Welcome to ReachMD. This medical industry feature, titled “How Hospice Can Help Home-Based Care Happen,” is sponsored by VITAS Healthcare. Presenting is Dr. Andy Arwari.
Hi. I’m Dr. Andy Arwari. I’m a medical director at VITAS Healthcare, a national hospice provider that specializes in delivering care to patients with advanced, chronic, progressive diseases.
For years, policy experts have discussed the need to shift high-risk patients from institutional care to home settings. And now, the COVID-19 pandemic has forced the healthcare system to do just that. Patients are now choosing home–based care options over long-term, acute, and office-based care. The pandemic has also increased the need for end-of-life care services, which, by extension, has increased the need for grief and bereavement support for patients, families, and healthcare providers. These changes may end up being the new normal, placing increased burden on clinicians, patients, and families. One thing that’s remained constant is the importance of aligning with our patients on what's most important to them and how they want to be cared for. A goals-of-care conversation can cover many steps, including decisions about specific treatments, preferred care settings and end-of-life care plans.
We can learn to prioritize these conversations reflexively after certain cues from our patient encounters. Consider implementing the following triggers. Ask yourself, “Would I be surprised if this patient died in the next 12 months?”. Recognize when a patient is no longer responding to disease-directed treatments. Monitor severe signs and symptoms from an underlying disease and observe for hospitalizations due to disease exacerbations. In many instances, a quality hospice partner can help lead or initiate advance care planning discussions and share information about the benefits of hospice care.
As a provider, we all know prognostication can be a challenge, especially when it comes to life expectancy for patients with progressive chronic illnesses. At VITAS, our clinical app leverages the Palliative Performance Scale to help determine if a patient with advanced, chronic, progressive diseases could be eligible for hospice.
Let’s take a look at this app to help determine hospice eligibility. First, select your patient’s primary diagnosis. Then, slide each Activity of Daily Living to the percentage that best reflect- reflects your patient’s current functional ability. Based on the information entered, the app will provide guidance if your patient may be eligible for hospice. In addition to a Palliative Performance Scale, the app offers disease-specific hospice eligibility guidelines and a Body-Mass Index tool.
When you, your patient and their family are ready to move forward with a hospice consultation, you can submit the referral via the VITAS app. From there, you’ll be contacted by a VITAS admission professional, and gain access to educational information that can be shared via email. The mobile app is available for both Apple and Android and can be downloaded for free of charge at VITASApp.com.
Naturally, no app can sufficiently replace the professional judgment of a clinician, but it can help establish hospice eligibility and make a difficult job easier. And in our line of work, that is a game changer.
Thanks for joining me.
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