Infection tracking of COVID19 for SNFs with Amy Ostrem, VP SNF Solution Strategy at MatrixCare

In this episode of the Post-Acute POV, Kevin Whitehurst, SVP of Skilled Nursing Solutions at MatrixCare sits down with Amy Ostrem, VP of SNF Solution Strategy. Listen in as they discuss infection tracking, including the impact of technology. With details on how to dive deeper into root cause analysis, contact tracing, trends, and more.

With over two decades of experience in healthcare technology, Amy has seen firsthand how smart innovation can improve efficiencies for skilled nursing facilities while driving down costs. Hear how she describes new ways these solutions can help identify risks for infections, including COVID19, and how they can enable providers to enhance their quality of care.

What we covered in today’s episode

1. Can you tell us a little bit about your journey? What led you to become the VP of Skilled Nursing Solutions Strategy at MatrixCare?
2. Can you speak to the topic of infection tracking in skilled nursing facilities? What are you seeing as far as infection tracking with and without technology?
3. One thing with COVID-19 that seems to be challenging for folks is to be proactive in managing resident risk. Do you have any suggestions for things to look for or research to better track COVID severity risks?
4. Do you have any hints for our listeners once they do get their COVID severity risk scores? And, what are some of the best practices on where and how to use this information?
5. Could you share briefly what is available in MatrixCare today from a technology perspective to support all of those topics?

Resources

• Learn more about MatrixCare solutions.
• Listen to more episodes of the Post-Acute POV.

Transcript

Speaker 1:

Hi, and welcome to the Post-Acute Point of View, our discussion hub for healthcare technology in the out of hospital space. Here, we talk about the latest news and views on trends and innovation that can impact the way post-acute care providers work.

Speaker 1:

And we take a look at how technology can make a difference in today’s changing healthcare landscape in both home-based and facility-based care organizations and the lives of the people they serve.

Speaker 1:

Today, we hear from Kevin Whitehurst, Senior Vice President of Skilled Nursing Solutions for MatrixCare and his special guest. Let’s dive in.

Kevin Whitehurst:

Hi, and welcome. I’m Kevin Whitehurst, Senior Vice President, Skilled Nursing Solutions. With a new look and a new name, our podcast Post-Acute Point of View will keep you informed of the latest trends and solutions through powerful conversations that post-acute providers and industry experts.

Kevin Whitehurst:

We have always been centered around the provider, and we’re proud that the name now reflects that. You serve a subscribe to Apple podcasts or Spotify so you can be notified with the new episodes. Thank you for joining. We’re talking about COVID-19 infection tracking today.

Kevin Whitehurst:

So I’d like to introduce you to Amy Ostrem, our Vice President of Skilled Nursing Solutions Strategy at MatrixCare. So Amy, why don’t you begin by telling our audience your origin story? Can you tell us a little bit about your journey and what led you to become the Vice President of Skilled Nursing Solutions Strategy at MatrixCare?

Amy Ostrem:

Sure, Kevin, thanks. I originally came to MatrixCare from working in the industry where I was focused primarily on revenue cycle management. MatrixCare really allowed me to open up my passion and influence for the entire country, and really all areas of long-term care that an electronic health record and technology influenced.

Amy Ostrem:

So after working for several years, focused on educating our clients and building value and quality, and then from a R&D or development perspective, it became totally evident that my favorite part is working closer with our clients, with industry experts and being able to influence the industry in a larger way.

Amy Ostrem:

So I have a ton of passion for this industry, and a lot of it comes from caring for our seniors and for all of you, the people who serve them. I’m completely energized by the passion and care that comes from all of you in the industry and where like MatrixCare and myself care runs deep. So there you go, Kevin. That’s the story.

Kevin Whitehurst:

That’s awesome. I mean, even more than ever, we need people like you who are in the industry, and in every way, we all have our role with improving the quality of life.

Kevin Whitehurst:

So with COVID-19 continue to be a forefront for the world population health, and most importantly, its impact and risk regarding the senior population, can you speak to the topic of infection tracking in skilled nursing facilities? What are you seeing as far as infection tracking with and without technology?

Amy Ostrem:

Yeah, absolutely. I’ve witnessed a variety of different ways infections are documented and tracked in various facilities. So first, I’ll speak a little bit without technology. So I’ve really seen that spreadsheets continue to be the ultimate end goal for the infection preventionists to use and to do their analysis and then be able to submit their reporting.

Amy Ostrem:

I have seen amazing spreadsheets created from various sources, such as the paper chart, paper Mars and infection logs. So really anything that infection preventionists can get their hands on as far as charts and documentation that’s available.

Amy Ostrem:

But with technology, just to change the story, it’s much more efficient. So I’ve found that some facilities use a software that’s separate from their EHR for infection tracking, and this allows them some additional built in analysis in addition to assisting them with root cause analysis and contact tracing and even trending.

Amy Ostrem:

Another flavor that I’ve seen is utilizing an infection tracking ability, right within an electronic health record. So the additional benefits that this brings, so beyond the root cause analysis and contact tracing and tracking and trending are more real time or immediate updates and consolidated views along with a wider variety of data integration.

Amy Ostrem:

So typically more clinical documentation. There are typically vitals integrated in orders, such as antibiotics, diagnoses, point of care responses, and a direct link to various areas of the resident’s chart for more details, as folks are performing their analysis.

Amy Ostrem:

So having a resident’s signs and symptoms, their testing results, treatments and precautions always available as you perform infection analysis can be just a major value add.

Amy Ostrem:

Some folks say that this route can be more cost-effective for a facility because the cost for the feature is typically built into your overall cost for an electronic health record or it’s included. So it’s really also one less vendor to coordinate and partner with.

Kevin Whitehurst:

That’s a huge advantage. Amy, thank you for the explanation, because especially when it comes to cost with everything that we’re hearing from our skilled nursing providers with all of the additional expenses that they incure because of the crisis.

Kevin Whitehurst:

So I can see how technology would definitely benefit since there’s so many pieces of a resident’s chart and they’re required to do a full analysis of these infections across the skilled nursing organization. And the residents changes in conditions can occur so quickly as with COVID-19.

Kevin Whitehurst:

One thing with COVID-19 is that seems to be challenging for folks in skilled nursing facilities to be even more proactive in managing the resident risk. Do you have any suggestions for things to look for or research to better track COVID severity risks?

Amy Ostrem:

Yeah, I do have a few suggestions, and that’s a very good question because there is no published standard COVID-19 algorithm to really measure risks that’s available out there.

Amy Ostrem:

So some of the research that you can do that I would really suggest where you can find information on contributing factors can be found from the Centers for Disease Control and Prevention or the CDC.

Amy Ostrem:

The Department of Human Services is another example, the World Health Organization. And then I’m sure everyone normally is signed up for different links and listserves that are out there, but there are so many white papers out there on the topic that you can track down from reliable and expert resources.

Amy Ostrem:

So you can really utilize all of these types of resources and then look at these across your whole demographic and clinical data. Maybe even going back six months in your facility regarding all of your residents, use all that research, put all this history together and form your own basic algorithm that will work for your organization.

Amy Ostrem:

So what you’re doing with this is coming up with even better, a score to really help you to identify that risk factor and to identify the key contributing factors so that your analysis and your interpretations can be used as a set baseline, as you begin to build and trend for residents and your organization going forward over time.

Amy Ostrem:

So starting basic, we’ve learned some of the residents demographics such as their age, for example, being 85 or older, their ethnicity, whether they have heart disease, pulmonary disease, all of these play heavily into the risk for COVID.

Amy Ostrem:

So you can take those as some of your identifiers for initial baseline, and then build on more including information around diagnoses. So then you might build in diagnoses like cancer or chronic kidney disease, CLPD, and other heart conditions.

Amy Ostrem:

From there, you might take a look at signs and symptoms and lab or test results or even results from radiology. All of this can begin to build that data and an algorithm that your organization can then have quick access to. You might even build in usage patterns like orders around your antibiotic usage.

Amy Ostrem:

Over time, You’ll be able to improve this algorithm and how your organization is learning more and identifying COVID severity risk levels. And then these scores can become more standardized, and potentially ultimately drive your process improvement and your proactive quality of care and interventions.

Amy Ostrem:

So you can identify these areas to further improve or change what you’re doing both during admission and following the admission process.

Kevin Whitehurst:

Wow, that’s very intriguing, Amy when I look at this and I see how far we’ve come in, both acute care, especially when it comes to the level of sophistication to really improve the overall quality of care and the data elements you described, and being able to have the ability to really define your own algorithms, to figure out what is the best way to prevent the spread of COVID in your facility is just awesome.

Kevin Whitehurst:

So thank you so much for sharing your thoughts around that. I really liked the suggestion on having a more standardized approach or a score that’s associated with the COVID severity risk in addition to just looking across at all of the clinical documentation.

Kevin Whitehurst:

Do you have any hints for our listeners on once they do get their COVID severity risk scores and are tracking down pack, what are some of the best practices on where and how to use this information?

Amy Ostrem:

Oh, yes, of course. So once you’ve identified and standardized the contributing factors and scores that will work for your organization and how you’re tracking this data, I’ve got some suggestions for it, yeah, how to use that for skilled nursing providers. So just here’s a couple recommended best practices.

Amy Ostrem:

So number one, I always want to influence our clients to be able to focus on being more proactive. So looking at the severity risk and taking action before a resident actually would be in a situation where they are exposed and do come down with COVID-19.

Amy Ostrem:

Another one is working with infection preventionists for their analysis and their expertise and guidance as they look at the data, a lot of our clients and different customers in the industry have their morning meetings. So this is information that you can definitely use at morning meetings to discuss overall risk with residents for COVID and any recent changes.

Amy Ostrem:

Another great thing as everyone is now influenced by the quality assurance performance improvement or QAPI is having this information available at those meetings where you’re discussing different risk data and how you’re going to continue to improve outcomes.

Amy Ostrem:

Another suggestion is using information to really determine if isolation is needed for a particular resident or unit. So as you watch those trends and those scores go up, watch if it’s around a particular specific resident, or if it’s growing across a physical location within a facility.

Amy Ostrem:

And then we talked a little bit about admissions, but for screening and placement of newly admitted residents in a building, and then for cohorting like residents, it can be really powerful information to pair like residents together.

Amy Ostrem:

And then also even monitoring changes with a specific resident as those scores go up or down, they might only go slightly up or down, but being able to monitor that and trend that is fantastic information that you can then act on proactively using the COVID risk data to guide clinicians, to then proactively add appropriate care plan interventions.

Amy Ostrem:

So maybe they’re going to do more vitals per shift. Maybe they’ll have some more care planning around isolation precautions, or therapy needs. Maybe some new tests will need to be ordered or medication care plans. All of these, your clinical experts can proactively monitor and then care plan for.

Amy Ostrem:

And then finally, to trend your COVID severity risks over time, it’s going to be so interesting as we move forward. If you have this data that you’re tracking month over month, week over week, and you can really look back over time and understand those trends and severity risks and the different impacts and ways that you change that trend month over month, week over week and what you did so much learning is going to take place and already is taking place for that matter with COVID.

Amy Ostrem:

And all of these uses for risks that I’ve pointed out in different ways to use the data. This is just the beginning. All of you out there are experts in interdisciplinary and your professional teams and leaders out there, I’m sure can think of many more.

Amy Ostrem:

So I definitely encourage you to keep all of your ideas going around monitoring and trending and really influencing with positive outcomes.

Kevin Whitehurst:

Those are excellent best practice tips. Amy, thank you so much for sharing those suggestions. And I was also wondering if we could switch back to the technology influence as we wrap this up.

Kevin Whitehurst:

With the key infection topics and infection tracking efficiencies, the suggestions on research and ways to build on and track risk and best practices and using all of the valuable data, could you share briefly what is available in MatrixCare today from a technology perspective to support all of those topics?

Amy Ostrem:

Yes, certainly. So here at MatrixCare, we have a few newer features that we’ve really fast tracked as a result of COVID-19, and where the industry is going. So here’s a few that really speak to this podcast presentation today.

Amy Ostrem:

MatrixCare has a built in infection tracker capability. It automatically brings together clinical documentation, resident demographics, orders in medications, such as we talked about antibiotic orders and then other infection information such as signs and symptoms, testing, treatments and precaution.

Amy Ostrem:

And it’s all integrated for our clients automatically in one central location for further analysis. The key to all this data and this technology feature is that it’s consolidated and it’s real-time meaning any updates or additions that our clinicians or our full interdisciplinary team makes are instantly made available to the infection tracker capability.

Amy Ostrem:

Another example is the MatrixCare COVID-19 severity risk dashboard. This is a major MatrixCare differentiator. It identifies each resident’s risk level for COVID-19 and user-friendly views that staff can quickly act on and be proactive with.

Amy Ostrem:

Your team with that severity risk dashboard gets an at a glance real-time look at a number associated with the resident severity risks. We have gone through research over research. We’ve involved clinicians from the industry, clinicians from our team here at MatrixCare to develop this predictive model and algorithm.

Amy Ostrem:

And it takes in over 60 different data elements and areas of MatrixCare and combines them together into this COVID severity risk dashboard.

Kevin Whitehurst:

That’s awesome.

Amy Ostrem:

Yeah. And then beyond that, I’ll mention one other feature. It’s our MatrixCare MyAnalytics tool. The analytics solution is key to quality assurance because it gives an organization wide look at infection diagnosis trends. And from there, you can drill down into facilities, into time ranges, into residents and more.

Amy Ostrem:

There’s statistics around the numbers and the percentages of residents with infections, information on statistics on infection rates, and on residents with anti-infectives. There’s also a breakdown of infection diagnoses. So you can spot trends over time in cases, for example, of upper respiratory infections and also influenza.

Amy Ostrem:

Our clients, especially appreciate the presentation of the data from this MyAnalytics tool, because it’s user-friendly, it’s got charts and colors and statistics. It’s really easy to change the parameters and drill down or focus on specific regions or date ranges. So it’s proven to be a really effective tool that again is organization wide from an analytics perspective.

Kevin Whitehurst:

Wow, that’s a lot of really valuable information. So for our audience out there, they already have it. There’s so many effective ways to improve your quality of care.

Kevin Whitehurst:

And we just want to thank you all for joining us for this Post-Acute Point of View, and stay tuned for more podcasts from MatrixCare. Thank you for joining and thank you so much, Amy.

Amy Ostrem:

Oh, you’re welcome, Kevin thanks.

Speaker 1:

That concludes the latest episode of the Post-Acute Point of View from MatrixCare. We have a lot of guests and topics coming up that you won’t want to miss. So be sure to subscribe. If you’ve enjoyed today’s podcast and if you have a topic you’d like us to discuss, leave us a review.

Speaker 1:

To learn more about MatrixCare and our solutions and services, visit matrixcare.com. You can also follow us on LinkedIn, Twitter, and Facebook. Thank you for listening. Be well, and we’ll see you next time.