state surveyors enter the building by selecting one of the illustrated indicators 162, 164, 166, 168. The indicators 162, 166, 168 are shown in their unselected state while indicator 164 is shown in a selected state. In the illustrated example, each indicator 162, 164, 166, 168 is associated with a particular region (although they are not to be limited to regions). This survey status alert feature does not currently exist today. In use, the date and time of the visit will be captured and predictability reporting will be available based on visit history. Because the disclosed embodiments record results of the surveys, information from the last survey may be used to alert the staff of prior survey deficiencies as soon as the site enters the survey window (e.g., before a visit so that past deficiencies can be corrected before the next visit).
The disclosed features also provide the user with the ability to distribute reports, graphs directly from the dashboard. That is, there is no need to save them locally before sending them. A month end close indicator (not shown) can also be used to monitor close progression during month end period. The disclosed principles provide the user with the ability to customize from and thru dates. Any hierarchy can be defined using typical known selectors, as desired.
Another key and unique feature of the disclosed embodiment is the KPI alerts feature 180.
It should be appreciated that reports can also be pushed out to the users and/or clients of the facility in more than one manner. For example, the reports mentioned above and below can be pushed via email, text message, posted to an FTP site, or SharePoint directly to the client or other interested party. The pushed reports can be graphical and/or textual in nature, can be images of what is displayed on one or more of the example pages described herein, and/or can contain the raw data that was used to monitor the KPIs and/or generate any of the reported information disclosed herein. The reports may pushed periodically, aperiodically or upon request, as desired based on system and/or user preferences.
The census versus budget report 302 may be the same as discussed above with respect to the executive tab. For the admissions trending report 304, the disclosed embodiments will perform Year over Year (“YOY”) Admissions trending. This will report the number of admissions by month, by source, and then as a percentage of YOY variance. As can be appreciated, this report provides a snapshot view of overall admissions as well as admission sources so marketing efforts can be allocated appropriately.
For the payer mix report 306, the disclosed embodiments will categorize skilled population based on client preference, and will include all other primary payers as a percentage of overall census population. As can be appreciated, this report can be used as a predictor of reimbursement expectations. For average length of stay 308, the disclosed embodiments will calculate the average length of stay as total inpatient days/discharges for time period selected. The illustrated graph may include total days in relation to average. As can be appreciated, this report allows for better management of resources and increases efficiency of patient care.
The page 300 for the census tab may also provide the additional functionality discussed above (e.g., distributing reports, customizable from/thru dates and hierarchy). In addition, it will provide access to payroll software solutions like ADP. Moreover, the page 300 for the census tab includes the KPI feature 320 (i.e., providing alerts when the KPI is beyond an acceptable threshold). For the illustrated embodiment, there is a “Census Occupancy %” KPI 322, which is calculated as inpatient days/available beds*100 (for a percentage display). Alerts will be generated when the occupancy percentage falls short of acceptable threshold amounts. For the “Census vs Budget” KPI 324, alerts are generated when the census totals fall short of budgeted numbers.
For the nursing average wage by job code report 352, the disclosed embodiments will determine total hours-total wages-total dollars worked and calculates the average wage as a total dollar amount worked/total hours. As can be appreciated, this report allows the user to manage labor hours.
For the labor hours PPD report 354, the disclosed embodiments will pull labor hours in PPD format for all job codes selected by client, and report those hours against budgeted PPD as well as a rolling average. As can be appreciated, this report provides real time monitoring of labor hours to better manage labor costs, and for comparison versus budget.
For the hours worked by department report 356, the disclosed embodiments will report the total hours worked by department for a selected period. As can be appreciated, this report allows the user to identify staffing needs and labor management opportunities by department. For the OT hours by department report 358, the disclosed embodiments reports the hours classified as Overtime (as defined by client), categorized by department for period selected. As can be appreciated, this report provides overtime hours identification and management.
As shown in the report listing 360, additional labor reporting may include an “Approaching Weekly Overtime” report to identify staff who are approaching overtime hours for a selected period, providing an opportunity to reallocate staff to save overtime dollars. An “Employees in Overtime” report can identify staff who have overtime hours for a selected period, providing an opportunity to reallocate staff to save overtime dollars.
The page 350 for the labor tab may also provide the additional functionality discussed above (e.g., distributing reports, customizable from/thru dates and hierarchy). In addition, it may provide the user access to AR and Payroll software. The labor tab will also include the KPIs feature 380 (i.e., pushing alerts to select individuals when the KPI is beyond an acceptable threshold). For the illustrated embodiment, there is an “RN Hours PPD” KPI 382 that will push an alert when hours coded to an RN job code fall outside good/acceptable threshold values. This may also comport to the Nursing Home Compare Five-Star Rating Staffing Measure. The “RN/LPN/NA PPD” KPI 384 will generate an alert with hours coded to RN, LPN and NA job codes if they fall outside good/acceptable threshold values. This may also comport to the Nursing Home Compare Five-Star Rating Staffing Measure. The “Total PPD vs Budget” KPI 386 will generate an alert when the PPD for all job codes falls outside of good/acceptable threshold values.
For the AR goal collected report 402, the disclosed embodiments calculate the goal for Medicaid and Medicaid pending as follows: Prior month revenue+/−Prior Month Adjustments/days in Month to get a daily Rate. The daily rate is then multiplied by the days in the State's billing schedule for the goal amount. For other payers, the goal is Prior month revenue+/−Prior Month Adjustments. As can be appreciated, this report allows the user to measure collections activity to determine the amount of funds in A/R that gets calculated based against the goals of the company.
For the DSO by month report 404, the disclosed embodiments determine the Net AR for a selected time period/Revenue Per Day (Revenue/Days in selected time period). As can be appreciated, this report illustrates the average amount of time it takes from when a dollar of revenue is received until it is put into the facility's pocket.
For the aging by payer report 406, the disclosed embodiments present graphical representations of total aging balances by payer (in percentages). As can be appreciated, this report assists with collection efforts by identifying payers that have the largest balances due. For the aging AR bucket report 408, the disclosed embodiments provide the total aging balances assigned by period (bucket), including payer/resident details. As can be appreciated, this report assists in identifying and collecting older balances.
The page 400 for the AR tab will also provide additional functionality such as e.g., reporting cash receipt entries for time period selected by user; reporting all residents that have a balance over $10,000 to identify and allow for appropriate AR decision making; and reporting past period days (with GL Period included) during the current GL month. The additional functionality discussed above (e.g., distributing reports, customizable from/thru date and hierarchy) may be provided. Moreover, the user can have access to the AR software and a month end close indicator. In addition, an auto-populated, exportable TrendTracker RUG data template that can be uploaded into LTC TrendTracker may be provided.
The page 400 for the AR tab will also include a report listing 410 and the KPIs feature 430 (i.e., pushing alerts to select individuals when the KPI is beyond an acceptable threshold). For the “Total AR over 90” KPI 432, alerts will be pushed when the Total AR percentage over 90 days is above an acceptable threshold. For the “Current Month Collected % of Total AR” KPI 434, alerts will be pushed when the percentage collected falls short of acceptable threshold. For the “Approaching BBL” KPI 436, alerts will be pushed/generated when claim counts approaching “Beyond Bill Limits” are higher than an acceptable threshold.
For the significant weight loss report 452, the disclosed embodiments provide 30-90-180 day look back of 5%, 7.5% and 10% of resident weight loss. This includes resident count and count as a percentage of ADC. As can be appreciated, this report provides optimal dietary & clinical care by preventing unhealthy weight loss. For the clinical ADT measures report 454, the disclosed embodiments provide the trending of the number of Medicare admissions (i.e., the number of Medicare RTH (Return to Hospital) to the percentage of Medicare RTH; and the number of Medicare Unplanned DTH (Discharge to Hospital) to the percentage of Medicare Unplanned DTH). In 2014, for example, potential fines for hospitals with high readmission rates are up to 3% of Medicare bills. As can be appreciated, this report identifies return to hospital ratios and will assist in care planning with hospitals, improving resident care by reducing transfers, and enhancing hospital relationships.
For the MDS—average Medicare rate report 456, the disclosed embodiments report the trending of the average Medicare rate, based on MDS ARD dates within a selected time period. This provides for financial forecasting for the Medicare population. For the RUGs distribution report 458, the disclosed embodiments provide the distribution of Medicare resident days in each RUG-IV group for selected time period. As can be appreciated, this report provides financial forecasting for the Medicare population and staffing projections.
Other functionality may be provided by the clinical tab. For example, the survey status alert feature discussed above may be provided as shown in
The page 450 for the clinical tab will also include the KPIs feature 480 (i.e., pushing alerts to select individuals when the KPI is beyond an acceptable threshold). For the “% with UTI” KPI 482, alerts are generated when the percentage of residents who have had a urinary tract infection within the past 30 days falls short of an acceptable threshold. A set of quality measures (QMs) has been developed from Minimum Data Set (MDS)-based indicators to describe the quality of care provided in nursing homes. These measures address a broad range of functioning and health status in multiple care area. One of these measures is the percentage of residents with a urinary tract infection. For the “% Falls” KPI 484, alerts are generated when the percentage of residents who have experienced one or more falls with major injury reported in the target period that falls below an acceptable threshold. A set of quality measures (QMs) has been developed from Minimum Data Set (MDS)-based indicators to describe the quality of care provided in nursing homes. These measures address a broad range of functioning and health status in multiple care area. One of these measures is the percentage of residents experiencing one or more falls with major injury. For the “ADL Assistance % Increase” KPI 486, alerts are generate when the percentage of residents whose need for help with ADL (Activities of Daily Living) has increased in comparison to prior assessment. A set of quality measures (QMs) has been developed from Minimum Data Set (MDS)-based indicators to describe the quality of care provided in nursing homes. These measures address a broad range of functioning and health status in multiple care area. One of these measures is the percentage of residents whose need for help with activities of daily living has increased.
It should be appreciated that the examples set forth herein are provided merely for the purpose of explanation and are in no way to be construed as limiting. While reference to various embodiments is made, the words used herein are words of description and illustration, rather than words of limitation. Further, although reference to particular means, materials, and embodiments are shown, there is no limitation to the particulars disclosed herein. Rather, the embodiments extend to all functionally equivalent structures, methods, and uses, such as are within the scope of the appended claims.
Additionally, the purpose of the Abstract is to enable the patent office and the public generally, and especially the scientists, engineers and practitioners in the art who are not familiar with patent or legal terms or phraseology, to determine quickly from a cursory inspection the nature of the technical disclosure of the application. The Abstract is not intended to be limiting as to the scope of the present inventions in any way.
This application claims priority to U.S. Provisional Application Ser. No. 62/188,122, filed Jul. 2, 2015, the entirety of which is incorporated herein by reference.
| Number | Date | Country | |
|---|---|---|---|
| 62188122 | Jul 2015 | US |
