Helping Hospitals Navigate Patient Throughput

Middle Tennessee can add another national headquarters to the long list of healthcare service firms that call this area home. This time it’s Hendersonville, and the homegrown start-up is NaviLife Health Solutions, LLC, which has carved out its own niche by offering virtual patient navigation solutions to hospitals across the country.

Co-founded by healthcare veterans Barry Dennis, RN and Andy Huckabay last October, the company already has formalized partnerships with hospitals in Alabama, Arizona, Texas and Iowa. Additionally, negotiations are underway with facilities in five more states. While a number of large hospitals and specialty lines offer onsite navigation services, Dennis said he and Huckabay believe NaviLife is the first to offer contract navigation services to hospitals nationally.

“One of the challenges faced by our healthcare system today and in the future is the increased utilization of healthcare services by the senior population,” said Dennis, who serves as the company’s CEO. “This population generally requires more healthcare resources.”

Between an aging population and greater access under the Affordable Care Act, hospitals are seeing an increased demand for services while at the same time facing declining operating margins.

“It’s all about throughput,” said Dennis. “The more efficient you can make the throughput, the more successful you can become.” Unfortunately, he added, hospitals are not always as efficient as they need to be in the face of new demographic and economic realities.

“Traditional methods of managing access to care and directing patients to the appropriate level of care are very fragmented with a host of people responsible for those functions on any given day,” said Dennis. “There’s a lot of variability in hospital processes depending on the time of day or even the day of the week.”

He continued, “When we contract with a hospital, we bring in a single process that is consistently the same 24 hours a day, seven days a week.”

For a patient requiring more specialized care, Dennis noted it isn’t unusual for an ED physician or nurse to make several calls to line up an accepting physician and facility … and then several more to arrange transportation. During the process, not only is that patient waiting, but all the other patients in the ED also are experiencing delays while the clinical staff is busy making arrangements. Instead, Dennis said, a physician could make one call to NaviLife, which has centralized all those functions.

NaviLife’s throughput solutions are provided around the clock by registered nurses from the Medical Access Center in Hendersonville, which serves as a virtual extension of each client hospital. “We require our nurses to be licensed in every state in which we operate,” noted Dennis. He added, NaviLife currently employs a dozen nurses with about 90 percent coming from a critical care or ED background.

The NaviLife nurse navigators remotely direct patients to each client hospital’s most appropriate healthcare resources to ensure entry at the correct access point. They also coordinate transfers, timely discharge services, and follow-up care, including referrals to physical therapy, rehabilitation and skilled nursing. Swift Admit is the company’s core solution to assess inpatient referrals, admission and transfers. Other solutions include Discharge Direct, Around-the-Clock Bed Management/After Hours Assist, and Call an RN.

Each client hospital has a unique phone number that is marketed within the facility’s catchment area by NaviLife’s outreach team. Area physician practices, clinics and rural hospitals are given that number to coordinate care for patients who require inpatient treatment.

“We direct connect the referring physician to the accepting facility,” explained Dennis. He added the NaviLife nurses could also provide access to clinical documentation from the referring provider or facility and oftentimes even write the admission orders to initiate care as soon as the patient arrives at the accepting acute care facility. “The goal is to help keep the receiving facility from having to repeat tests,” he said.

“The quicker you can get patients to the level of care they need, the better their outcomes will be,” Dennis noted. “Healthcare doesn’t always deliver services expeditiously. We get tangled up in our own web sometimes, and we don’t always get the patient to the right level of services either on the front end or the back end. That’s the gap NaviLife is trying to close.”

While the scope of services depends on each individual contract, Dennis said follow-up after discharge is a popular option since roughly 60 percent of the volumes for client hospitals come from the Medicare population, which now comes with financial penalties for many avoidable readmissions.

“We offer a readmission migration strategy. We’re calling that patient and following that patient after they are discharged home to make sure they are receiving the resources they need,” he said.

Nurses typically call the patient or a family member within 48 hours of discharge to make sure post-acute care instructions are understood, prescriptions filled, physician appointments are set, and transportation is available. If the answer is ‘no’ to any of those, the nurses help the patient or family find solutions.

Dennis noted having patients access care at the most appropriate level, helping facilities avoid duplicative tests, and then following up with patients to ensure the necessary steps are being taken to promote optimal recovery makes sense financially and medically for all parties. It just takes a little coordination and navigation to maximize the available resources.