BOZEMAN, Mont., November 30, 2023 (Newswire.com) - The journal article was directed by author Faith M. Jones, MSN, RN, NEA-BC, a highly respected national expert in the field of Medicare-defined Chronic Care Management, Heather Gilchrist, DNP, MEd, MS, RN, PLLC, and colleagues. Their work resulted in significant quality improvements by incorporating the CMS Transitional Care Management (TCM) Program into an established Chronic Care Management Program (CCM) throughout multiple western Rural Health Clinics (RHCs) and a Critical Access Hospital.
During the initiative, the clinic ran into a common problem faced by many rural clinics: the shortage of local staff. An RN contractor with expertise in the CCM program was brought in to support local efforts. Augmenting the program with external staff is considered a hybrid approach to CCM; the program continued to be maintained internally and externally with best practice workflows. Both workflow types (TCM and CCM) were and are currently enabled by the HIPAA-compliant CrossTx platform.
With the support of innovative software and despite the staff shortage, the Quality Initiative (QI) was able to accomplish the following:
- Enhanced, more engaged patient care
- Optimized program sustainability through increased reimbursement
- Reduced gaps in care
- Increased CCM patient enrollment
- Improved financial viability
- Decreased hospital readmission rates
In regard to the use of specialized platforms to support Quality Initiatives such as this, the authors convey “…[T]he use of a care coordination platform is ideal for supporting the TCM regulatory elements, to close any gaps in care, and to provide timely patient follow up. For this QI, the clinic’s [CrossTx] CCM program (structure) was already in place, with the remote RN care coordinator [also] using the CrossTx™ care coordination platform to manage their CC patients.”
Faith Jones, RN, national CCM program director with HealthTech, lean consulting expert, and CrossTx partner, shared, “This project is ongoing and remains sustainable. So often I hear care management is too complicated when, in reality, with the right system and workflow, it can and should be integrated into everyday care. This initiative is proof that it can be done.”
The QI's results are not unique to CrossTx’s successes. Chandra Donnell, Vice President Client Success with CrossTx, explains, “Across the nation, CrossTx RHCs consistently witness enhanced patient outcomes, elevated reported quality metrics, and augmented reimbursement attributed to the robust capabilities of the CrossTx platform.”
About CrossTx
CrossTx, a healthcare technology company, offers market-leading solutions delivered via its closed loop, care coordination and referral management platform. Over 100 healthcare institutions use CrossTx for referral management, care coordination and compliance with Chronic Care Management, Principal Care Management, Behavioral Health Integration, Transitional Care Management and Remote Physiological Monitoring. With a focus on innovation and user-centered design, CrossTx develops solutions that make healthcare more efficient, accessible, and effective.
Contact Information:Chandra Donnell
VP Client Success
[email protected]
406.595.1326
Original Source: CrossTx Powers Successful Quality Improvement Initiative in Peer-Reviewed Journal
