Cayuga County's Certified Home Health Agency (CHHA) has been providing home care service to residents of Cayuga County for more than 40 years. The agency provides nursing, aide services, physical therapy, occupational therapy, speech therapy and social work. In order to better serve residents of Cayuga County, the county decided to switch from a paper medical record to an electronic computerized medical record.

The county committed to a point of care documentation system last fall, and the bid was awarded to 3M, now known as Progresa. By partnering with Progresa and moving to a computerized clinical record, the Cayuga County Home Care Agency hopes to reduce time spent by clinical staff on paper work, travel time in and out of the office for paperwork purposes and reduce data entry time as well as achieve better coordination of care. Since February, the Certified Home Health Agency staff members have been involved in the planning and preparation for this huge undertaking.

The billing office has been up and running for six weeks now, actually running two systems, our old system and testing the new. The billing office is working to bill Medicare and Medicaid and commercial insurances.

Now the clinicians will be trained on documentation of all aspects of a patient's record including notes, medication list and care plans. The clinicians will be trained on the required Medicare OASIS assessment on their laptops. This will ensure current information from other members of the health team and improve coordination by more timely communication and documentation. Supervisors will be able to manage the efficiencies and effectiveness of staff right from their computer. The on-call nurse will have all patient's information to better triage the calls that come in.

Patients will see nurses and therapists bringing laptops into their homes. The assessment, teaching tools, communication and coordination will be done right in the home with the computer and also with the patient's involvement. At first, it will take the clinicians a little longer to use until they become more comfortable with the laptop and documentation system. Visits may take a little longer at first, but after a few months, the staff should be more proficient with laptop use, and it will become more like their other nursing equipment - i.e. thermometer, scale, stethoscope and blood pressure cuff.

By synchronizing each day, the staff won't need to come into the office to get schedules, assignments and patient information. Our goal is to improve coordination of patient care and reduce the amount of time spent on paperwork.

Elane Daly is director of Health and Human Services for Cayuga County. She can be reached at 253-1560 or cchealth@dfa.state.ny.us