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In an interview with Chief Healthcare Executive, Hu discusses the challenges for hospitals and post-acute providers, the potential of data and how health systems need to collaborate.
As a doctor, Lissy Hu says she has enormous empathy for staff shortages throughout the healthcare system.
Hu is the CEO and founder of CarePort powered by WellSky, a healthcare coordination company that helps providers determine the best setting for patients when they’re ready to be discharged from the hospital.
“I’m very, very sensitive to some of these burnout challenges and staffing challenges that seem rampant across both the hospital side and post-acute care side,” Hu says.
Since CarePort works with both hospital systems and post-acute care providers, Hu possesses a keen perspective of the labor problems at hospitals, nursing homes and home health agencies. Those staff shortages are having a big impact on providers and their patients.
Often, a hospital is ready to discharge a patient to a nursing home, but the facility doesn’t have any available beds due to staffing shortages, Hu says. So the patient remains in the hospital, which is also dealing with a shortage of nurses and other key staff. The hospital also faces more costs with the patient staying longer.
“The burnout challenges, the staffing shortages are affecting both sides … it highlights the huge amount of interdependency between parts of the care continuum, between the acute and post-acute,” Hu says.
With those staffing shortages likely to continue for the foreseeable future, Hu says, “It becomes really important that you have efficient ways to transition that patient from one setting to the next.”
In an interview with Chief Healthcare Executive, Hu discusses the challenges in the hospital and post-acute settings and the need to use data and analytics to improve the transition of care. She also stresses that health systems, nursing homes and home health agencies need to work more cooperatively, especially as patients are being discharged with more complex health needs.
“Unfortunately, because of the staffing shortages, there’s no way to hire your way out of this problem,” Hu says. “You can’t just wave your magical wand and hire more staff. You’ve got to find ways to make people more efficient. That’s where technology and data come in.” (The story continues after the video.)
Reducing ‘provider abrasion’
CarePort’s software is being utilized by 1,000 hospitals and 130,000 post-acute providers.
In January 2021, WellSky, a health technology company, completed the $1.35 billion acquisition of CarePort. Hu says the move made sense in many ways, including the growing preference of patients to recover from a hospital stay in their own home, as opposed to a rehabilitation center or nursing home.
“WellSky is a healthcare technology analytics company that has tens of thousands of home and community based providers,” Hu says. “It allows us to bring those options to patients who are coming out of the hospital in a way that we were never able to do before.”
With more post-acute options, Hu says patients have more choices and it “frankly helps hospitals be able to get their patients out in a much more timely manner,” Hu says.
Patients prefer recovering at home. By March 2021, home health agencies accounted for 60% of referrals, compared to 40% for skilled nursing facilities, according to a CarePort report released last month.
“A lot of patients coming out of the hospital want to recover in the home,” Hu says. “Even before COVID-19 hit, they wanted to recover in the home. I think certainly the pandemic has accelerated some of those trends.”
“The challenge for us going forward will be how do we ensure that these patients not only get the care they need, the home health care, but also get it in a timely manner,” Hu says.
Patients see a 3% greater risk for readmission to the hospital for each day they don’t see a home health provider, CarePort found in its report.
Again, staffing challenges are coming into play. CarePort’s report found a 33% increase in referrals to home health, but a 15% drop in acceptance.
Health systems need to take into account a host of factors to ensure patients can recover at home. Hospitals must consider if patients have access to transportation to get to follow-up appointments or the pharmacy, if they have family nearby to offer assistance, and if nurses are available to assist with wound care.
“There’s these huge coordination challenges that are needed in order for patients to really be successful in the home,” Hu says. “That’s probably going to be a combination of technology and analytics that help you really determine who really can be successful in the home.”
If providers are sending a patient home who is too sick to be there, Hu says, “that patient ultimately is going to bounce back to the hospital."
“You have to take into both considerations, the patient characteristics but also what providers are available and how well equipped are they to take care of those patients,” Hu says.
She adds, “I think it’s really helpful to have data that shows you both which patients have done well previously … and also, here are the providers and this is what we’re seeing in terms of performance.”
CarePort’s software helps match up patients and post-acute providers, easing headaches for overworked staff, Hu says. The goal is to reduce “provider abrasion,” Hu says.
“If I were a provider, some of the things that I would be looking at is, one, how do I leverage technology, analytics to better enable my clinicians? I don’t think the strategy of just telling our providers to work harder, you know, works,” she says. “It only leads to more burnout.”
“So you have to find ways to make them more efficient and effective at their jobs and to have a better experience at their jobs,” she says. “I think that's one of the areas where technology and analytics have to help.”
'This perfect storm'
The health system is also dealing with the fact that hospitals are discharging patients with more serious health challenges, Hu says.
“Because you have sicker patients coming out of the hospital, they need more services after they leave the hospital,” Hu says. “There’s even more need and it’s even more challenging now that you’re trying to find services for patients who on balance need more services coming out of the hospital.”
In its May report, “The Evolution of Care,” CarePort found many patients are being discharged from hospitals with higher acuity and more health challenges.
Nearly three-quarters of providers (73%) said they were dealing with sicker patients.
“That definitely caught me off guard,” Hu says. “In some ways, it’s this perfect storm. You’ve got higher acuity patients, you have staffing shortages on both sides, higher acuity patients who need more services. There’s record demand for post-hospital services in the setting of record staffing shortages that allow you to deliver those services.”
It’s time for more cooperation between hospitals and post-acute care providers, Hu says. In an encouraging development, she said she’s seeing more collaboration to ensure patients have a more successful transition.
“Hospitals are meeting with skilled nursing facilities and home health agencies to put together better transfer processes for their shared patients, to have better communication, even though they’re on different health records,” Hu says. “I think it’s really reaching across the aisle and starting to build some of those relationships.”
Health systems also need to consider building better processes to ensure patients can recover at home successfully.
“You’ve seen more of a demand for home-based care,” Hu says, adding that healthcare leaders should ask, “How do I think about ways to really make that transition seamless? Because that’s not going away either.
“How do I build the processes that I need to build in place today so that as the trend in home-based care and community care continues, that I can rise to the occasion?”
Hu says she’s glad to see a greater recognition of the important role of post-acute care providers.
“In the past, post-acute providers in many ways have been a little bit of an afterthought,” Hu says. “And now what we’re seeing is they’re a really important part of the healthcare ecosystem.”