This research intends to find out how IT personnel and Electronic visit verification (EVV) systems can benefit In-Home Care Services. The study will explore how the adoption and utilization of EVV have benefited homecare services in terms of efficacy, time management, transparency, and reduction in fraud. The proposal intends to find out what different areas can IT personnel and EVV system reduce the workload of managers and supervisors. EVV being a more advanced form of technology that has recently been assimilated into homecare services, the pioneers expected that it would lessen the workload of homecare administrators. This survey, therefore, intends to find out how possible is it to reduce the workload and the EVV aspects that can achieve the mandates.
The study will adopt the quantitative research methodology and the questionnaire will be the tool for data collection. Data will be collected from managers and supervisors in-home care agencies. The respondents will respond to the Likert questionnaire that will be sent to them via Google forms. The findings of the survey will be analyzed through an excel spreadsheet and presented in form of charts. This study will also involve a review of past scholarly articles, which is important because it gives the researcher a basic understanding of what has been investigated regarding EVV and the outcome. The work of past researchers will give the researcher an understanding of the existing knowledge gaps that need require to be filled. With the knowledge of the gaps, the researcher can proceed to investigate aspects that provide information to create those gaps.
Project Description
The main objective of this research is to increase the productivity of managers and supervisors while reducing the manual effort at an In-Home Service. This survey intends to provide information that will create more insights for stakeholders in the homecare system ensure to that make informed decisions in the choice to use EVV. The reason for this study is that EVV is still new to many people in this sector. providing information might be a great way of encouraging those who use in-home health services to accept this new technology.
Introduction
Advancement in technology has greatly changed the traditional way of doing things, information technology has been adopted and continues to be assimilated in various sectors. Companies are using technology to enhance effectiveness in service delivery. The healthcare sector has integrated the use of IT into its operations especially in compiling and storing data and also connecting healthcare providers with their customers. Electronic visit verification (EVV) is one of the innovations that healthcare has established to improve service delivery in-home care system (Driver, 2022). The EVV system’s establishment was fueled by many fraudulent complaints the Medicaid insurance was receiving. According to Medicaid, there were discrepancies between the care offered and the financial claims made by the home care agencies.
EVV is an application used to confirm and track home health care services electronically. The federal government established EVV in the 21st Century Cures Act of 2016 to make and retain quality data on home healthcare services offered and compensated under Medicaid (Oakes, 2019). Act mandated all personal care services to begin using the EVV by January 1, 2020, while all home health services were required to begin using EVV by January 1, 2023 (Illinois Department of Healthcare and Family Services, 2020).
The EVV obligation was structured to assist warrant that persons acquire necessary care while reducing fraudulent claims. This approach is good for managers and supervisors in-home care services because they only need to hire IT personnel to monitor the devices. The administrators can utilize a mobile phone, a computer, or other devices to record the kind of service provided, location, time, date, and duration of the service (Oakes, 2019). Additionally, they can employ the EVV method to access up-to-date patient health data.
The health care sector has observed an increasing number of people receiving medical treatment as compared to past years. The National Research Council observed that there are many factors resulted in decision to acquire in-home care (National Research Council, 2010). The increasing number of patients receiving care at home translates to high workload for supervisors and managers in homecare business. Home care managers and supervisors can use EVV to control and observe the provision of home healthcare services. Systems like EVV have helped the healthcare sector is gradually switching from paper-based notations and patient monitoring to electronic records (Mateescu, 2021).
Additionally, improvement in IT and the application of EVV is expected to improve communication between patients and their clinicians (Home Health Notify, 2022). EVV has aided managers to streamline operations, improve efficiency, and reduce human error and fraud in the care system. The pioneers of EVV predicted that the program was going to solve the conflict between Medicaid insurance and its users by making the homecare service provision more transparent.
EVV can be helpful to managers and supervisors in healthcare in various ways including enhancing connectivity, visibility, and security. EVV can help managers and supervisors stay connected to the caregivers they sent in the field even when they do not have access to landlines (Mateescu, 2021). The administrators can gain real-time visibility of caregivers’ locations and schedules. Further, EVV gives homecare agency administrators different elements to verify caregivers’ visits including GPS coordinates, CCTV cameras, and electronic signatures (HHAeXchange, 2021). Additionally, the managers can also have secure broadcast messaging abilities from the office and secure communication among care team members.
Moreover, the EVV can improve data collection and reporting. With EVV home care supervisors can see client demographic information and report on how their clients are faring (Ndikom, 2021). The managers are also able to review messages from and to care team members, care plans and history as well as care team information. Greater efficiency is another advantage of the EVV application because it provides managers and supervisors with complete point-of-care visit documentation, tasks completed, notes, and assessments (Ndikom, 2021). EVV can also provide optimized driving directions with accurate, GPS-based mileage. The application can also give caregivers’ team full-timekeeping capabilities, including out-of-home visits and trips to care-related institutions. Primarily, the EVV system is expected to lessen missed visits and late starts, paper documentation, and overall expenses while advancing patient care and client outcomes.
In addition to the many advantages associated with EVV, some challenges come with this application. Many homecare managers have argued that the method is a bit costly to them because it requires the installation of various devices either in officers, homes, cars, or devices of caregivers. The EVV will also require trained IT personnel to handle and manage it. Various researchers have investigated the impact of using EVV in the delivery of home care services and came up with different findings.
For instance, Sage et al., (2022) conducted a qualitative survey and the respondents reported that although EVV kind of interfered with services, it was protective, beneficial, and helpful in reducing fraud. another investigation done by Gallopyn and Iezzoni (2020) showed that home care consumers of EVV felt that it was intrusive, reduced flexibility from the consumer-worker relationship, technical difficulties, but helpful to some consumers. Having observed what other researchers found out, I intend to investigate how the incorporation of IT and EVV can help managers and homecare supervisors improve efficacy and service delivery.
Prior Work
In my previous work, I did research where I investigated how IT staff assisted in hiring caregivers during the pandemic. IT could be incredibly beneficial for creating websites and posting job adverts on multiple platforms. The pandemic changed normal operations and many companies turned to IT. Many people began to work from home, particularly during the lockdowns, and many patients were treated remotely. My prior work connects with the current study, the present work builds on my previous work. It can show how EVV can help monitor and manage the delivery of health care services for patients seen at home.
Proposed Research Objective/Research Question
In what different areas can IT personnel and EVV system reduce the workload of managers and supervisors in the homecare sector?
Justification of Project
IT plays various roles in the home care system, technology advances continuously and therefore institutions using technology also need to update their systems and continue to assimilate new changes in technology. Healthcare has been using technology for quite, especially computers for data storage (Benson et al., 1996), however, with advancement in IT, it also has to advance accordingly. EVV is an addition to various technologies the homecare system has been using only that it is more advanced in features to enhance effectiveness and transparency in the homecare sector. However, since it is still new in the market, being adopted by homecare agencies since 2020, there is a need for information more about this application to reach the public. Particularly the consumers of homecare services need to understand why managers of their care might want to integrate this structure into their care.
My investigation intended to fill a knowledge gap by identifying the various types of assistance that IT staff and the EVV system may offer to managers and supervisors. I found it necessary to carry out this survey because a majority of past studies that have been conducted concerning IT and EVV have majorly focused on the benefits and challenges of using IT and EVV in-home care. This investigation will point out exactly in what ways IT and EVV are being used by managers and survivors of in-home care service delivery.
General Application of Proposed Study
My proposal targets all the stakeholders in the home care system. However, data will be collected from managers and supervisors of home care agencies who will shed more light on the utilization of EVV and its impact on the sector. The outcome of this survey will be beneficial to in-home care service staff, management, managers, and supervisors. This study will provide information on various ways EVV can be adopted to improve homecare service delivery.
The study will also evaluate its benefits and challenges by acquiring data from managers and supervisors who have already tested and used the method. Since EVV is still in its infancy and many patients have conflicting ideas on how beneficial or harmful it is to them, there is a need for more surveys to be done on EVV. All the homecare stakeholders and the public need to be enlightened on why it is necessary to use this technology in care.
Research Methods
I adopted the quantitative research method and my instrument of data collection was a Likert questionnaire. I selected the quantitative method for my research because it is effective in collecting and analyzing numerical data. Additionally, the method is utilized to find patterns and averages, make predictions, test causal relationships, and generalize results to a wider population. I will also adopt the questionnaire as a data collection tool because it compliments the quantitative method of collecting numeric data.
The questionnaire contained various questions that needed responses from the selected sample. Under each question the participant responded by ticking one among the stipulated five options; strongly agree, agree, neutral, disagree, and strongly disagree. I chose this method because it is an easier method of collecting data in a study that involves a large number of people. The Likert questionnaire also makes it easier for respondents to tick the answer that is more desirable to them. Quantitative data is also easier to analyze and translate numerical findings into themes and explanations. My suggested research will be used by the staff of in-home care providers as well as management, managers, and supervisors. I structured the tool to be completed by managers and supervisors in a Google Forms survey, this way, it was easier to email the forms to the participants and for the participants to email them back after completion.
Data Collection
I collected two kinds of data; primary data and secondary data. I acquired secondary data from past scholarly articles and also from existing data on the utilization of IT and EVV in-home care agencies. I then collected primary data using the Lirket questionnaire that I sent to various managers, supervisors, and administrators in homecare services. Before I sent the questionnaires, I phoned each organization and talked to a representative to make my intentions of collecting data known. I only sent questionnaires to home care agencies that agreed to be part of this survey. After sending the questionnaires, I gave the respondents a span of one week to fill the questionnaires and sent them back to me, after one and a half weeks I had received back enough questionnaires to generate data for my study.
Measurements
In my survey, I asked the respondents questions to gather information on how many IT personnel they employed to handle their EVV applications, and the types of EVV they use in their home care services. Additionally, I asked questions that enquired about the impact they feel the EVV system and the IT personnel have on the home care service delivery.
After receiving the questionnaires back, I reviewed them to ensure that all the aspects were answered correctly. I eliminated the few that did not meet a complete criterion, and also ensure that questionnaires represented all the districts in Illinois so that results will be representative of Illinois as a whole. I used a quantitative questionnaire and so I collected numeric data which I carefully read and entered the answers into an Excel file and then tabulated the results. I then converted the tabulated data into explainable these following the research objective.
Materials and Procedures
My research required a well-thought-out and structured survey questionnaire that was sent out via Google Forms. My questionnaire contained items that investigated all the variables of the study. After I completed structuring the questionnaire, I sent it via Google Forms to various homecare agencies across Illinois. I sent the questionnaires with an indicated deadline to send the questionnaires back, I kept track of the questionnaires that were sent back each day, and at the end of the one-week deadline, I received a significant number of filled questionnaires. After one week I gave those who had not sent back their responses an additional five days to do so. After the five-day grace period, I put together all the questionnaires I had received.
Data Analysis Strategies
I created a Likert-style survey questionnaire using Google Forms. It provided me with information on how each participant had answered the questions. I organized and carefully entered the collected data in a Microsoft Excel file to put the numbers together and come up with the percentages. I presented the final results of my study in a form chart.
Ethics and Human Subjects Issues
My research included staff members from my organization. I had to gain their trust in the issue that I was proposing. Additionally, I indicated my student’s details in an introductory letter that the respondents had to read before answering the questionnaire. In the letter, I made it clear to the respondents that their engagement in this survey was voluntary and they could withdraw at any time if they wished to. I also assured them of confidentiality and made it clear that their personal information will not appear anywhere on the questionnaire. I ensured that I did this survey purposely to inform the homecare system and bring more insight into the use of EVV, so this study was beneficial to those who took part in the study. I also ensure that data collected in this process will solely be used for research purposes.
Timeframes
I calculated my time to carry out this research very well. I completed structuring my questionnaire on time to give the respondents humble time to answer the questionnaires and return them. since my questionnaire was sent via Google forms, I needed to give the respondents enough time so they can respond in their own time, I gave them one week and an additional grace period of five days for those who had not completed it in one week. The questionnaire itself could only take 20 minutes to complete because it was straightforward. I send an email in the mind the one week to remind those who had filled out the questionnaires to answer, after the one week, I sent another email to those who had remained and gave them five more days.
Results
My questionnaires collected data from managers and supervisors of homecare agencies. I acquire data on the types of EVV they use at home care, and the impact they feel the system has had on their ability to effectively deliver homecare services. Supervisors and managers provided the best data for this study because they are the direct people who handle the day-to-day running of the systems. They are also in the best position to tell whether a certain product is beneficial or costly to their organizations and also work directly with the caregivers they sent into the field to visit their clients.
Analysis of Results
The results were important. I created an excel spreadsheet and filled it with the information I had collected. I created questions for managers and supervisors to better understand their thought processes. The questionnaire asked the respondents to what degree they agreed with statements concerning the use of IT and EVV in homecare services. There were three options to pick from in each answer; agree, neutral, and disagree. The analysis of the findings depended on the five measures mentioned above. The Likert questionnaire (see Appendix A) made it possible to easily analyze the responses provided by managers and supervisors.
The majority of the respondents agreed already having adopted the EVV system. several agreed they utilized car-GPS to track where their caregivers are especially in connection to the location of the patient. Many managers and supervisors agreed that they used timers and login apps for caregivers to log in when they are at a patient’s house and log out when they are done with the care. Further, the participants agreed that they used a record manager app to record and keep patients’ information (Appendix B). A good number of managers also agreed that with trained IT personnel, the EVV application increased efficacy in their firms and reduced fraud complaints from their clients, and improved client data storage. The majority of the respondents also agreed that the app help manages time and team care time wastage is reduced greatly with the use of this approach. Most managers and supervisors agreed that majority of their clients do not like the installation of EVV in their homes.
Conclusion
My conclusions were drawn from the findings of the quantitative survey answered by the supervisors and managers in the homecare sector in Illinois. Past scholarly articles also contributed to the conclusions I made. I conclude that technology has largely been adopted in the home care system way before the establishment of EVV in 2016. EVV has been accepted by homecare agencies since its foundation, and many of the supervisors and managers find it beneficial in time management and reducing the cases of fraud reported in Medicaid before. Homecare administrators have found it effective to manage and control their caregivers and improve on service delivered to their clients.
The study especially the literature reviewed showed that many homecare clients are not very comfortable with the EVV because they find it invasive. Therefore, people need to be more educated on the importance of having EVV included in their care. There is a large gap of knowledge that needs to be covered about EVV to ensure that those who receive care are on the same page with the care providers.
The survey also showed that IT personnel play an important role in the adoption and integration of new technologies in every sector. Homecare systems that have adopted EVV require IT personnel who will control, monitor, and ensure that the application is working as it should be. The application will not fully meet its mandate without the workers who can translate data collected by the devices into meaningful themes that involved parties can easily understand. The findings of this study are therefore very important and must be disseminated to the general public as well as other managers and supervisors in the homecare system.
Dissemination
After my findings, I will make a flyer that will intend to educate the public and anyone involved in the homecare system about the use of EVV. My flier will contain three major sections; the first part will contain information on various forms of EVV that can be used in the homecare system. The second part will highlight the benefits of using EVV in-home care and the last part will highlight possible challenges that people using EVV in-home care might encounter. With this information summarized into major points, people who read it quickly acquire a lot of information about EVV in short time.
After designing and printing the flyers, I will distribute them in various places. I will distribute both in hard copies that I will drop physically in places that I can access and soft copies that I will send via email. Distribute them to two main places where my intended target can get them; the homecare agent offices and hospital. My fliers need to be distributed in hospitals because homecare necessities begin in hospitals where a doctor tells a patient that he/she can receive care at home. These people need to understand some of the aspects that can make their home care transparent and effective. I will also post my flyer on my social media platforms where people can access this information and pass it to their loved ones who might be struggling with acquiring effective care.
I will also look to see whether I can get any magazine or print media that might be interested in publishing my findings. I am passionate about providing quality and timely home care to people who cannot receive their treatment in the hospital for various reasons. I intend therefore to ensure that people particularly patients who consume the services of homecare agencies make informed decisions on the kind of care they want. Acquiring various kinds of information just like the information provided by my proposal is one way of achieving the former.
References
Benson, J. A., Michelman, J. E., & Radjenovic, D. (1996). Using information technology strategically in Home Care. Web.
Driver, C. (2022). EVV and how it will impact the Home Health Care Industry. Celayix. Web.
Gallopyn, N., & Iezzoni, L. I. (2020). Views of electronic visit verification (EVV) among home-based personal assistance services consumers and workers. Disability and Health Journal, 13(4). Web.
HHAeXchange, (2021). Q&A: EVV in 2021 – what’s working, what’s not, and what’s ahead. Web.
Home Health Notify, (2022). Home Health Care Industry adapting New Technology. Web.
Illinois Department of Healthcare and Family Services, (2020). Illinois’ Electronic Visit Verification (EVV) | HFS. Web.
Mateescu, A. (2021). Electronic visit verification: The weight of surveillance and the fracturing of care. Web.
National Research Council. (2010). The role of human factors in home health care- NCBI bookshelf. Web.
Ndikom, K. C. (2021). Use of electronic visit verification system to reduce time banditry for optimized quality of care in home health care by certified nursing assistants. [Doctoral dissertation]. Xavier University.
Oakes, R. P. (2019). Electronic visit verification. Home Healthcare Now, 37(4), 237. Web.
Sage, R., Mashinchi, G. M., Lissau, A., Standley, K., & Ender, J. (2022). “Less time committed to care”: Beliefs about electronic visit verification among adults using home-based personal assistance services. Home Healthcare Now, 40(2), 82-91. Web.
Appendix: The Likert Questionnaire
Appendix B: Questionnaire Response Results
