Gentiva Health Services to Cure Paperwork Blues with Windows XP Tablet PC Edition

Published: November 2002

Gentiva Health Services employs approximately 30,000 home healthcare workers including nurses, therapists, and administrative staff. Home healthcare involves significant amounts of paperwork and record keeping—including clinical records, claims, and benefits-related forms and documentation—and Gentiva caregivers enter volumes of data manually. In addition to taking time and creating frustration for the caregiver, this situation prolongs the turnaround of important patient data and billing information. Gentiva believes the remedy may be in pen-based technology and the Tablet PC.

Situation

Gentiva Health Services is the nation’s leading provider of home health care services. Gentiva employs a wide variety of staff to support its home health business, from business executives to registered nurses to administrative personnel. Healthcare professionals, including nurses, therapists, and other trained specialists, are considered to be Gentiva’s most valuable resource. The United States—along with the rest of the world—is experiencing a shortage of nurses in particular. Many industry experts predict that the nursing shortage might soon reach crisis proportions.

Home healthcare and healthcare in general, involves significant amounts of paperwork and recordkeeping, including clinical records, claims, and benefits-related forms and documentation. A significant portion of a healthcare professional’s time involves this paperwork.

Gentiva’s30,000 remote workers still complete their paperwork manually, not only requiring additional data entry associates throughout Gentiva’s 300 sites, but also prolonging the turnaround of important patient data and billing information. In an effort to streamline the process, Gentiva had examined and piloted point-of-care solutions involving a variety of computing devices. However, Gentiva never implemented any of these solutions on a large production scale because of following issues:

  • High cost of investment and expense to support large numbers of mobile devices with low or no return on investment
  • Immaturity and technological weaknesses of the computing solutions
  • Complexity of security and patient information privacy issues, including Health Insurance Portability and Accountability Act of 1996 (HIPAA) requirements

Solution

Gentiva believes that the Tablet PCs powered by Microsoft Windows XP will be not only a replacement for laptops in the business ranks of the corporation, but may also be the long-sought answer to field workers’ paperwork blues. “The Tablet PC technology has the potential to make a dramatic difference to our nurses,” says Bob Creamer, Chief Information Officer and Senior Vice President for Financial Operations at Gentiva. “This type of technology could give our company a competitive edge for recruiting and retaining nursing staff, which is crucial to delivering good service to our patients.” Gentiva is also looking at IVR Technology and Pocket PCs to capture subsets of patient data. A variety of needs will require a range of technology.

Gentiva has begun a pilot program to deploy the Tablet PCs: first, releasing to a cross-section of the whole organization and thendeploying a Tablet PC–based line-of-business application for field workers.

Introducing the Tablet PC

The purpose of the first phase of the Tablet PC deployment has allowed them to evaluate the hardware and software, plus the total effectiveness of the Tablet PC. Issues examined include:

  • How does the Tablet PC change an information worker’s approach to work in general? For instance, are the employees able to work in unexpected places, like in a hallway during a discussion with a coworker?
  • How viable is the Tablet PC for use by field workers? Will the learning curve be high? Will the Tablet PC be powerful enough to run the necessary programs?

Introducing the Cure for Paperwork

The company is moving quickly to develop a pilot Tablet PC–based solution using Microsoft Visual Studio® .NET with C# and XML programming languages, along with the Ink controls included with the Tablet PC Platform Software Development kit (SDK). Ink-enabled Microsoft Office applications ease documentation and communications tasks by allowing the user to work with forms using a digital pen, right on the screen.

Because Windows XP Tablet PC Edition is a superset of the Windows XP Professional operating system, it addresses issues that were previously difficult and expensive for Gentiva to solve with traditional mobile devices. For example, Windows XP can protect patient information security and privacy by offering robust, industry-standard security and encryption features such as the Encrypted File System (EFS), and public key infrastructure (PKI) and virtual private network (VPN) features and protocols.

Also, because the Tablet PC is a powerful personal computer and as such includes support for USB devices, additional peripherals can be added easily:

  • Digital cameras for patient identification and wound care documentation photos
  • Data backup devices for field-based, automated backups
  • Color printers for producing patient education materials

Benefits

The Tablet PC contains features that address and resolve key difficulties Gentiva experienced with its previous point-of-care devices, PDAs, and even traditional laptops:

  • Operating system—Windows XP Tablet PC Edition includes the full set of capabilities of Windows XP, plus pen-based computing enhancements.
  • Handwriting-recognition technology—Microsoft Ink is truly advanced handwriting recognition, with the ability to translate handwriting to text for use in other programs and even the capacity to search handwritten notes.
  • Design—All variations of the Tablet PC are truly lightweight and portable, while maintaining the same power, speed, and capacity of a traditional notebook computer.

Fosters Higher Worker Satisfaction

Gentiva realizes that to recruit and retain valuable caregivers, it must diminish the paperwork and allow the caregivers to focus on the reason they became health care workers in the first place: to take care of the patients.

Gentiva has unveiled to its health care workers early prototypes of the Ink-enabled application that will automate much of the paperwork they currently must fill out manually. Early response is extremely positive.

“The nurses have only one question: when can we have this [Tablet PC-based program] in the field?” says Matt Rebeck, Principal Technical Specialist of Gentiva Health Services. “It was amazing! Even though the nurses each had varying levels of computer skills, they were all able to use the pen to interact with the program successfully right away.”

Increases Business Productivity

Initial response from the business ranks within Gentiva confirms that switching from a traditional desktop or notebook computer to the Tablet PC not only happens smoothly but also immediately begins to pay off. Says Rebeck, “The Tablet PC is the obvious choice to replace notebooks and desktop PCs for our information workers.” The lightweight, compact design makes traveling with the computer easier, whether it’s being carried onto an airplane or along the hallways of the corporate office—no more lugging a seven-pound laptop and balancing it on a knee while trying to type in notes.

In addition, clear benefits exist for the field worker.

“The freedom and mobility of a pen-based tablet computer is particularly suited to home healthcare—it’s a natural transition from paper,” says Mike Hannah, Chief Technology Officer and Vice President of Information Technology for Gentiva Health Services. “Microsoft Ink performs better than any previous handwriting-recognition solutions we have tested.”

Facilitates Cost Savings and Revenue Increases

Gentiva finds that both its large staff of home healthcare workers and its corporate personnel are excited about the Tablet PCs, and the company expects that general worker productivity will rise. Once Gentiva introduces the pen-based application feature, it anticipates:

  • Cost savings on data entry because caregivers can automate some paperwork and input information directly into their records system from the Tablet PC
  • Reduction of paperwork and staff turnover

For More Information

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