Looping in home-based caregivers

Managing a patient on a care plan means not just keeping in touch with the patient but also with caregivers at home. That can be tough, since patient portals generally don't allow multiple recipients on the patient side to receive messages. Instead, caregivers and case managers often end up resorting to phone calls—lots of them—to stay on the same page.

Those phone calls, plus time spent actually caring for patients, can add up quickly. On average, family caregivers spend about 24 hours per week on care, according to a 2015 AARP report.

“A lot of times, you end up leaving messages over and over again, so you kind of feel that you're stalking someone,” said Monique Fleurant, a nurse case manager with Rhode Island Primary Care Physicians Corp.

The physicians group, which says it cares for over 150,000 patients, recently sought to ease that communication burden and turned to Seniorlink, with which it partners. The company's Vela software, which complies with HIPAA, serves as a platform for everyone involved in a patient's care to send text messages, images, files, videos and other formats, keeping in touch when the patient is not in a medical facility.

“Think of it as a virtual care room,” said Seniorlink CEO Tom Riley. Each person involved in a patient's care can have a different set of permissions, allowing them to view some or all of a patient's information, including advanced directives and medication lists. Or, Riley said, think of it like Slack, the workplace messaging program. Like Slack, Vela lets users directly message each other and send group messages.

A few other platforms, such as Lua, offer similar capabilities. Others are more patient-directed, such as CaringBridge, which lets patients create websites to share updates with family and friends. And My Circle, from Quest Diagnostics, gives family members access to each other's lab results.

But in general, HIPAA-compliant communication tools for caregivers who aren't necessarily healthcare professionals are rare. Researchers found that just 15 out of 200,000 mobile health apps provided communication tools for family members.

Vela provides a shared calendar that helps people involved stay on top of appointments. The messaging platform also allows for a more efficient and documented way for a case manager to make sure a patient is taking the right medications by informing the patient's entire care team and family.

And that includes the patient's home caregivers, who might otherwise be left out of the communication with the patient's medical care team. “No other application that we came across meaningfully integrated the caregiver as part of the care team,” said Noah Benedict, chief operating officer of the Rhode Island physicians group, which is now a partner client of Seniorlink. “It was always a logistical hurdle.”

By looping in all caregivers, Vela allows them to share information and add value, Benedict added.

The success of platforms like Vela depends in large part on the care teams themselves. “Technology is never the tail that wags the dog,” Benedict said. “You have to have a solid care model and care team to pull something like this off.”

And as these models become more prevalent, vendors would be smart to find ways to connect the dots between all members of a care team, said Rebecca Altman, managing director at Berkeley Research Group.

“Being able to care for patients in a lower-cost setting, which is their home, is far more cost-effective than taking care of them in an ED or hospital,” she said.

Based on current results, Seniorlink is projected to end the year with $150 million in annual revenue, Riley said. Some of that revenue comes from risk-bearing healthcare organizations that pay to use Vela's secure messaging on a subscription basis.

The company also offers other care-management services, including what Riley calls a “virtual nursing home bed,” which is now available in seven states, with deployments slated in a few more by year-end.

For that service, Seniorlink charges a Medicaid program or at-risk managed care organization $80 a day for care coordination and management through Vela, telephone calls and home visits. “We're saving state Medicaid and managed-care organizations 50 cents on the dollar,” Riley said.