Covenant Hospice came to Bit-Wizards to build a hospice and palliative care referral mobile application for the iOS and Android platforms. The application would allow physicians to refer patients quickly to hospice or palliative care. Covenant wanted to reach more patients with their care services. The purpose of this app is to increase the number of referral patients from existing physician relationships, build new physician relationships, and allow them to distinguish their company in the hospice/healthcare market both regionally and nationally.
The Challenge
Covenant Hospice’s President and CEO Jeffery Mislevy took the helm of Covenant Care in 2014, and he set Covenant on a new vision committed to service excellence and growth. As a part of this strategy, Covenant wanted to grow the number of patients they were serving and increase their pool of referring physicians. To achieve this, Covenant wanted to utilize a technology-driven way to streamline their business within the referral process. All of these requirements would have to include their new brand Covenant Care, which was a change and expansion of services from the original Covenant Hospice branding. To achieve these business goals, Covenant realized they would have to invest in technology and grow into a national company while continuing to be innovative in their service offering from a regional and national standpoint.
At the onset of discussions with Bit-Wizards, Covenant already owned a mobile app, but they had no developer to maintain it and no marketing to support it, and at that point, the app was three years old. They initially built the app just to “have an app,” it did not feature the necessary functionality or integration that would be beneficial to the growth of their business.
Covenant began the search for a “white label” app service to fill the need for their new app project. The CIO decided it was important to get an evaluation to determine if the white label app service would be the right direction for their project. At this point, Covenant came to Bit-Wizards. Covenant’s relationship with Bit-Wizards began in 2009 when the development team at Bit-Wizards built the Accra Time App for Covenant.
Covenant requested that Bit-Wizards evaluate the white label app service that they were considering and compare it to the cost and functionality that a custom app would provide.
Bit-Wizards’ evaluation of the white label app service included:
- A detailed comparison to Covenant’s existing app
- A cost/benefit analysis for choosing the app service or building a new custom app
Bit-Wizards’ recommendation explained the necessity of creating a custom app to achieve the required functionality and allow for the addition of additional features in the future to support the level of growth and expansion of services that Covenant would need. The custom app route would also ensure HIPPA compliance and bring their technology investment up-to-date.
The Solution
Business Solution
After the initial evaluation, Bit-Wizards met with Covenant’s CIO to discuss the recommended approach for submission to the Board of Directors. Covenant’s board agreed that to meet their exact business requirements and goals; the right solution would be to build a custom application.
The Bit-Wizards client services team met with the various departments within Covenant that hold a stake in the ICare app project. They complied lists of features and functionality required by the departments and then provided screen mock-ups to Marketing, IT, and Patient Care for feedback to confirm accuracy for the initial plan. This process helps to ensure end-user acceptance of the new application and a successful project launch.
Next, the Bit-Wizards development teams built the iOS app according to the specifications gathered and approved by the stake holding departments. After the initial development, Bit-Wizards led several review and feedback sessions with the Covenant team. They then moved on to develop the Android version of the application.
In addition to the end-user the applications for iOS and Android platforms, Bit-Wizards build a web-based management interface using Microsoft technology and leveraging Covenant’s existing IT infrastructure. This web interface allows Covenant to manage the patient and doctor information that enables the coordination of patient care and onboarding. The web interface also offers Covenant the ability to administer the app data such as locations and diagnosis codes without having to contact Bit-Wizards for content updates.
Technical Solution
Being careful consider the design and UI for both iOS and Android platforms the Bit-Wizards development team laid out the initial wireframes for the application. Then utilizing their partnership with Xamarin, Bit-Wizards developed a native interface for both platforms while using a shared cross-platform codebase to decrease the overall cost of maintenance and initial capital development costs.
Using lightweight JSON web interface on the Microsoft .NET platform Bit-Wizards built a SQL database, to store the necessary tables to manage the app data for the contacts, doctors, patients, and locations. Stored procedures are also used to transfer the app data into that database.
Bit-Wizards set up an email process to allow the end users (doctors) to send notifications of a new patient referral to the care coordinators.
Microsoft Entity Framework is in use on the backend web interface system and gives Covenant the ability to manage records and other data.
Using a data-driven plan for the ICare app, helped Bit-Wizards build in functionality that allows Covenant to manage information easier. Information such as the End User License Agreement (EULA), diagnosis code lists, and notification options that tend to require frequent changes. The backend web interface makes changes such as these quick and easy it was designed so that Covenant IT or data managers can perform these changes as needed. They can log in and add, remove, or edit the information and the app is updated immediately; and there is no need to push an app update to the end user. This functionality also means that Covenant does not have to contact Bit-Wizards for app information updates that only take minutes. The Bit-Wizards development team is contacted only when Covenant decides that they need significant functionality added.
How the Covenant ICare App Works
When a doctor has a patient that is in need of hospice care, they fill out the in-app referral form, digitally sign the referral, and submit a CTI Attestation. CTI Attestation is a Certification of Terminal Illness. A CTI Attestation is a written certification and healthcare compliance certification required under the US Code of Federal Regulation (CFR) that an organization providing hospice services must obtain to submit a claim for payment. The physician completes the attestation when a patient is referred to hospice care. The app collects more information than the original paper process, such as the patient's current location and the contact information for their primary advocate. The app sends this referral request to Covenant's care coordinators using a secure connection.
Since doctors are usually very busy, the app maintains a profile for the user, allowing much of the data to be pre-filled when the doctor logs in for new patients. Also, since patient advocates can refer their loved ones to Covenant's care, the app allows non-medical professionals to create a profile and referral, as well as access more information about Covenant's services.
The Result
The initial launch of this app has been so successful; Covenant is already finding ways to add new features and functionality such as adding other profile types as referral providers (home health care aides, clergy, and nurses).
With the death rate growing annually at a rate of 6%, the ICare App makes it possible for Covenant to directly reach the 848 physicians and 350 physician’s assistants in the Northwest Florida region, which in turn, will bring a much better quality of life to those who are in need of care.