Enabling health care delivery in the community | AccountingWEB

Enabling health care delivery in the community

One of the aims and consequences of health care payment reform is pushing care to lower cost settings. More and more, we hear this means treating patients in outpatient settings or in their homes.

So, it is with great interest that I attended the Massachusetts Technology Leadership Council's seminar  on How Technology is Enabling Dynamic Community Care Teams.  My goal was to learn more about:

  • the kinds of care providers are delivering at patients' homes and in the community,
  • why pundits view home and community-based care as essential to improving health outcomes and minimizing costs
  • which technologies contribute to delivering these results and why

Care delivered in the community

As it turns out, the patients most likely to receive care in the community are those that are well, recuperating, or have a chronic condition.  For these individuals, the key to getting better is ensuring that their care progresses according to plan.

Usually, a health care provider develops the plan upon examining the patient in a clinical setting.  The community-based care centers around:

  • ensuring patient compliance,
  • monitoring specific measures to ensure that patient is achieving desirable outcomes, and
  • alerting providers to either problems or unanticipated delays in recovery.

Why community-based care is cost-effective

Community care is cost-effective because its administration doesn't depend on the technical or human resources available only in higher-cost inpatient or outpatient settings. Instead, providers can address patients'  needs with a combination of media, remote monitoring, and lower cost community care providers.

Technology can aid in delivering media and remote monitoring, and sometimes reduce the number of visits lower-cost community care providers need to make to the home.  This means that patients can receive care where they prefer to get it: in a familiar setting and among friends and family.

It's all about the relationship

Perhaps the greatest surprise of today's technology conference is that the importance of human relationships took center stage.  According to keynote speaker, Rick Siegrist, CIO at Press Ganey, patients' satisfaction  and health outcomes depend most on the emotional connection with the caregiver.

As the speakers explained, patient engagement matters more than anything else.  Patients need to understand their care plan.  They have more control over their recovery than anyone.

Some need a personally meaningful goal to motivate them to act.  As one speaker said most patients are more interested in attending an upcoming family event, such as a wedding, than improving the level of a medical statistic.

Patients  need confidence that they can manage the disease process.  And according to another speaker, there needs to be a sustained connection, so that patients can interact with their health care providers when needed.

Technology is great when it works

As the speakers noted, technology can help providers deliver the right information at the right time without requiring a separate home care visit.   And, equally important, technology helps strengthen connections between the patient and the care team by facilitating the exchange of information each party finds valuable.

Technology also helps enforce clinical protocols.  For example, it can prompt providers to get answers to important health status questions they might otherwise forget to ask.

Desired improvements

Nevertheless, both panel and audience members expressed frustration with technology gaps and complexity.  At present, much of the technology is still hard to use. Moreover, it floods caregivers with data-rather than presenting just the information they need, the way they need it.  There is also a need for industry standards.

For technology to be truly useful, caregivers  need filtering, the ability to customize content and presentation by user, and full integration with their own and others' systems.   Regulation will drive some of these changes.  As one panelist said, "Look for future releases."


This blog

by Barbara Bix - In tough economic times, more and more clients are looking to their accountants to help them improve the bottom line. Often, the best way to do that is to start with the top line-since one can only decrease expenses so far. This blog discusses concrete actions you and your business-to-business clients can use to accelerate revenues.

More from this blog

Bloggers crew

Steve Knowles has spent 25 years in business and practice in the UK, but he also worked in the states and the years haven't dulled his way of seeing an alternative view to everyone else, and every day is a new adventure.


Joel M. Ungar, CPA is a lifelong resident of the Detroit area and a graduate of The University of Michigan. He is a principal with Silberstein Ungar, PLLC, a Top 15 auditor of SEC public reporting companies.


Allan Boress, CPA, with over 25 years as a practitioner and consultant to the accounting profession. Mr. Boress is the author of 12 published books in 6 different languages, including a best-seller, The "I-Hate-Selling" Book.


Larry Perry, CPA, CPA Firm Support Services, LLC, is the author of accounting and auditing manuals, author and presenter of live staff training seminars, and author of webcast and self-study CPE programs. He blogs about small audits, reviews, and compilations.

Sandra Wiley, COO and Shareholder, is ranked by Accounting Today as one of the 100 Most Influential People in Accounting as a result of her prominent role as an industry expert on HR and training as well as influence as a management and planning consultant. She is also a founding member of The CPA Consultant's Alliance. Sandra is a certified Kolbe™ trainer who advises firms on building balanced teams, managing employee conflict and hiring staff.

Maria Calabrese, CIR, Human Resources manager for Fazio, Mannuzza, Roche, Tankel, LaPilusa, LLC in Cranford, New Jersey, Maria's topics revolve around the world of: Mentoring, Performance management, and The "Y Generation," a.k.a. "The whY generation".


William Brighenti is a CPA, Certified QuickBooks ProAdvisor, and Certified [Business] Valuation Analyst, operating an accounting, tax, and QuickBooks consulting firm in Hartford, Connecticut, Accountants CPA Hartford.


Ken Garen, CPA, is the co-founder and President of Universal Business Computing Company (www.ubcc.com), a software development firm of high-volume, high-productivity accounting and payroll technology.


Eva Rosenberg, MBA, EA, is the publisher of TaxMama.com, and author of the weekly syndicated Ask TaxMama column. She provides answers to tax questions from taxpayers and tax professionals worldwide.


Amy Vetter, CPA, CITP is the CPA Programs Leader for Intacct Corporation responsible for leading the CPA/BPO Partners nationally.

Brian Strahle is the owner of LEVERAGE SALT, LLC where he provides state and local tax technical services to accounting firms, law firms and tax research organizations across the United States. He also writes a weekly column in Tax Analysts State tax Notes entitled, "The SALT Effect." For more info, visit his website: www.leveragestateandlocaltax.com
Scott H. Cytron, ABC, is president of Cytron and Company, known for helping companies and organizations improve their bottom line through a hybrid of strategic public relations, communications, marketing programs and top-notch client service. An accredited consultant, Scott works with companies, organizations and individuals in professional services (accounting, finance, medical, legal, engineering), high-tech and B2B/B2C product/service sales.

Rita Keller is a nationally known CPA firm management consultant, speaker, author, mentor and blogger. She has over 30 years hands-on experience in CPA firm management, marketing, technology and administrative operations.

Stacy Kildal is the mom of two fantastic kids, an Advanced Certified QuickBooks ProAdvisor, Certified Enterprise Solutions ProAdvisor, Sleeter Group Certified Consultant, a nationally recognized member of the Intuit Trainer and Writer Network, and co-host of RadioFree QuickBooks.
Michael Alter's blog specializes in providing practical advice to those who seek greater profitability and practice management tactics that enhance deeper client relationships.

Sally Glick, CMO, Principal, Marketer of the Year in 2003 and AAM Hall of Famer in 2007, leads a lively discussion of the constantly expanding roles of marketing and the professional marketers that drive this initiative in accounting firms of all sizes.


The IMA Young Professionals Blog features the insights of IMA’s Young Professionals Committee. Committee members share advice and experiences on careers, continuing education, work/life balance, and other issues affecting young accounting and finance professionals.


FEI Financial Reporting Blog provides highlights from SEC, PCAOB, FASB, IASB, and other regulatory news, including reporting under Sarbanes-Oxley Sect 404. It is written by Edith Orenstein, Director of Technical Policy Analysis at FEI.


Sue Anderson has 30 years of experience in continuing education for accountants. Currently she is the program director for online CPE provider CPE Link.


Jim Fahey is COO of Apple Growth Partners, a regional CPA firm in Ohio. His focus is on the effective and efficient use of technology within the firm by all team members.

Caleb Newquist is the Editor-in-Chief of Sift Media US, overseeing content for both AccountingWEB and Going Concern.

Leita Hart-Fanta, CPA, CGFM, and CGAP is the author of "The Yellow Book Interpreted" and owner of Yellowbook-CPE.com a website devoted to training for governmental auditors.


AccountingWEB is more than just a U.S. team of journalists and financial and technology experts - we have an international side, too! Members of our British team who publish AccountingWEB.co.uk share their ideas, insights, and perspectives from across the pond.