Taking Care of the Most Vulnerable

When you have a chance, please take a moment to read this tender New York Times story, “Fighting to Honor a Father’s Last Wish: To Die at Home,” by reporter Nina Bernstein, about a man named Joseph Andrey and his desire to end his days with dignity in his own home. The article, as well as the accompanying “Care at Life’s End” graphic, demonstrates how cost-effective and more humane it is to Age in Home than moving from institution to institution during the most fragile of years.

One of the benefits of new digital technologies is how it can empower people to do many things that were not previously be possible. In particular, they can allow for a greater level of personalization in care assessment, management and delivery.  But while patient engagement, connectivity and electronic health records have become current buzzwords, we must remember that the dignity of the patient should always be paramount. For all of the buzzwords, none will have as much impact on bending the health care cost curve or improving care if technology is not accessible to help the costliest, neediest, most vulnerable users in the system.

A systemic cost impact requires an ability to access and generate communications, interactions and responses for the most vulnerable and underserved populations.   A systemic solution is critical to any genuine success in reducing overall US health care costs and enhancing lives through better care quality. It is essential, on an organizational level, for plans, payers and agencies that are exposed to the risks of their costs under capitated rate programs, and versions thereof, such as value-based payments, bundled payments and shared risk programs, to reach the costliest and neediest patients in our system.

We need to focus on the means to generate useful information from homes that are otherwise unconnected and badly underserved, which in turn will enable rapid, timely interventions to minimize problems, optimize treatment cost effectiveness and better manage overall care. That accessibility will be a meaningful new strength to the extent that it can be accessed by all, including people such as Mr. Andrey and their families and caregivers.

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Developmental Disability Care Managers Now Using eCaring

We are excited to share news from Wisconsin about a promising application of our award-winning eCaring technology.

Have A Heart, a non-profit 501c3 that helps  children and adults with physical and developmental disabilies, is the first facility of its type in the country to use our eCaring system.  eCaring now enables staff and family members to track whether individuals got their medicine, had eaten food, slept OK, and had been turned in their beds.

We look forward to a long future with our friends in River Falls!


 eCaring’s Real-Time Care Management System Selected By Have A Heart to Support Individuals with Physical and  Developmental Disabilities

eCaring’s real-time alerts and actionable analytics to support Have A Heart individuals with physical and developmental disabilities, reduce costs, improve quality of care and provide greater peace of mind

  River Falls, WisconsinAugust 27, 2014 – eCaring, a leading health care quality company, announced today that its Web-based health care management and monitoring system is now being used by Have A Heart, Inc.,  a leading Wisconsin-based provider of services to physical and developmentally disabled children and adults.  eCaring is supporting Have A Heart’s primary goal of maintaining the best possible independence for individuals under their care.

eCaring’s transforming technology turns the Have A Heart residence into a powerful real-time source of actionable health care information.  eCaring empowers Have A Heart caregivers to generate extensive amounts of clinical, behavioral and medication adherence data for each resident, which the system filters into alerts for the Have A Heart team.  With eCaring, Have A Heart is able to respond immediately if a patient misses their medications, or if a wheelchair or bed bound patient has not been turned or positioned appropriately, preventing potentially serious complications.  Have A Heart management and family members receive real-time alerts and can monitor care on a 24/7 basis.

“We chose eCaring after an intensive search, because I found no other system that comes close to eCaring in giving us a whole new quality assurance compliance tool for management oversight.  Its ease of use and access to real-time data, which can be quickly adapted to group residential, supportive residences and community program settings, also gives families a new level of reassurance,” said Amber Carlson, executive director of Have A Heart.  “Most systems that I evaluated are inflexible and require intensive staff training.  With eCaring’s simple interface and responsive support staff, we had our system up and running and trained our staff a matter of days.”

“Our program with Have A Heart demonstrates how robust and flexible the eCaring  system is in meeting the needs of specific patients populations,”  said Robert M. Herzog, founder and CEO of eCaring.  “We are pleased that our technology enables the Have A Heart team and family members to obtain the best possible care, while reducing risks and costs and providing greater peace of mind to families and patients.”

Have A Heart, is the pioneering client in the development disabilities space for eCaring and joins eCaring’s growing list of clients, which includes Senior Health Partners, Jewish Home Lifecare, Beth Israel Medical Center, and others.

About Have A Heart, Inc.

Now celebrating its 20th anniversary, Have A Heart, Inc., a non-profit 501c3 organization, is dedicated to providing relief for families with physically and/or developmentally disabled loved ones, with a primary goal of delaying or preventing out-of-home placement.  Have A Heart’s programming uses a social and recreational model to provide an opportunity for increased independence with daily living skills and decision making.  Have A Heart, proud to provide a flexible, comfortable environment for clients to grow their skills, is certified and licensed in full compliance with all state rules, regulations, and guidelines.

About eCaring

eCaring, a privately-held, New York-based health care company, integrates behavioral, clinical and medication adherence data to provide a real-time home health care management and monitoring system for seniors and people with chronic conditions. The unique cloud-based platform allows care managers and providers, hospitals and health plans to spot changes in a patient’s normal patterns, receive alerts when intervention is required to keep small problems in the home from becoming big ones in the hospital.   The result is more efficient allocation of resources, improved information sharing, and reduced overall cost of care.  www.ecaring.com.





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Breaking Language Barriers in Healthcare using Digital Technology

The non-English speaking patient population in the U.S. accounts for an estimated 30 million people. Navigating our health system is challenging enough for native speakers but what about for those for whom English isn’t their first language?

Language barriers have been demonstrated to lead to a number of adverse health outcomes including:

  • Decreased patient satisfaction
  • Lack of preventive health services
  • Repeat visits to the emergency room
  • Longer hospital stays
  • Non-compliance with treatment
  • Increased number and severity of medical errors
However, digital technology has opened an entirely new frontier for addressing communication problems. eCaring is one of the first health care technology companies to address the issue head on. Our copyrighted icon-based language was designed in mind for people with limited technology skill and for whom English may not be a first language. Our home care monitoring interface allows home care aides and patients, regardless of English literacy, to capture huge amounts of information about the real-time care and condition of patient’s at home, including clinical, behavioral measures as well as medication adherence information.
MedCity News shares more about how eCaring’s unique icon-based program is breaking down language barriers in home health care, here


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eCaring Receives Prestigious Corporate Leadership Award From The New York Academy of Medicine for “Creation and Use of Technology in Service of Elder Health”

This evening The New York Academy of Medicine (NYAM) will hold its 20th Annual Gala, “Healthy Cities, Healthy World,” at the Pierre Hotel.  The Gala will honor companies and organizations that use technology to improve health, particularly among older adults. NYAM will present eCaring with the Corporate Leadership award for its creation and use of technology in service of elder health. eCaring’s CEO and Founder, Robert Herzog, will accept the award.

Creating healthy environments in cities is more critical than ever before now that more than half the world’s population lives in cities, with that number continuing to grow.

“The Academy has a proud tradition of bringing together the best minds, leaders, and practitioners to address its vital mission of advancing the health of people in urban settings, supporting healthy aging, preventing disease, and the elimination of health disparities,” said James Flynn, Gala Co-chair and NYAM Trustee. “This Gala serves to highlight our commitment to these objectives and to strengthen our ability to execute on these priorities.”

eCaring, honored for its “creation and use of technology in service of elder health,” was founded by CEO Robert Herzog who was deeply involved in the home and extended care of his mother Grace, which gave him an understanding of the problems that eCaring is designed to solve.  Mr. Herzog helped develop eCaring’s cloud-based care coordination system that generates comprehensive real-time clinical, behavioral and medication adherence data from a patient’s home.  Home care aides, family caregivers and patients, regardless of computer or English literacy, can enter significant information including medication intake, vital signs, sleep and diet patterns, and critical events. The system allows doctors, care managers, family members or any member of a patient’s care team to access this information easily in real time and receive alerts when situations require immediate attention, keeping patients in their homes and out of the hospital. Use of eCaring’s digital home care management system has reduced hospital and ER visits and readmissions in programs with several major health care providers in the New York region. 

In accepting the award, Mr. Herzog said, “We are humbled and delighted to see our vision of helping New York seniors through the real-time monitoring and delivery of information that matters being validated by the Academy.  What started as a way to help my mother Grace promises to revolutionize home healthcare and in so doing, give all what they most deserve – peace of mind and hope that eCaring can improve the quality, and integrity, of our lives.”

In addition to honoring eCaring, the 20th Annual Gala festivities will honor OATS and HITE, two New York non-profits that teach and enable seniors to use technology.   Special acknowledgements will be made for emeritus trustees, previous corporate honorees, including executives from Aetna, Pfizer, Merck, NBC Universal, Johnson & Johnson, PepsiCo, Omnicom, Citibank, Kraft Foods, and Wyeth, as well as Nobel Laureates, scientists, public health advocates and luminaries such as Katie Couric and Magic Johnson, both previous Urban Health Champion Award recipients.

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New York Fully Integrated Duals Advantage Program: An Overview

[updated June 10th at 11:56am]

Dual eligibles, those people who qualify for both Medicare and Medicaid, make up a disproportionate amount of federal and state health care spending.

New York State is no exception. More than 700,000 people in New York are simultaneously enrolled in both Medicare and Medicaid. The State has the highest annual cost per dual eligible, $30,384, which is double the national average of $15,459. 

Dual eligibles often have greater complex care needs versus the average Medicaid enrollee, which can present cost and service delivery challenges for managed care organizations. In recent years policy developments at both the Federal and State level have unveiled innovative, new mechanisms for improving care for duals. In light of challenges facing managed care organizations, New York State is implementing landmark Medicaid reforms developed by New York’s Medicaid Redesign Team. One such model is the Fully Integrated Duals Advantage Program or FIDA. FIDA is a significant part of a State demonstration proposal to integrate care for duals. FIDA could affect 150,000 New Yorkers.

FIDA aims to fully integrate all service delivery for duals across the health care spectrum, including acute care, long-term care, and behavioral health, under a single capitation payment per beneficiary. Essentially, FIDA expands care management for the Medicaid population, and goes beyond what other initiatives have done to bring all service delivery under the same care management entity.

As the Western New York Law Center explains: 

FIDA plans will combine under one managed care plan:  (1) a  Medicare Advantage plan, (2) a Part D prescription drug plan, (3) a Medicaid Managed Long Term Care plan, and (4) a regular Medicaid card covering all other Medicaid services.   FIDA plans will cover not only Medicaid long-term care services, as MLTC plans do, but also cover ALL other medical care covered by Medicare and Medicaid.  In other words, a FIDA member will essentially trade in ALL of their insurance cards — Medicare (Original or Medicare Advantage), Medicaid, MLTC, Medigap, and Medicare Part D — and only have one health plan — their FIDA plan.

When does enrollment begin? The initial enrollment was schedule for July 1st 2014. That has since been pushed back to January 1st 2015.

For the most update to date information about the FIDA roll out, visit New York State’s Medicaid Redesign Team website.

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Elderly refusing water? Here’s What to Do

Are you finding it increasingly difficult to get your patient or elderly parent to consume water?

If you’re concerned, you have reason to be. Dehydration is a serious problem for seniors: Dehydrated older adults are more susceptible to urinary tract infections, pneumonia, pressure ulcers, and confusion. The condition can lead to unplanned hospitalizations and even death. 

So, why is it so hard to get elderly patients to drink enough?

Aging research shows it may be all in their head – literally. Over time the hypothalamus, the area of the brain that controls thirst, changes. The area does not produce the same degree of natural thirst response (dry mouth) as a person ages, meaning some older adults do not feel thirsty despite real fluid needs.

If your elderly patient or aging parent is not drinking enough water, here a few steps to take in order to prevent illness or an emergency.

  1. Track the frequency of refusal – In order to understand if the situation is getting better or worse, you need to document how often a person refuses water. If the frequency jumps up from 3 times per week to once per day, you’ll have a better understanding of the severity of the condition. You’ll also be able to trace what could have changed in that time frame to cause further refusal such as a change in medication, constipation, or UTI. 
  2. Explore the situation from the patient’s point of view – It’s critical to find out the reason behind why the patient is refusing drink. Get to know the patient and try to understand why they don’t want to drink water. Common reasons include: being afraid of having to urinate during the night, feeling its too much effort to get up, being embarrassed over a medical condition or lack or coordination and spilling on themselves.
  3. Educate – Try to help the patient understand why it’s important they drink at least some water, and help them work up to drinking larger amounts. Help encourage them by finding creative alternatives to plain water such as fruits, soups, or Jell-O.
  4. Choose an intervention – Discuss the trends found by recording the patient’s activity as well as qualitative information gained from the patient with the entire care team to devise a plan of action.
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