Nestor Plana, Chairman & CEO
Hospitals in the U.S. perform exceptionally well in delivering care to patients within the bounds of the hospital, but once the patient is discharged, the story is different. Dearth of constant communication and contact with patients—having post-acute or chronic conditions— increases the risk of hospital readmissions. “23 percent of patients admitted to hospitals will be readmitted in 30-days because of the disconnect between healthcare providers and patients,” highlights Nestor Plana, Chairman & CEO, Independent Living Systems (ILS). Further, “There is also a lack of one medical record and one care plan that provides the complete details about the patient condition in an up-to-date manner.” Founded with the idea of delivering patient-centric healthcare services by engaging non-traditional types of providers, ILS helps in building and executing care plans where granular information pertinent to medical, social, and behavioral conditions are carefully considered. ILS’ aim is to secure the health of people thereby enabling them to navigate through the rest of their lives with dignity by being a part of the community and empowering those with chronic conditions to improve their lives with little dependence on others.
Streamlined Care Delivery through Data Integration
For ILS, data integration forms the fulcrum of its technology approach in curbing healthcare cost while improving quality of care. Plana explains, “A patient seeing a physician may decide to visit a specialized hospital for any of their health issues, and the reports, medicines, and the health outcomes through this diagnosis and medication may not be communicated back to the physician.” “This is exactly why we pursue the idea of having care plans integrated into the patient’s Electronic Health Record (EHR),” stresses Plana. And ILS’ care coordination and care management systems are designed to achieve just that. By integrating all the health data into one care plan, ILS’ technology system platform empowers all the stakeholders with easy access to a comprehensive and unified care plan for each patient.
Our care coordination and management systems are playing an instrumental role in reducing readmissions and avoidable admissions
Additionally, ILS’ technology system allows care managers, nurses, and social workers to conduct patient assessments and load the data into the software system from any location. This intuitive system provides a unified view of discharge summaries from a hospital and delivers comprehensive visibility into the patient’s up-to-date medical diagnostic records. “Our care coordination and management systems are playing an instrumental role in reducing readmissions and avoidable admissions.”
Once the patients are discharged from the hospital, they are usually advised to visit their primary care physician within 72 hours. If the patient is unable to get an appointment with the physician in due time, there is an increased likelihood of a medical emergency resulting in a hospital readmission. ILS tackles this situation by notifying the physician and setting up the appointment within 72 hours. Additionally, the company coordinates with transportation, social services and even provides meals delivered to the home. “We are also focusing on getting the right medication and nutrition to the patients,” informs Plana.
Cloud-based Care Management
ILS powers its healthcare services through its cloud-based eCare technology platform which is an all-encompassing turnkey solution for the end-to-end needs of health plans and care managers. From building care plans, to contracting healthcare providers, to compliance reporting at the federal, state, and local level, ILS’ eCare and eClaims platform provides a single record of each patient regardless of the plan—care management, care transitions program, or long term care program. This way, care managers have a unified view of the patient and have the ability to access historic medical data even if the patient switches plans during the course of the healthcare journey. Used by thousands of care managers in the U.S., the eCare technology platform collects data from labs, pharmacies, and health plans including all claims that have been paid in order to stratify the patient into one of three different levels: low, medium, or high risk.
“While we focus on improving the process workflow, we ensure our data repository is secured and meets HIPAA compliance,” highlights Plana.
The eCare system is carefully built with a high degree of customization and reporting. The system provides accurate information whether the patient is taking medicine or meals, and also schedules the next appointment with the doctor. If a patient is hospitalized, it records the hospitalization summary and the health outcomes. The additional capabilities of the platform include electronic verification where the system validates whether the home care worker visited the patient’s home at the scheduled time. “Through electronic verification, we are successful at reducing instances of abuse within the system,” Plana explains. Furthermore, the system simplifies the building of care plans which otherwise is time consuming and expensive. “We help care managers to navigate through the system with simple scroll down options for the medications, making it easy to operate while interacting with patients.” While building the care plan, if the internet connection is off, the system works in the offline mode. Once the internet is working, the recorded information can be synced to the centralized cloud-based care plan which enhances the overall productivity of the care managers. This validates the expertise of ILS in simplifying the data extraction at every level of the care delivery system in order to achieve better health outcomes.
Currently serving more than 4 million members including 25 thousand managed long-term care plan members across seven states, ILS is at the forefront of technology transformation in care delivery, helping health plans and care managers to make informed decisions through a centralized, accurate view of health data. One such instance is when one of its clients, a health plan, had 12 disparate systems acting in silos and managed through a manual approach. ILS implemented its eCare and eClaim systems to manage their services. Having a single patient record system enabled the health plan’s care managers to reduce the time spent on building care plans and allowed them time to focus more on delivering healthcare while ensuring that providers received their remunerations quickly.
“The idea of empowering healthcare providers and caregivers with the right technology tools to improve care coordination and communication in patient care delivery is what drives me—because at the end of the day, a patient is a member of someone’s family,” says Plana.