Paper vs Electronic Oasis

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Specializes in Case management Float Acute Care.

Hello! I will be starting home health nursing very soon and have heard from my manager that oasis charting was horrendous however she was using a paper charting system over 10 years ago. Now it's all electronic. I'm wondering if it is much easier? I would work 4 10 hr shifts, 7-8 hrs to see patients and then the rest of the time to chart.

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Specializes in Functional Medicine, Holistic Nutrition.

Hello, I would recommend that you spend some time reading some posts here. Before you attempt to start your own agency, it would benefit you if you work for an agency that is already established first. This will allow you to gain some valuable insight in the home care industry and what it will take to run an agency.

I've done both paper and electronic charting and both can be challenging. Depending on what kind of an EMR you are using, my opinion is that it can *sometimes* take even more time than paper. Not specificly filling out the OASIS (that's probably easier on an EMR), but all of the other documentation requirements that come with any home health nursing visit. Unfortunately, I haven't seen a lot of home health EMR systems that are very user friendly, easy to navigate, and allow one to document a visit quickly and throughly, while painting a clear picture of what occured during the visit. On the other hand, an EMR allows for better coordination of care and can streamline other agency processes like billing and scheduling. So, it depends...if I were going to own an agency, I would definitely go with the EMR.

The plan to spend 7-8 hours seeing patients and the rest of the time charting is probably not realistic. You have to consider travel time that it takes to get to the patient's home. After a full day of seeing patients, it would take me typically 2-3 hours to finish charting- this on an EMR and having completed the majority of the documentation in the home during the visit. If I wouldn't have done any of the documentation in the home, it would take me 4-5 hours, if not more.

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Specializes in Home Health.

Add it all up and you've made about $8.00/hr.

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Specializes in Case management Float Acute Care.

O dear god no, I'm not starting an agency lol. I am transferring to the home health department for a large hospital. So it really takes that long to chart and see everyone, wow.

My friends who work there say that they usually see 6-7 patients, get home by 4-5pm and spend a few hours charting. Average 40 hours per week and get paid a lot more than I do on the floor. Is this totally unrealistic?!

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I thought most people don't make as much in home health as they do in the hospital setting.

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Specializes in Case management Float Acute Care.

Not sure but my friends in home health make more money than I do. And we work for the same hospital! lol

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Specializes in COS-C, Risk Management.

I've always made more in home health than in the hospital, but it also depends on where you are, what your agency's productivity requirement is, and other factors.

I am generally a fan of electronic documentation over paper, but much of it depends on the software involved. The software system our agency currently uses allows for far too many holes for my comort level and not all required forms are computerized, leaving the nurse with a considerable amount of actual paper to be completed. I've worked for an agency whose computerized documentation was so thorough as to be painful for the nurse to complete. A happy medium would be nice.

Home health is not the easy specialty that it is assumed to be by those who have not ventured into it. Look through the forums here, familiarize yourself with the OASIS data set, the CMS website, and your state's rules for home health agencies. Documentation can make or break you in home health, so it pays to be vigilant and very descriptive. Each note must stand alone and not refer to anything previously written, except for the plan of care. Each note must be skillable and billable, otherwise the agency is open to recoupment from the RHHI, RAC auditors, etc. Ask about your orientation period, who is responsible for teaching you about the OASIS, and how you can attend continuing education seminars, like those put on by the OASIS Answers people--they are excellent and well worth the money spent. (No, I don't work for them and they don't give me a kickback).

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I've never done a paper OASIS. I prefer electronic charting but some computer programs are cumbersome and inefficient to complete the OASIS and some are great. Personally, I don't mind the OASIS (except for the lame demographic type questions) as most of it contributes to a complete assessment anyway. I can usually complete my OASIS in the home while assessing the patient in just a bit more time than it would take me to do a simple routine visit documentation. For example, an admission visit with assessment, orientation to HH care, consent forms, medication review and documentation and developing the Plan of Care and completing the OASIS takes about 50-70 minutes. Completing the OASIS itself takes about 15-25 minutes of that time.

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Not sure but my friends in home health make more money than I do. And we work for the same hospital! lol

If this is the case, you might want to look into the disparity and try to rectify it. No reason to be getting treated as if you are less than any other employee doing the same job.

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