Rice County District Hospital Improves Clinical Outcomes by Using Motient’s Mission Control

Motient, a pioneer in patient movement solutions, announced today that Rice County District Hospital (RCDH), a critical access hospital in rural Kansas, has reached a two-year milestone using its Mission Control platform. For the past two years, RCDH has relied on the patient movement and communications platform to broaden its reach and secure appropriate care for critical patients. RCDH has a track record of success using Mission Control to expedite emergent patient transfers, secure specialist consultations, and coordinate interfacility transport across a large geographical region.

As a 25-bed critical access hospital, RCDH provides emergency services to residents of Rice County and the surrounding areas, with a lean staff of 160. The facility is a designated Level IV Trauma Center, and acts quickly to stabilize critically ill or injured patients before transferring them to a higher level of care at a larger hospital. Without a surgeon in-house, approximately 40% of RCDH’s patients require a higher level of care facility transfer.

In May 2020, RCDH implemented Motient’s Mission Control platform as part of the company’s partnership with the Kansas Department of Health and Environment (KDHE) to manage emergent patient transfers. All state hospitals had access to Motient’s patient movement software and services to find available beds, arrange appropriate transportation, and streamline the patient transfer process.

“Implementing Mission Control was like gaining another two team members. The system performs all the patient transfer-related administrative tasks that our physicians and RNs previously did,” said Bonnie Goans, RN, trauma/emergency preparedness coordinator at Rice County District Hospital. “Now we can quickly coordinate transfer and transport across greater distances, making our world smaller and giving patients more and better options for care.”

When COVID-19 surges strained hospital capacity across the state, the two Level 1 trauma centers that normally received RCDH’s transfer patients were routinely on diversion, with no available beds. The team would spend hours calling potential receiving facilities in search of an available placement, starting with the ones closest to RCDH and working their way out. With just a few clinicians working each shift, this time-consuming process had a negative impact on patient care at the bedside. During the pandemic, Mission Control helped RCDH transfer patients to facilities in seven states, including Oklahoma, Colorado, Nebraska, Iowa and Missouri.

Implementing Mission Control has broadened RCDH’s patient transport reach, expedited patient transfers, and improved inpatient care. As soon as the team receives a patient report from its Emergency Medical Services (EMS) agency, they assess the acuity of the patient’s condition in Mission Control. The Motient team handles the search for an appropriate bed placement, and coordinates with hospital administrators to authorize and confirm transfer and transport.

If the RCDH team requires additional expertise while patients are awaiting transfer, Motient quickly connects them with cardiology, neurology, pulmonology, and other specialists for immediate telemedicine consultations.

When the transfer distance is greater than 90 miles, RCDH’s local EMS agency cannot take the patient, as the trip would leave the community without ambulance care. Motient then works with multiple ambulance services and flight companies to identify the fastest, safest method of patient transport, whether it be ground, helicopter, or fixed-wing aircraft.

“It’s amazing how fast we can get transportation to our hospital using Mission Control,” said Goans. “Our new ability to coordinate transport to facilities that are farther away and even out of state has given our patients transfer options they would never have received otherwise, which truly saves lives.”

For the 20% of America’s population that lives in rural areas of the country, accessing emergent care can be challenging. Due to financial constraints and thin margins, more than 130 rural hospitals have closed within the past decade, and 30% of the remaining rural hospitals are at imminent risk of closing.

Motient’s patient movement platform helps critical access facilities like RCDH establish universal workflows and standardized acuity assessments for emergent patient movement, which enables more effective care management. Facilities are often able to keep more of their lower-acuity acute care patients, which helps provide needed revenue.

“Our nation’s rural healthcare system depends upon strong collaboration between facilities, as we’ve seen firsthand during the pandemic. But without common infrastructure or shared patient movement data, it becomes difficult to match the right patients with the right system resources,” said Dallan Huff, president of Motient. “We’re proud to help vital critical access hospitals like Rice County access specialist care for their patients in need. Mission Control helps to ease the logistical burden of care coordination, which is essential for keeping emergent care available to rural Americans.”

To hear Bonnie Goans discuss RCDH’s patient transfer process in detail, listen to her interview with Sue Schade, principal at StarBridge Advisors, on ThisWeek Health’s Town Hall podcast.

Addressing Rural Healthcare Disparities with Patient Movement Data

The Kansas Department of Health and Environment (KDHE) collected and monitored statewide disease activity and resource utilization through Motient’s Mission Control, a web-based patient movement platform which tracked facility capacity status. In 2021, the platform was used by 122 Kansas hospitals to facilitate more than 5,000 patient transfers to 209 destination facilities, some of which were outside of the state.

KDHE used this patient movement data to help educate state policymakers on the capacity limits of the ecosystem, objectively demonstrating the need for action. The data helped leaders justify and enact mitigations to expand hospital and long-term care center capacity, including engaging the Federal Emergency Management Agency and the Veterans Health Administration to provide short-term medical treatment for transferred patients.

Read the full article by John Sittser, director of analytics and business intelligence at Motient.

Prioritizing Care: Stroke Treatment Requires Expediency and Expertise

When a patient presents at the ED with signs of a stroke, every second counts. Rapid detection and treatment can increase a patient’s chance of survival and decrease long-term physical and mental complications.

According to a recent study, researchers report that each one-hour treatment delay of a patient with severe stroke correlates with an 11-month loss of “healthy life.” John Hopkins Medicine also outlines how delayed treatment contributes to life-altering conditions like speech and language processing, memory issues, depression, limb weakness, paralysis on one side of the body, and trouble swallowing, depending on the region of the brain affected by the stroke. 

Time is of the essence, but expeditiously delivering the appropriate care to stroke patients can be challenging, particularly for America’s rural community and critical access hospitals. These facilities typically don’t have the neurological specialists on staff to assess symptom severity, nor are they equipped to fulfill the care needs of patients suffering from massive stroke. Caring for stroke patients in these settings typically involves stabilizing the patient and getting them to a tertiary facility as quickly as possible. A standardized acuity index and centralized patient movement platform is essential to accelerating this process.

Stroke Assessment and Treatment Protocols

Treating people who experience stroke symptoms requires an enormous amount of medical expertise from physicians. When patients are transferred to a facility by air, in the pre-hospital treatment phase, flight paramedics and registered nurses rely heavily on orders from physicians and nurses at the receiving hospital.

NIH Stroke Scales includes a battery of questions that helps the medical team assess stroke severity. While stroke scales give an initial picture of a person’s physiological symptoms, neurologists need to see brain images to make a full assessment and diagnose stroke.

To treat stroke, thrombolytic medications help dissolve blood clots and restore oxygen flow to the brain.

  • TPA tissue plasminogen activator, administered with IV
    • Given within three hours of symptom onset [Source: Mayo Clinic]

Click here to read the latest guidelines for early treatment of ischemic stroke, reported by the American Heart Association and American Stroke Association.

During a stroke, getting the patient to the CT is the top priority of the medical team, said Juli Heitman, RN, customer success & quality manager with Motient, Mission Control. She currently works with sending hospital nursing staff who use Mission Control to transfer patients experiencing STEMI, stroke, and sepsis.  Previously, Heitman worked as an adult critical care bedside nurse, clinical educator, and quality manager.

Before medications can be administered, Heitman said it is critical to consider several factors that often mimic stroke.

“Before giving a clot-busting drug, first rule out low glucose levels and obtain a completed medication history, especially other blood thinners.”  

When monitoring blood pressure during an ischemic stroke, Heitman also said the body will increase the blood pressure to maintain appropriate cerebral perfusion. Lowering the blood pressure too quickly or too much, may cause a further exacerbation of stroke symptoms. [additional source-Critical Care Trauma Centre]

[INFO BOX] Types of Strokes

  • Ischemic stroke—indicates limited blood flow to the brain, usually from blood clot
  • Transient Ischemic Attack (TIA)
  • Hemorrhagic—indicates bleeding on the brain from ruptured artery in the brain
  • Posterior stroke–three times more likely of misdiagnosis [Source:  CDC and AHA]

Prioritizing Care Means Finding the Best Facility

Prioritizing patient care when a patient shows symptoms of stroke may require interfacility patient transport. And this is especially true for people who live in rural communities with limited resources.

In rural areas, the primary care doctor-to-patient ratio is 39.8 doctors per 100,000 patients compared to 53.3 doctors for the same patient load in urban settings, according to National Rural Health Association. And the number of specialists like cardiologists and neurologists–even lower in rural areas.  

Do you have the right tools to make quick decisions about patient transfers? Let’s face it, there are many moving parts when it comes to sending patients to and from facilities. While planning and coordinating these efforts, it’s just as important to maintain high-quality patient care. At Motient, we believe Mission Control can help with both.

To conduct safe, efficient patient transfers, having access to tools like the Acuity Index built into Mission Control can make all the difference. Think of the Acuity Index as a common language that helps clinicians assess patient severity and monitor worsening conditions while deciding the best method of transport, whether by air or ground.

When a patient rapidly deteriorates and needs an urgent transfer, Mission Control also helps ease the search of finding a receiving facility with beds. That means sending facilities can expedite transfers so that patients receive time sensitive quality care from receiving facilities.

“Our goal is to supply the information and structure so facilities and hospital systems can make informed choices about moving patients from one place to another,” Richard Watson, MD, Motient co-founder said, during a podcast interview with “An Empowered Patient.”

How Mission Control Helps the Healthcare Team

  • Facilitates early activation of resources and IFT
  • Reduces door to needle time – ideal goal 90 minutes
  • GPS tracking—real time tracking from the sky

Want to learn more about how Mission Control can help your facility ease the coordination of patient transfers while maintaining high-quality patient care? Visit Motient.io and request a demo today.

Taking a standardized approach to acuity assessments not only provides more objectivity, but also gives hospitals the data they need to make a variety of tactical and strategic decisions, from daily unit staffing to future space, specialty services, and bed capacity. 

In addition to providing clinicians with a standardized perspective of their patient populations, acuity assessments also enhance patient safety. The number of handoffs between inpatient care providers and units is a proven risk factor for negative clinical outcomes, and a uniform language of assessment can help manage that risk. 

The decision to transfer a patient to another facility reflects a myriad of considerations. Unlike much of medicine, the decision is traditionally made without the benefit of a large body of evidence. In the emergency department, a patient’s care is driven by the experience of physicians, nurses, and ancillary staff, who rely on their accumulated clinical wisdom in selecting the next step in a patient’s care. Yet when a patient is handed off to a transport team for transfer, there is often a communication gap regarding how the patient’s current condition, their care needs during transport and upon arrival, and the risk of those needs changing. 

Although patient handoffs are central to the field of medical transport, there are no national standards for patient severity of illness, or the clinician accreditation needed for that severity. According to the Association of Critical Care Transport, a national patient advocacy association, this lack of standardization presents patient safety risks that are often invisible to referring and receiving clinicians, as well as to patients and their families.

Transport staff delivering a patient to the hospital or another care setting initially seek to understand two variables: exactly how sick the patient is, and how urgently they need the care at their destination. A standardized communication framework that centers on patient acuity and uses objective language turns this universal assessment into a repeatable, organized process that can be applied to every patient across the board.

The patient’s acuity functions as the most pivotal information at a fundamental point-of-care decision point: do we have the resources to give this patient what they need, or will they require greater resources available at another facility? An acuity score allows sending and receiving hospitals to prioritize patient movement based on the time-sensitive acuity of those patients. Receiving centers can also survey incoming patients to assist in their internal bed management.

When clinicians have the common language of acuity at their disposal, the patient’s score functions as shorthand, immediately conveying the difference between patients. This utility is essential, as a score can quickly communicate the core gestalt of “how sick is this patient?” without the listener having to parse the details in that moment.

Making Value-Based Care Work in a Rural Setting: Three Factors to Consider

The transition to value-based care (VBC) is well under way, and accelerating rapidly. According to the Health Care Payment Learning & Action Network (LAN), 41% of U.S. healthcare payments in 2021 stemmed from value-based reimbursement models, with an additional 20% of fee-for-service payments tied to value or quality in some manner.

Traditional Medicare and Medicare Advantage are leading the way, driven largely by the Medicare Shared Savings Program, which rewards participating accountable care organizations (ACOs) for delivering high-quality, high-value care. CMS also provides specialty VBC programs that reward providers with incentive payments for the quality of care delivered to Medicare members.

For rural healthcare organizations, participation in value-based payment agreements has often been limited by eligibility restrictions, low patient volumes, and a lack of financial stability required for risk assumption. For example, critical access hospitals and federally qualified health centers are exempt from some federal programs, such as the Merit-Based Incentive Payment System (MIPS) that is a part of Medicare’s Quality Payment Program, due to a low-volume threshold.

To combat barriers to entry for rural providers who wish to participate in VBC, the Center for Medicare & Medicaid Innovation (CMMI) has created several regional models and programs used as a template by many Medicaid and commercial payers to create VBC contracts. These typically address three main concerns:

Reflecting rural patient population and volume

Residents of rural communities have a greater overall incidence of disease and disability as compared to urban residents, and are more likely to die from heart disease, cancer, and respiratory disease. In addition to facing limited access to healthcare specialists, rural residents are also less likely to be insured and more likely to live in poverty.

To attract rural providers, a successful VBC model should recognize the differences in rural patient populations and case volumes by region.  Sophisticated population health management and advanced data analysis are often not feasible for rural providers with limited resources. By incentivizing team-based, whole-person care, VBC models can have a positive impact on both cost and outcomes in rural communities.

For example, one randomized clinical trial found that the use of home-based nurse care coordination program focused on medication self-management for elderly Medicare patients resulted in a net cost savings of $296 per beneficiary per month. Another study found that a bundled acute care intervention, which paired early discharge planning, patient education, and medication management with follow-up services, decreased ED use for Medicaid patients, saving $4,295 per episode.

Establishing a data-driven culture  

Rural healthcare facilities rarely have access to the IT infrastructure required for effective population health or financial risk management, and performance data is often delayed or absent. These limitations can make it difficult to improve outcomes and reach expected parameters for traditional VBC models. Adjusting model expectations based on limited data reporting and analysis capabilities can increase the likelihood of VBC program participation for rural providers.

In December 2020, the Center for Rural Health Policy Analysis co-hosted a virtual summit of rural participants in VBC models to identify critical program elements. To increase data-driven decision-making, the participants recommended that rural facilities provide “timely and actionable performance data to allow appropriate participant responses designed to improve outcomes.”

Patient movement data can provide an immediate source of performance data without requiring additional staff for data collection and reporting. Motient’s Mission Control dashboard reflects all aspects of patient movement, including time-critical diagnoses, wait times, resource utilization, vendor relationships, service line analysis, and system leakage. This system transparency allows healthcare organizations to assess operational performance in real time and identify new opportunities to improve system-wide management.

Establishing standardized protocols for how interfacility patient transfers are handled can also enable higher quality care choices, as it streamlines the decision-making process. By implementing objective means of assessing patient acuity and risk, care teams can make better decisions for emergent patients. In a Deloitte Insights survey on VBC, less than half (46%) of physicians report following clinical pathways adopted at their organization. The authors recommend that facilities build their care management capabilities, such as risk stratification and care navigation, and provide physicians with intuitive, easy-to-use tools for decision-making.

Ensuring limited financial risk

Rural healthcare organizations are typically under-resourced, both financially and in terms of staff. A successful VBC model will recognize that rural facilities cannot assume too much financial risk, and will delineate the differences between variable costs, which are directly attributable to patient care, and fixed costs, which are required to support patient care regardless of case volume.

Reduced utilization and the avoidance of low-value care will only impact a facility’s variable costs, which are likely to represent a small percentage of a rural facility’s overall expenditures. Even if some degree of financial risk is mandated, a successful VBC model for rural facilities will link that risk to performance outcomes other than cost savings.

Rural facilities seeking to enter into VBC agreements will need to ensure that their care teams can control the measures of performance on which they are being evaluated. With careful planning and model selection, rural hospitals and health clinics can begin earning incentives for the quality care they deliver.

Motient Facilitates Over 5,000 Patient Transfers for 120 Healthcare Providers in 2021

Patient movement pioneer triples headcount while streamlining transportation for critical care patients

TOPEKA, Kan./Jan. 5, 2022 — Motient, a pioneer in patient movement solutions, announced today that its web-based patient movement platform facilitated more than 5,000 patient transfers from 122 hospitals to more than 209 destinations in 2021. Nearly half of these interfacility transfers represented time-critical cases.

Motient’s Mission Control solution streamlines providers’ transport workflow via patient acuity scoring and a comprehensive logistics dashboard. The platform is now averaging an accelerated rate of 20 to 30 patient transfers per day — and, on many days, sees more than 40. Interfacility transfers typically arise when one facility lacks the specialized resources needed to properly care for a patient and play a key role in the delivery of optimal patient care.

Over the course of the year, the Mission Control solution assisted hospitals, health systems, healthcare networks, and other healthcare facilities with a wide variety of patients requiring a higher level of care.  The vendor-agnostic platform worked with more than 132 transport agencies to move patients across 11 states. More than half (52%) of client requests involved ground transport, while 48% of patients were transferred by air.

In 43% of transfers, the referring hospital requested Motient’s assistance to locate an appropriate destination for the patient, particularly as the pandemic exacerbated inpatient acute care capacity constraints. Overall, 17% of transferred patients were identified by the sending facility to require COVID-19 transfer protocols.

Among the company’s key milestones of 2021 was the extension of its partnership with the Kansas Department of Health and Environment (KDHE) and Kansas Department of Emergency Management (KDEM) to facilitate and track emergent interfacility transfers. Under the terms of the agreement, all Kansas hospitals and state correctional facilities will be able to use Mission Control to arrange patient transportation, source destination facilities, and analyze data to improve the patient transfer process.

Internally, Motient tripled its employee headcount and launched a new data analytics department focused on simplifying the consumption and application of patient transport data for clients. The company also evolved its product development process, adopting a responsive, rapid iteration deployment model to reflect customer feedback in real-time.

“Motient is proud to conclude a year of innovation and growth. We value our partnership with the state of Kansas and are deeply appreciative of the response we’ve received from so many EMS agencies and local and private transport vendors,” said Dallan Huff, president of Motient. “In 2022, we look forward to collaborating with forward-thinking healthcare organizations to improve patient outcomes through a more cohesive interfacility transfer process. We are grateful to our key stakeholders for partnering with us to harness the power of patient movement.”

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I have really enjoyed working with the knowledgeable and innovative staff within Mission Control! They have observed and created a dashboard that significantly meets our data abstraction needs. This information is in real time and we can access the data points we need very quickly. Mission Control has saved me hours of manual abstraction and I can now present this information to our physicians and leadership through creative charts and graphs. At Newman Regional Health, we are very excited to integrate Mission Control into our daily workflow and look forward to the valuable information the dashboard can provide!

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We started using Mission Control a few months ago because we were struggling with finding patient placement and transportation. Mission Control helped with that significantly. MC is very user friendly! All staff has been so kind and helpful! They are always prompt with assisting us and do a great job in keeping us up to date and informed on any progress they’re making whether that be with a phone call or a message through mission control. They continue to work until transport has been found! We would be lost without them!

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The Creation of Motient: Two Doctors See Possibilities in Challenges

After experiencing the hurdles of patient movement first-hand, two doctors decided to transform them.

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