Providers and EHRs partner with Eventium to deliver a comprehensive library of evidence-based and best practice guidelines/care plans. Along with best practice guidelines, CMS CoPs and Accreditation standards are integrated into Eventium content. The Care Plans focus on moving patients to higher levels of disease management to prevent ACH, ER Visits, Falls, Med Issues or other high-risk events.
Patient-Centric Disease Management Tools: Patient Education Tools created based on the evidence-based clinical content >>
Eventium is unique in that it offers both clinician-centric and patient-centric tools aimed at managing care, improving health outcomes, preventing adverse events (ER, ACH, Falls, Wounds, Infection, etc.) and lowering cost. Eventium’s focus has always been on how the patient is doing (outcomes) as a result of care/interventions. To promote achievement of these patient outcomes, Eventium offers patient education tools with content that coincides with care plan interventions. Working together, the Care Plans and related Patient Education Tools produce high levels of quality care at lower costs. Sample of CHF Care Plan teaching interventions and associated patient education tool content location.
By giving the patients and caregivers the tools they need to drive their care to promote self-management and higher levels of disease management, this results in more efficient care. Less visits are needed because patients and caregivers can plan for visits and know what is expected of them. They often read ahead, and therefore can move quicker through the care plan or package of care. Eventium Patient Education tools have been developed over the past 2 decades. As standards change, the tools are updated. Eventium Patient Education Tools by condition (click link for list) are continuously updated with edits/improvements or new tools.
Efficient Care Planning: Eventium Care Plan Wizard offers efficient care planning starting with Eventium’s industry Gold Standard evidence-based, outcome-driven protocols >>
Eventium is a clinical partner to organizations utilizing the care planning content. Often organizations do not have the resources or expertise to develop and maintain evidence-based protocols.
→ Comprehensive suite of care plans and pathways for all disciplines
→ Easy to access and utilize as referential tools to guide clinicians
→ Easy to modify for specific patient or as an organizational standard for your patient population
→ POC/485 content recommendations (Order text- intervention summary and Goals) ensure compliance between POC Orders and the Care Plan interventions performed during visits
→ Measurable patient outcomes delivered with Interventions easily support Goal achievement statuses
Meet payer requirements, CoPs resulting in Defensible Care
Eventium acts as a clinical partner to organizations utilizing the care planning content. Often organizations do not have the resources or expertise to develop and maintain evidence-based protocols. Eventium continuously monitors payer requirements related to conditions of participation, quality of care, documentation of care and QAPI processes. These requirements are integrated into Eventium content and workflows. Interventions related to CoPs are tagged with the specific requirement. These associated Tags can be visualized within the Eventium Care Plan Wizard.
The content supporting CoPs is presented in the workflow within the Visit Note documentation. This ensures the CoPs are presented to document against at the point-of-care.
There are currently 686 pieces of Eventium content with a CoP TAG. Below if a brief example of some of the Interventions with CoP TAGs
Support Proactive Improvement of VBP/HHQI Outcome and Process Indicators
Eventium content and workflow offers a proactive approach to ensure compliance with quality process measures and to promote improvement of quality outcome measures. Eventium evaluates these current measures as well as the proposed measures and evaluates them against the content offerings. Content that promotes these measures is identified and TAGGED with the quality measure. As an example, there are currently > 150 Interventions delivered in Eventium content that support the Diabetes, Fall, Depression, Influenza and Pneumonia process measures and that promote prevention or improvement of the Falls, Dyspnea and ACH/ER visits outcome measures.
Outcome-Driven Care demonstrates Progress to Goals
Since the inception of the Eventium content, patient outcomes have always been a part of each care plan to determine the patient’s status, knowledge or behavior resulting from the intervention. The Outcomes are what drives the care through a pathway or care plan, true patient-driven care.
Content Relationships – POC (Blue), Visit Workflow (Green), Progress to Goals (→), POC Compliance(→)
Why focus on Outcomes
→ Important to the patient
→ Consumer – driven choice of healthcare services
ACO; Hospital; Physician; SNF; Home Health
→ Measure of success of healthcare services
→ Conditions of Participation (CoPs)
→ Value-Based payment system
→ Provider success
There are several different types of outcomes or measures used in VBP, quality initiatives, evaluation of a patient’s response to an intervention, or in defining how a Care Plan Goal is achieved. All of these are included in or impacted by the Eventium content. These may include the following outcomes/measure types:
→ Status
→ Event
→ Knowledge
→ Behavior
→ Process
→ Satisfaction
→ Resource use/Cost vs Value
Care Plan Interventions have associations to patient outcomes. The interventions are also associated to Goals. These Outcomes are used to define Goal Status. In PCC, the Care Plan overview includes the number of Outcomes associated to the Goals and how many have been met so far. The patient’s response to the outcome – as Met or Not Met – determines if the Intervention will remain in the list for the next visit. This is patient-driven or outcome-driven care.
Evidence-Based and Best Practice Care Plans
The Eventium team continuously monitors industry evidence and best practice standards, compares them against the Eventium content and updates the content as needed. Eventium content is associated to Evidence as appropriate. Currently, 100’s of pieces of Eventium content associated to Evidence sources. This is a work in progress.
Eventium’s Evidence sources are given a Grade that includes the following grade levels:
→ Best Practice
→ Evidence-based Medicine
→ Validated by Editorial Panel
→ Good Practice (text books)
→ Common Practice
Currently, 135 evidence-based and best practice sources are being used. This list continues to be modified on an ongoing basis. The following are sources used for Eventium Protocols and Patient Education Tools related to a Cardiac Condition.
Standardized Care offering efficient demonstratable Individualized Care
Most providers are looking for a way to manage or control to care being provided in the field. By managing the care though a standardized care planning process, resource use and outcomes become more predictable. This puts the organization at a lower risk and makes the organization a sought-after partner in the current market of ACOs and Health Systems for the care continuum.
If a Standard of Care or best-practice care plan is not in place, how do you demonstrate how care was individualized for an individual patient with similar condition? Individualized against what? By using a standard to provide care, as a patient varies from the standard, this is documented along with the reason why (variance codes/reasons). This easily demonstrates the uniqueness of a patient episode. Variance reason code example include issues related to psychosocial, environmental, physiologic, caregiver, compliance, education level, etc.
Eventium Care Plans and Pathways offer different levels of managed/standardized care.
→ Care Plan Interventions are delivered in the order they are recommended to be performed, starting with lower level safety interventions, to disease control, then to higher levels of health promotion. Clinicians work the list of interventions during the episode. Patients with similar conditions will vary in the amount of resources needed to get through a care plan or ‘package of care’. Using Variance Codes against Outcomes that are not met, defines the uniqueness of the patient experience.
→ Pathway Interventions are presented by ‘Step’ or encounter. This is the highest level of managed care, predictable care. Each encounter, the clinician completes the interventions. If Interventions are not able to be completed, then the reason or variance is documented. The Steps progress the patient from lower level disease management or Safety, to Disease Control and then to higher levels of self-care or Health Promotion.
Risk Prevention and Prevention of Events
Eventium content and workflow are proactive and preventive vs reactive. All Eventium Care Plans include Interventions aimed at preventing events. Eventium identifies Interventions that assist in preventing such events as ACH, ER visits, Falls, Infections, Wounds, Medication issues. There are currently 500 pieces of Eventium content with TAGs related to Risk identification, prevention and management. See below for a sampling of interventions aimed at preventing Risk/Events for ACH/ER visits, Falls, Infections and Meds.
Compliance with Physician Orders
Eventium Standard Orders that are delivered within each Care Plan are recommended for the POC/485 and are associated/mapped to Care Plan Interventions that are used to guide the Routine Visit workflow. Each visit, the clinician performs interventions as recommended. By documenting against the interventions, this demonstrates compliance with orders.
Eventium Standard Orders are a summary of Interventions presented in the working care plan during Visit workflows. For skilled care, the three types of Orders include Skilled Assessment with focus on AND Instruct on AND Perform/Instruct on. There can be a one to one or one to many relationships between an Order and one or more interventions.
Content Relationships – POC (Blue), Visit Workflow (Green), Progress to Goals (→), POC Compliance(→)
See below for a few CHF Interventions associated to some of the CHF ‘Instruct on’ Orders. There are many more interventions that are in the SN Care Plan. Order Text provides a succinct summary of the interventions for the Physician’s orders.
Efficient QAPI Process
As described in the previous pages of this document, implementation of the Eventium Care Plans provides for proactive support for:
→ Quality outcomes, VBP, quality initiatives
→ Standardized, managed care reducing cost
→ Payer and accreditation body requirements related to clinical care and risk prevention
→ Physician order compliance
→ Industry standard best practice and evidence-based practice
As a result, time spent on Quality Assurance activities (QA) is reduced: Eventium point-of-care content supports Quality Assurance (QA) efforts by minimizing the need to perform chart reviews to ensure the user is meeting the standards.
Use the reduced QA time for more productive Performance Improvement activities (PI): Organizations using the Eventium content usually reduce their QAPI staff FTEs. QAPI efforts can focus on performance improvement and staff training activities.
History, Content Development >>
Content Facts
1987-1992 VNA First Original content/protocols development of Home Care Steps® Protocols
Initially 10 home care and hospice agencies, grew to more than 30 agencies in the mid-west. Approximately 6,000 hours spent on initial 16 protocols. Developed based evidence, best-practice, field-testing and field-based consensus.
1993-2011 VNA First Continued protocol development, management of updates
Protocol list grew to > 70 for all disciplines and > 16,000 hours of R&D with organizations across the U.S. These protocols were utilized by organizations through the U.S. and internationally either as paper or electronic pathways – in EHRs. The protocols are patient, disease management based, not country or payer based.
Eventium Patient Education Tools first published in 2002, then grew to > 200 tools
2012-Present Eventium, LLC purchased the VNA First content and began development of electronic versions of the content within a proprietary content management system (ECM)
→ Assessment development and build in ECM resulting in over 200 comprehensive, routine and evidence-based standardized assessments for all disciplines
→ Care Plan relationships/mappings between content types, attributes and tags added to content to assist EHRs
→ Protocol titles grown to > 160 including Care Plans, CoStep and Pathways
→ Patient Education titles grown to > 620 in English, Spanish, Chinese, French, Italian, Russian
Eventium continuously monitors evidence-based and best practice, payer requirements, and any other documentation requirements and as needed, updates the content and added tagging to the content for EHRs to use for compliance reports of these requirements.
Identified content needs for the post-acute environment leads to development of new protocols and patient education tools and/or updating existing content.
Care Planning Components >>
Eventium protocols include Care Plans, Pathways and CoSteps.
→ Care Plan content is directed at an episode of care and interventions are presented in the order they are recommended to address.
→ Pathway content is directed at a visit or ‘Step’. The interventions presented are recommended to be addressed during an encounter. Patient outcome results determine if the patient is to move on to the next Step for the next encounter. Both models are ‘Packages of Care’.
→ CoSteps are used as addendums to the primary care plan or pathway for significant secondary or high-risk conditions.
Each Protocol consists of the following content types:
→ Problems (may be used in addition to ICD10s)
→ Goals – these are for the episode. The Outcomes associated to Interventions are like objectives to the goals for goal achievement status.
→ Standard Orders or Order Text – these are recommendation Intervention summaries for the POC/485. Interventions in the workflow are mapped to these.
Order Types
Perform/Instruct on
Instruct on
Skilled Assessment with focus on
These components are considered part of the care plan Overview, used to set up the care plan, or modify the Intervention list.
→ Interventions – these are presented in the following order and guide the care through the episode.
Intervention Order/Workflow within Care Elements: The Care Elements or Topics are in the Order of typical workflow during a visit. However, depending on the patient needs, the topics can be addressed in any order. For SN, Care Elements include the following and are delivered in this order:
Care Elements
Disease Process
Test/Treatments
Medication
Nut/Hyd/Elim
Activity
Safety
Psychosocial
Interteam/Community
Intervention Order within each Care Element is by Type, and in this order
Type
Surveillance
Procedure/Treatment
Teaching/Guidance/Counseling
Care Management
Intervention Order within each Type grouping are by level of disease management
Disease Management Level
Safety
Disease Control
Health Promotion
Interventions associations exist to Problems, Goals and Standard Orders in the context of the Protocol. Interventions for the routine visit workflow are associated to the following for reference and documentation of the patient’s response to the intervention:
→ Patient Education Tools
→ Checklists for detailed documentation of what was taught or evaluated
→ Outcomes – to document if Met or Not. If Not Met,
→ Variance Codes are used to describe why.
Interventions also have associations to the following the ECM and can be viewed in the Eventium Care Plan Wizard:
→ Tags – identifying related CoPs, TJC, HHQI/VBP, Risk Prevention associated interventions
→ Evidence
Recommended Use of Eventium Care Plan Wizard >>
Implementing evidence-based practice in your organization is a snap! Need care plan content to guide consistent practice in the field or to ensure best practices and payer requirements are presented at the point-of-care? Simply access the proprietary Eventium Care Plan Wizard to access the gold standard, individualize if needed and save to your organizations Care Plan folder in the app for users to access before or during care. The care plans may be used as a reference in the field, referred to or copy/pasted in clinical documentation, or printed, documented against and uploaded to the patient’s EHR.
Accessing, Modifying Care Plans OR Pathways and CoSteps
→ Select Protocol by entering ICD10 to view recommendation or go to dropdown list and search/select.
→ Review the Overview components and edit lists only if needed (SN Protocols – likely no need to modify Problems and Goals, focus on Orders for removal of NA content; non-SN protocols – likely will remove NA Problems, Goals and Orders).
→ Editing the Problem, Goal and Order Lists will automatically modify the care plan Intervention List.
Problems – Review/accept
Goals – Review/accept
Orders – Review/accept
Patient Education Tools – Review/accept
→ Interventions – Review/accept
→ Finish
Overview – view POC/485 Recommendations for Skilled Care/Locator 21 – Orders and Goals/Locator 22
Interventions – view
→ Save to Organization’s Care Plan File
→ Print PDF if needed for immediate use or download and upload to patient record for reference.
Use of Care Plan PDF in Field options
→ Copy/paste recommended content into POC/485
→ Refer to document during visits.
→ Copy/paste the Interventions completed into patient record. Document Outcome Status as well. Use Eventium Variance Codes for Not Met Outcome if accessible. Documenting against the Outcome support Goal statuses. Many of the surveillance ‘Assess’ Interventions are recommended to be performed every visit. These may be in a different color in the PDF.
→ CARE PLAN Clinicians perform a few interventions in each Care Element each visit, starting from the top and working down the lists for each topic. Work the list in each Care Element during the episode. Perform the Assess interventions, then one or two Instruct interventions from the top of the list, then move to the next Care Element. Address a few Interventions from each Care Element as appropriate for meeting the patient’s needs. The Care Plan interventions may be used for Telephone Visits in place of in-home visits for appropriate patients.
→ PATHWAY Clinicians perform all the interventions in the planned Step. If not performed, indicate reason using Eventium Variance Codes. If more than 3 Outcomes are not met, then the Plan for Next Visit should be to stay on the same Step for the next visit. If not, then Plan for Next Visit is to move on to next Step and readdress unmet outcomes from previous Step. A Step may be used for Telephone Visits in place of in-home visits for appropriate patients.
→ Highlight and cross-off interventions in the PDF that have been completed and do not to be readdresses.
Use of Care Plan Content in EHR
→ Organizational level – add content to EHR for access during routine visits to document against.
Demo of Eventium Care Plan Wizard used for organizational level standard
Demo of Eventium Care Plan Wizard used for patient-specific level
Print/Download Care Plans as needed, see CHF Care Plan Sampling
Teaching ‘Instruct’ Interventions – Patient Education Tools: Eventium offers a comprehensive suite of patient education tools to be used along with their care planning content. The tools provide the detail of the teaching, procedure/treatment and care management interventions. These tools are given to the patient, and together, the clinician and patient use them during the episode. Many patients or caregivers read ahead in the books and are ready to move faster through the care plan. This workflow empowers the patient/caregiver and allows them to drive the care and the outcome of the care. This often leads to the need for less resources (visits) to achieve the disease management Goals.
Continuity of Care: Each clinician visiting the patient knows to work the list of interventions within the Care Plan – Care Elements. Within each Care Element, perform the surveillance (Assess) interventions first, then do one or two teaching (Instruct) interventions – as they appear in the list. These should be crossed or highlighted if they do not need to be readdressed.
Care Plan Completion VS Readiness for Discharge: If all Teaching, Procedure/Treatment and Care Management Interventions have been performed and outcomes met, then the remaining interventions should be ‘Repeat’ Surveillance interventions that have likely been previously addressed. At this time, evaluate if further care is needed based on patient stability, risk, Goal achievement and skilled care need, or discharge/transition the patient to self-care or to their next point-of-care. For SN, if the patient needs continued service, then consider discontinuing current care plan and initiating an Extended Care – Care Plan (Skilled Management and Evaluation OR Extended Skilled Treatment) or recycle the current care plan by adding it to the patient again.
SN Extended care plans are less educationally intense, and more assessment/evaluation or treatment focused (Extended Skilled Treatment and Skilled Management & Evaluation).
Content License >>
An Eventium Content License is required to access and utilize the copyrighted Eventium Content. An initial fee is required for Organization and User access set up and for education on the use of the Care Plan Wizard. Then a License fee is charged to the organizations credit card as determined by the Organization and Eventium (monthly, biannual, annual). An organization is defined as one site/address with an ADC of 500 or less. For organizations with higher ADC and/or multiple addresses, see Multiple Sites below.
Note: Only Organizations with an Eventium Content License have permission to access and utilize the copyrighted Eventium Content and are prohibited from sharing any login/passwords outside of the organization. Eventium Licensees are prohibited from sharing the content outside of their organization without permission. This includes using the Eventium Content in presentations and marketing materials. If the Organization’s License is terminated, the organization must remove and stop using Eventium Content as they no longer have permission to use it.
Multiple Users >>
Organizations with ADC > 500 or multiple sites/addresses require a Multiple Users License. The License fee(s) are dependent on the number of sites and volume of patients.
Content Updates >>
Eventium Content is continuously being monitored against the industry’s requirements and evidence-based practice. The content is continuously being updated and reflected in the Eventium Care Plan Wizard.
If an Organizations chooses to modify an Eventium Care Plan, it is assigned a new Care Plan ID. If the Care Plan has been updated by Eventium, then an update report will be accessible to see what changed. It is up to the Organization to change their modified care plan as they wish.
If an Organizations utilizes an unmodified Eventium Care Plan, then the Care Plan will automatically be updated as changes are made.
Discounts >>
The Eventium Content License fee may be discounted if the Organization purchases the Eventium Patient Education Tools. This discount is dependent on the volume of tools purchased in the previous year.
Access to Eventium Clinical Staff >>
Included in the Eventium Content License is access to Eventium clinical experts via email or scheduled telephone/remote meetings. Possible reasons to access Eventium staff may include, but not limited to, the following:
→ Patient Education Tool implementation questions
→ Eventium Care Plan Wizard Implementation questions
→ Request for modified file format exported from Care Plan Wizard
→ Content questions or recommendations (also see below)
→ Permission for other uses of the Eventium Content (Marketing, Presentations, etc.)
User Recommendations for Content edits, or new protocols>>
The Eventium content development and continued evaluation has always been a community effort including feedback from Content Users. User feedback or recommendations may include, but not limited to, the following:
→ Content edit
→ Content addition
→ New protocol
→ Content modification for use in different point-of-care
→ Care Plan Wizard user experience improvements
→ Errors or issues with Wizard