San Francisco-based Hospice by the Bay, the second oldest hospice care facility in the nation, has introduced an app to help physicians refer patients to end of life care.
"If you look at the overall population, the eligible population of Medicare patients, only about 50 percent of those eligible ever get hospice care for a lot of reasons," David Zwicky, director of business strategy at Hospice by the Bay, told MobiHealthNews. "So there's a lot of education that needs to happen for both the general public and the 'medical public,' if you will. Anything we can do to get the information out there is a good thing."
The app, which is available for free from the Apple AppStore and the Google Play store, provides doctors with several different tools to help them treat patients who may be reaching the end of their life. Hospice by the Bay developed the app in partnership with iReferDR, a developer that's created similar apps for other hospices in the past.
The Centers for Medicare and Medicaid Services (CMS) will reimburse patients for six months of hospice care. Because of this, CMS has released guidelines, called "local coverage determinations", to help doctors determine when patients are in their last six months of life based on the patient's symptoms. The app organizes all those guidelines by condition so doctors can easily access them.
Physicians can also see the hospice's drug formulary, which might not be familiar to them because hospice facilities use much larger dosages of certain medications like morphine and opiates than most care providers.
The app also includes educational materials to help physicians feel more comfortable with hospice care, including a video about how to have the hospice care conversation with a patient or family, bios of Hospice by the Bay's medical directors, and links out to articles about the benefits of hospice and palliative care.
"That's often a barrier, because it's a very difficult conversation to have," Zwicky said. "Our medical directors do this day in and day out, and we thought it would be good to give that advice to a clinician."
Finally, the app allows doctors to hit the "Refer Now" button and either call the hospice on the phone or fill out a form on the app to submit a written referral. Physicians can lock in information about themselves that they might enter over and over again, or they can use the phone number for a consultation, Zwicky said.
Zwicky said it was too early to share download numbers, since they only released the app last week. The facility intends to reach out to physicians via direct mail and advertising to encourage them to download and use the app. He said Hospice by the Bay is also considering taking the app beyond the hospital.
"One of the things we've talked about is whether or not we need to do something similar for the general public," he said. "It would be a little different in nature, more educational. And I'm not sure how we would get people to download it. But we're talking about it."
Zwicky said the current app could help people get into hospice sooner, which could improve the end of their life. Despite that Medicare will cover six months of hospice care, Zwicky said, "the average length of stay is about 60 days, and the median is down around 20. So there's a huge gap in terms of benefit coverage between what's out there and what people are taking advantage of."