2012 Conference Preview: Contain Costs with Interactive Voice Response at the Point of Care

By Scott Herrmann, Procura

Home care agencies and hospices have been struggling to contain the cost of delivering care without compromising the quality of the care delivered. One solution often overlooked is both inexpensive and easy to use.

By combining Telephony with Integrated Voice Response (IVR), providers of services in the home can gain better analysis of cost data, increase staff productivity, reduce errors in care, as well as eliminate potential timesheet and travel fraud.

Let’s explore the ways in which Telephony and IVR can reduce the costs of delivering care.

Visit verification as it stands today

Home care agencies are required to keep records of their services for accountability/audit purposes to prove those services were actually delivered. Currently, most companies use manual, paper-based processes to obtain and file these records. What if we changed this? After all, it is a system that is highly vulnerable to waste, inefficiency and inaccuracy, and one that presents several areas where costs can be reduced.

Consider the following:

  • All paper from the field must be returned to the office and entered into one or more databases for payroll/ billing purposes.
  • Many agencies pay for the travel time and mileage back to the office, merely to deliver documents.
  • Caregiver arrival and departure times are self-reported, with little to no accountability. In most cases, caregivers appear to arrive when they are told to and leave on time. Rain, traffic, even snowstorms never seem to be a problem, even at 8:00 on a Monday morning. Could it be that accountability is lacking? Patient signatures on paper verify the visit took place but cannot attest to arrival and departure times. When times are rounded up five or ten minutes per visit, it may appear the staff member’s day was full when actually there was time to do one more visit that day. Eliminating this practice might mean increased agency revenue without increasing the number of field staff.
  • Most days, the patient is alert and their signature is readable. But what about the days that the best they can manage is simply a scratch on that paper? Does that truly prove the visit occurred?

Integrated Voice Response

Telephony or IVR systems respond to each of these concerns by offering a very simple way to improve accountability, deliver accurate time and attendance data, and eliminate travel costs for bringing paper back to the office. IVR can be used not only to record visit times but also to provide proof that each visit actually tool place in the home. It eliminates the need for paper timecards and the labor required to verify them, and makes paper storage unnecessary as well.

Most importantly, IVR systems go beyond merely verifying time and attendance. They can also collect what was completed on the care plan (the tasks) by recording spoken yes/no answers.

Here is how it works. When the caregiver arrives or leaves a client’s home, they simply call a toll free number from the client’s home phone. The automated system prompts them to enter their own personal staff identification number. The simplicity of the application allows the least technically savvy staff members to automate time and attendance reporting.

Proof of visit location comes from collecting the caller ID from the patient’s home telephone. Time data collected from calls is used for payroll and billing, one call to start a visit and another at its completion. Precise start and stop times means fraud is not possible. The benefits of accurate timesheets can help agencies on many levels, including proactively managing visits and gaining insight into whether staff is working a full eight hour day or not.

The agency will also know if a caregiver has not shown up for an appointment versus waiting for the call from an irate patient or family member waiting for that worker to arrive. Alerts can be built into these systems based upon an agency’s criteria. You decide if five or fifteen minutes is considered late and have the system call your attention to it at that time. Similar alerts can be set up for missed visits, staying too long or not staying long enough.

Counting benefits

In this scenario, as telephony system data is analyzed, the agency might discover it is possible to add more client visits to the schedule of one or more field staff member, increasing revenues but not increasing staff. We have eliminated paper and manual processing by replacing self-reported time cards. We have also improved accountability and now know what is really occurring in the field. Savings are realized from reduced paper costs, reduced data entry costs and associated errors, reduced storage space and reduced payroll expenditures previously wasted on fraudulent times for both visits and travel.

While the number one goal of a telephony-with-IVR application is to automate payroll and the time and attendance process, in other words to shift the focus from paperwork to patient care, the agency also gains the ability to monitor staff visit functions, for safety purposes, timeliness, as well as accountability.

Caregivers in the field who are using this technology are confident that their patient data, time and attendance, and visit tasks are all captured and securely transmitted back to the office. With that in mind they can concentrate on delivering the best patient care possible.

If you are looking for a better way to gain accountability and reduce operations costs, you may want to think about the following:

  • Could we be more responsive to our clients if we could manage staff proactively?
  • How many times have we lost the visit paperwork?
  • Timely/accurate payroll enhances worker relationships and minimizes turnover
  • Travel reimbursement costs can be dramatically reduced
  • Paper storage costs can be slashed or even eliminated

Telephony’s benefits may help an agency develop new and better processes in the delivery of home care services, knowing, not assuming that services are delivered as needed. As operational processes improve, costs decrease. Most telephony adopters find that cost reductions exceed their investment in the system. The same cannot be said about paper and manual processes.

Scott R. Herrmann is the Director of Mobile Solutions for Procura. This is the first in a series of periodic articles we have scheduled Scott to write for HCTR this year. He can be reached at sherrmann@goprocura.com.

This article first appeared in Tim Rowan’s Home Care Technology Report. Reprinted by permission. Further reproduction is not permitted without consent of the publisher. Write to editor@homecaretechreport.com.

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