New App Makes Electronic Care Plan Tracking Possible

by Mary Kay Thalken, RN, MBA on Aug 9, 2017

GPS for Post-Acute Care? Sync and Connect Reshape Patient Interactions 

Imagine taking off on a cross country road trip with your destination in mind. Now imagine not conducting research to figure out what routes you need to take to get there or how long you’ll need to be on the road. 

Crazy, right?

No doubt you would use your phone or, at the very least, purchase an atlas (Millennials: think of an atlas as a paper version of Google Maps). After all, you need some way to ensure you reach your destination safely.

Yet this unpreparedness is unfortunately what can happen when a patient leaves the hospital. They leave with a discharge plan provided by their physician, but many members of the care team are essentially blind when it comes to determining whether or not that patient is following that plan or if they’re at risk for readmission. 

At least that used to be the situation. Now, thanks to care coordination platforms like Ensocare’s Sync and Connect, it’s possible to use software as a sort of GPS device, creating a roadmap for a patient’s transition out of the hospital and into post-acute and home care settings.

Here’s precisely how Sync and Connect work together to get the patient to their ultimate destination: recovery.

Set Your Destination

ensocare-hero-connect-2.jpgWhen preparing for a long trip, your first step is to enter your final destination into your GPS so you have a clear direction and a plan to arrive safely.

So it goes for patients. Before you begin, you need some idea of where you want your patient to be and how long it’s going to take to get them there.

Is the ultimate goal to be out of the post-acute care setting and back home within six to eight weeks?

This envisioned end point is your starting point for what comes next.

Plot Your Route

Sync allows you to direct every stage of your patient’s journey so that, ultimately, they’ll arrive at the destination you’ve laid out for them. 

The case manager sets up an array of data and care reminders so that the patient, their family and all pertinent caregivers can access this information at any time. The app processes this data and distributes it as necessary in a legible, streamlined format that’s remarkably easy to use.

Does your patient have a check-up with their cardiologist scheduled for X date? Do they need to take X medication or have a consultation with a home health nurse by such and such time? Sync establishes the workflow to ensure all of those steps are included.

With Sync, you plot the route from the very beginning so that every member of the care team is alerted to deviations. Which brings us to the next benefit…

Everyone Knows the Journey 

You know the stereotype of the dad refusing to pull over and ask for directions? You don’t need to worry about that with Sync.

That’s because Sync acts as a digital command center that’s accessible to all members of a patient’s care team, including the hospital care coordinator, post-acute care provider, primary care physician, home health nurse, pharmacist and family members. Think of it like air traffic control. The software communicates the care plan to all involved and monitors the patient throughout the process, generating updates and alerts as the individual’s needs change.

In this manner, everyone understands the path being taken, with Sync acting as a veritable GPS to let all involved know the progress that’s been made. 

Construction Ahead. Proceed With Caution

Modern GPS devices have technology that updates the route information with the latest traffic, construction, and accident information, helping the driver to circumvent hazards. Rerouting is seamless and lets you arrive in a timely fashion. 

That’s the power of Sync. The technology is able to identify missed steps (such as neglected appointments or a lack of regularly uploaded vitals) while the patient is on the road to recovery, resolving or escalating concerns to the appropriate care team member. 

Did your patient miss an appointment with a physical therapist? Did they forget to enter their medication intake? You’re going to know about it and, as a result, you can initiate an intervention earlier than would otherwise be possible. That lets you potentially avoid an unnecessary and costly readmission.

The Human Connection

That covers a lot of ground as far as Sync is concerned. But what about Connect?

Connect is perhaps the most critical piece of the whole endeavor, as it’s the application that enables patients and their families to, well, “connect.” 

Using wearable technology like fitness trackers, cellphones and more, patients are able to log in to access critical information about the specified care plan, including directions for medications and details about follow-up appointments. They’re also able to input information so that the care team doesn’t have to wonder if all is well. 

With an intuitive user interface that makes application easy, the patient or family member is able to record things like blood pressure and glucose levels, nutritional information, records of doctors’ visits and more.

Connect also allows hospital and post-acute staff to share educational materials with the patient and his or her family members to encourage compliance and engagement. 

Think of Connect as the car itself. The patient’s actions via the Connect app are the conveyance that allow the destination of recovery to be reached. It ensures that everyone is on the preplanned route together without the risk of taking a wrong turn. 

Safe Travels

By using care coordination tools such as Sync and Connect, organizations can offer their patients and physicians a GPS for the post-acute care transition experience, ensuring that individuals stay on course, achieve positive outcomes and avoid unnecessary return visits to the hospital. 

Where will the Ensocare journey take your hospital?

Ensocare Sync and Connect

Meet the Author

Thalken brings more than 30 years of experience in health-care leadership to our company. Prior to joining the company, she served as Enterprise Vice President for Care Logistics in Atlanta, Ga. She has held executive leadership positions at hospitals in Nebraska and Iowa, including the position of System Quality Executive for Alegent Health. Thalken has presented on the topics of improving quality, patient flow and throughput at various industry conferences and webinars. Thalken holds an MBA from the University of Nebraska at Omaha. She is a member of the American College of Healthcare Executives, American Organization of Nurse Executives and American Case Management Association.