Patent Publication Number: US-2016239612-A1

Title: Home health care system and method

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
     This application is a non-provisional application that claims priority benefit of U.S. Provisional Application Ser. No. 62/077,689, filed Nov. 10, 2014 the contents of which are hereby incorporated by reference. 
    
    
     FIELD OF THE INVENTION 
     The present invention in general relates to patient care and in particular to a system and method for a management and performance platform for home caregivers. 
     BACKGROUND OF THE INVENTION 
     Home health care is a wide range of health care services that are provided in a patient&#39;s home for an illness or injury. Home health care is usually more convenient, less expensive, and just as effective as care that would be obtained in a hospital or skilled nursing facility (SNIFF). Home health care covers a wide range of services and can often delay the need for long-term nursing home care. 
     Home health care may include occupational and physical therapy, speech therapy, behavior therapy, and skilled nursing. Examples of tasks provided by home health care may include wound care for pressure sores or a surgical wound, intravenous or nutrition therapy, injections, and monitoring serious illness and unstable health status. Home health care may also involve helping the patients with activities of daily living such as bathing, dressing, eating, housekeeping jobs, and monitoring a daily regimen of prescription and over-the-counter medications. The people who provide home health care are often licensed practical nurses, therapists, or home health aides (HAH). Most home health care providers work for home health agencies, hospitals, or public health departments that are licensed by the state. 
     The amount of record keeping and information required to properly care for a patient can be extensive, and the accuracy and the timeliness of the information is critical for the health and well-being of the patient. However, the remote locations of patients can make the process of information transfer difficult, especially with the amount of documentation required that has to be constantly updated. Thus, while there are many advantages to home health care there exists a need for improved systems and methods for managing information flow between home health care workers in the field and the health care agency office. 
     SUMMARY OF THE INVENTION 
     An automated method for assigning tasks and monitoring the performance of tasks by a home health caregiver is provided, the method includes providing a graphical user interface (GUI) on a remote computing device assigned to a patient location. A care plan is sent with a set of tasks to the remote computing device, the set of tasks to be performed by the caregiver for the patient during a defined period of time. An opening time stamp is received in response to the caregiver logging on to the remote computing device. The caregiver performs an individual task from the set of tasks on the patient. Additional time stamps are received as individual tasks from the set of tasks are performed and logged on the remote computing device. An assessment of the patient&#39;s condition is received in response to the caregiver inputting the assessment into the remote computing device. A closing time stamp is received in response to the caregiver logging off the remote computing device. At least the opening time stamp, the additional time stamps, and the closing time stamp are communicated to the central computer. A caregiver modifies the care to a patient based on a set of tasks given in a time period following the closing time stamp and based on the data communicated to the central computer. 
     A system for assigning tasks and monitoring the performance of tasks by a home health caregiver is provided that includes: a server connected via a network to a central computer. One or more remote computing devices are located at patient locations. The central computer is in communication with the one or more remote computing devices. A memory system in electrical communication with the server contains a machine readable medium having stored thereon one or more sequences of instructions which, when executed by a processor, cause a method to be carried out, the method includes: providing a graphical user interface (GUI) to the remote computing devices. A care plan is sent with a set of tasks to the remote computing device from the central computer, the set of tasks to be performed by the caregiver for the patient during a defined period of time. An opening time stamp is received in response to the caregiver logging on to the remote computing device at the central computer. Additional time stamps are received as individual tasks from the set of tasks are performed and logged on the remote computing device. An assessment of the patient&#39;s condition in response to the caregiver inputting the assessment into the remote computing device is also received by the central computer. A closing time stamp is also received by the central computer in response to the caregiver logging off the remote computing device. At least the opening time stamp, the additional time stamps, and the closing time stamp are communicated to the central computer. A caregiver modifies the care to a patient based on a set of tasks given in a time period following the closing time stamp and based on the data communicated to the central computer. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The subject matter that is regarded as the invention is particularly pointed out and distinctly claimed in the claims at the conclusion of the specification. The foregoing and other objects, features, and advantages of the invention are apparent from the following detailed description taken in conjunction with the accompanying drawings in which: 
         FIG. 1  is a flow diagram of the high level process of using the inventive management and performance platform for home health care in accordance with embodiments of the invention; 
         FIG. 2  is a flow diagram of the execution of a care plan at a remote client/patient location in accordance with embodiments of the invention; 
         FIG. 3  is a flow diagram for performing task updates in accordance with embodiments of the invention; 
         FIGS. 4A, 4B, 4C, 4D, and 4E  are a series of inter-related flow diagrams of the processes for carrying out certain embodiments of the invention; 
         FIGS. 4F, 4G, and 4H  show a table outlining critical processes and activities for carrying out certain embodiments of the invention; 
         FIGS. 5A, 5B, 5C, 5D, 5E, 5F, 5G, 5H, 5I, 5J, 5K, 5L, 5M, 5N, 5O, 5P, 5Q, 5R, 5S, 5T, 5U ,  5 V,  5 W,  5 X, and  5 Y are screen shots of a graphical user interface of the management and performance platform for home health caregivers on a remote portable computing device according to an embodiment of the invention; 
         FIGS. 6A, 6B, 6C, 6D, 6E, 6F, 6G, 6H, 6I, 6J, 6K, 6L, 6M, 6N, 6O, 6P, 6Q, 6R, and 6S  are screen shots of a graphical user interface of the management and performance platform for home health caregivers on a personnel computer for use in the health care agency office in accordance to an embodiment of the invention; and 
         FIG. 7  is a schematic diagram illustrating an overall view of communication devices, computing devices, and mediums for implementing embodiments of the invention. 
     
    
    
     The detailed description explains the preferred embodiments of the invention. 
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS OF THE INVENTION 
     The present invention has utility as a system and method for managing and tracking home care workers. A graphical user interface (GUI) implanted on a network of computing devices is provided for a management and performance platform. Embodiments of the inventive management and performance platform provide utility for scheduling and monitoring tasks to be performed by a caregiver during a shift or visit to a remote location such as a patient&#39;s home or residential setting. 
     As used herein, a caregiver is defined to include registered nurses (RUNS), licensed practical nurses (LENS), physical therapists (PTS), occupational therapists (LOTS), speech therapist (SLAPS), medical assistants (MASS), certified nurse&#39;s aides (CNAs), home health aides (HHAs), Behavior technicians and Board Certified Behavioral Analysts (BLABS), familial caregivers, and patient care technicians/aides (PACTS/PICAS). 
     As used herein, a central computer is defined to be a computer that receives the inputs from at least one remote device, either directly of a network or via a server. In this context central does not imply geographic centrality of the computer relative to remote devices. 
     The tasks performed by a caregiver are based on a plan that a clinical nurse or other supervising medical personnel establishes ahead of time prior to the caregiver visit. As caregivers, also referred to as field staff, log in on their remote device, a timestamp is captured and recorded that reflects the “Clock in” time for a time sheet record. Furthermore, as tasks are completed (or attempted), additional timestamps are captured and recorded. In addition, while working in the field, caregivers may complete assessments or capture statistics on the patient, and at the end of a shift when the caregiver logs out the information is captured as a “Clock out” for the timesheets record along with the employee and client signatures. Documentation is generated from the captured information and used for applications illustratively including timesheets, payroll, insurance billing, and medical record keeping. In an embodiment an on line archive of data for insurance purposes is maintained. In still another embodiment, patient care plan is modified based on the caregiver inputs that are received by the central computer, with or without supervisory medical personnel input. 
     Additional activities provided by the software of the inventive management and performance platform in specific embodiments illustratively include one or more of: the real time monitoring for overdue tasks, supply updates, deferred priority tasks, time sheets, incident reports, and in some cases inactivity at a client site. All of the monitoring results may be communicated to the home office during a shift so that office staff may follow up with the caregiver to ensure that the care plan is applied correctly, consistently and in a timely manner. 
     Embodiments of the invention may apply a rules engine program for converting tasks into a daily shift schedule, where the tasks are rules and the program interprets the rules in the context of the specific day, shift time and user role. Inputs from previous shifts are used in some embodiments to modify the care plan for a subsequent shift of patient care. 
     Computing devices used in inventive embodiments of the home care management and performance platform include remote devices in the form of portable computing devices including tablets and mobile communication devices. In a specific embodiment, a dedicated tablet such as an pad™ manufactured by Apple Computer, Inc. Serves as the data entry and monitoring device for each specific patient at a time. The remote devices are dedicated to a certain location for the specific service of a client, also synonymously termed a patient throughout, at the location. In a specific embodiment, multiple patient clients are served using the same remote device at that location. In a home healthcare setting, the device is locked and thereby devoted to a single patient and a single care plan. The configuration of the remote device and applications available on the remote device are restricted, and may only be changed by an administrator. The administrator may remotely clear or wipe data from the remote device, as well as load or restrict apes. Locating features on the remote device such as global positioning satellite (GPS) or an Internet protocol (TIP) address allow for the identification of a client location as the device is intended to be retaining at the patient locale. The use of remote devices in embodiments of the invention allow for paper less record keeping and client interaction, while simplifying documentation of shift activity. The use of remote devices further provides in certain embodiments for improved communication, data security, timesheets and payroll processes. Users must login to view data on the remote devices, and data sent and received by the remote devices is encrypted. Care plan adjustments are enabled by the present invention in a way that have not previously been available. 
     Referring now to the figures,  FIG. 1  is a flow diagram of the high level process  10  of using the inventive management and performance platform for home health care. Health care personnel (clinical staff) in the central office of a home health care agency devise a care plan for a client/patient at step  12 . The care plan with specific tasks is sent to a portable computing device at a client location for field staff (caregiver) execution of the care plan at step  14 . The clinical staff reviews the work of field staff personnel during or after the shift in step  16 , and manages any critical issues that may have arisen during the shift at step  18  on an ongoing basis which may also be in real-time. In some embodiments, task activity and timesheets/billing hours are automatically reported to the accounting department for the generation of verified timesheets on a daily or weekly basis at step  20 , as well as for client billing and insurance claims at step  22 . 
       FIG. 2  is a flow diagram of the execution of a care plan  30  at a remote client/patient location. The caregiver signs on at step  32  to their portable computing device and a time stamp is automatically generated (icon  46 ) to mark the beginning of their shift. The device is synced (icon  48 ) upon login. During the syncing process the remote device will exchange information with the server to gather any changes made by the clinical or office staff that may impact the caregiver&#39;s shift, and to provide proper care to the patient. During sign on, the application checks to see if the caregiver has an open timesheets. If there is an open timesheets, the caregiver will be notified to use that timesheets. In some inventive embodiments, when tasks are performed notifications are communicated but do not otherwise receive the completed task details until completion of the shift. If other users have open timesheets for the client, in some inventive embodiments, these timesheets will be automatically closed so that the caregiver can continue to sign in. If the caregiver does not have an open timesheets, one will be created. Upon sign on, the caregiver is automatically taken through several screens and asked to confirm that they have reviewed the information at step  34 . These screens include a patient care plan, the previous shift for the patient (what tasks were performed and patient condition during the previous shift), and any notes about the patient. By way of example, a 48 hour log is maintained on the device for caregiver reference. A task will be created or each review step indicating that the caregiver has reviewed the steps during their shift. During the shift the caregiver updates the status of the assigned tasks at step  36 . The supply inventory may be updated at step  38  for ordering additional supplies to replace what has been used, as well as in some inventive embodiments for generating billing or order sheets for used consumable supplies. The caregiver in some specific embodiments, inputs information about the patient status (assessment, vitals, statistics, or a combination thereof) into their device for reporting and record keeping at the home office at step  40 . Any incidents, such as an injury to either the patient or caregiver, which may occur during the shift are documented at step  42 . At the completion of the shift the caregiver signs out at step  44 , and a time stamp is automatically generated (icon  46 ) to mark the end of their shift. The information on the device is also automatically synced (icon  48 ) with the home office using conventional software. 
       FIG. 3  is a flow diagram  50  for performing task updates at the client location in accordance with embodiments of the invention. Prompt  52  is based on alerts from the home office, and tasks moving from “upcoming” to “due now” and then to “overdue”, as will be discussed in greater detail with respect to  FIGS. 5A, 5B, 5C, and 5D . In a specific embodiment, the prompts may be color coded. Complete task  54  represents the providing of care, performing assessments and taking vitals of the patient. The step of updating status  56  involves the caregiver to mark the status of a task as complete, attempted, or deferred. The step of save and update time  58  involves the caregivers portable computing device storing the completed task, capturing the timestamp, client name, or a combination thereof, and sending the information back to the home office server at shift end. 
       FIGS. 4A-4E  are a series of inter related flow diagrams of the processes for carrying out specific embodiments of the present invention.  FIG. 4A  shows a process overview of the separate internal processes involved for support of embodiments of the management and performance platform for home health care.  FIG. 4B  illustrates the process flow for case development for a client/patient.  FIG. 4C  illustrates the process flow for execution of a client/patient case.  FIG. 4D  illustrates aspects of the payroll process.  FIG. 4E  illustrates aspects of the billing process.  FIGS. 4F, 4G, and 4H  show a table outlining critical processes and activities for carrying out embodiments of the invention. 
       FIGS. 5A, 5B, 5C, 5D, 5E, 5F, 5G, 5H, 5I, 5J, 5K, 5L, 5M, 5N, 5O, 5P, 5Q, 5R, 5S, 5T, 5U ,  5 V,  5 W,  5 X, and  5 Y are a series of screen shots of the graphical user interface (GUI) of the management and performance platform for home health caregivers on a remote portable computing device according to an embodiment of the invention. The example shown is based on an AP designed for use on the pad™ manufactured by Apple Computer, Inc., however it should be noted that other portable computing devices and tablets may be used to implement embodiments of the invention. 
       FIGS. 5A, 5B, 5C, and 5D  show the dashboard  60 , which is the home or main screen of the inventive AP. The dashboard  60  has a title bar  68  which has the name of the client that is being treated as well as the current time and date of the shift. The dashboard  60  is organized into tabs. The caregiver taps on a tab to go to that section. One additional tab contemplated is to send an email to the client care coordinator (CC) that is synonymously referred to as a client service Manager (CSM) Some tabs are further organized into sub tabs or have multiple slides. An additional embodiment of the dashboard  60 ′ is organized into separate section that are chosen through the tabs shown in  FIG. 5B . In the specific embodiments shown the tabs include:
         Tasks ( 64 )—Shows tasks that are due or completed during the caregiver shift.   PRN Tasks ( 65 )—Shows (pro re nata—when necessary) tasks (excluding meds) that may be completed as needed tasks, and may also add unplanned tasks in this section.   Activities ( 66 )—Use this tab to add unplanned tasks. It is appreciated that in some embodiments of the present invention, this tab is integrated into the Tasks tab.   My Timesheets ( 67 )—Review timesheets for a specific client on the tablet, and user may update signatures for previous shifts.   Send Email ( 69 )—Send a non-critical email to the CSM/CC or Clinical Lead. Email is one way—office staff cannot send return emails to the tablet.   Docs ( 70 )—Use this tab to view relevant documents during a caregiver shift. The Docs tab  70  is organized into three sub-tabs.
           View  485 —View the Care Plan for the client as shown in  FIG. 5G  and  FIG. 5H . The user may be presented with an image of the  485 . Tap on that image and the user will be presented with an option to “View”  122 . Select that option to open a full screen view of the 485 Plan PDF. You can use your finger to swipe up and down through different pages.   Assessments/HAH Summaries ( 124 )—View previously completed assessments or HAH Summaries.   Schedule Summaries ( 126 )—View previously completed shift task summaries.   
           Sign Out ( 71 )—Initiates the sign out process.   Medications ( 72 )—is the report that serves as a legal record of the drugs administered to a patient at a facility by a health care professional and is analog to the tasks tab but specifically for medications. Medications shown here are scheduled at the specified times in the task tab if the user is a nurse, or simply displayed here if the user is an HAH. Medications is a part of a patient&#39;s permanent record on their medical chart. The health care professional signs off on the record at the time that the drug or device is administered. Medications  72  includes the list of medications that the client takes and their schedules Skilled Nursing Staff can also use the Medications  72  tab to indicate that a PRN (pro re nata—when necessary) medicine has been given.   Assessments ( 74 )—This tab is organized into sub-tabs based on the assessment section. Some tabs are restricted. HHAs may view and update the Vitals, Intake/Output, Pain and Narrative sections.   Supplies ( 76 )—This tab displays the inventory list for the client. Use the supplies tab  76  to update quantities on hand, or to see if an item is on order.   Incidents ( 78 )—Use this tab to record an incident.   Contacts ( 82 )—Use this tab to look up important client contacts.   Previous ( 86 )—This tab displays information related to the previous shift completed by the caregiver or another employee. It is appreciated that in some embodiments of the present invention, this tab is integrated into the Tasks tab via a filter to allow display of completed tasks for the past 48 hours.   Notes ( 90 )—Notes added by the Clinical Staff, CC, or CSM will be included here Or synonymously referred to herein as case notes.       

     Continuing with the dashboard  60 , the clock icon  62  leads to list of prior timesheets limited to the only patient. The run sync icon  80  initiates the syncing process, and the info icon  88  is used to access on line help. The run sync icon is optionally used for caregiver initiated synching and for system troubleshooting. The sign out icon  84  initiates the closing of a session or shift. During sign out several actions are carried out by the AP software automatically including: 
     Check for Incomplete Tasks—All tasks scheduled for the caregiver&#39;s shift must either be marked Completed or Deferred. The sign out procedures will not be able to continue if there are incomplete tasks remaining. 
     Check for Open Assessments/HAH Summaries—If the caregiver has an “In Process” assessment, the sign out process will not be able to continue. Complete the assessment as needed, then mark it complete. It is appreciated that in some embodiments of the present invention, this will close automatically. 
     Timesheets Confirmation—If all tasks and assessments are completed, the caregiver will be presented with the Timesheets Confirmation screen (see  FIGS. 5R and 5S ). The caregiver will then complete goals and sign. The caregiver must also review the shift activity with the client and have them sign. If the client is unable to sign, you may indicate that as well. 
     Close Timesheets—In the background, the timesheets will be closed automatically. 
     Sync—The application will exchange information with the server automatically to send back any changes made during your shift. This includes the timesheets. 
     The task tab  64  is selected in  FIGS. 5A, 5B, 5C, 5D, and 5E , and the tasks that are to be completed during a shift are presented in 1 of 5 categories: Overdue  92 , Due Now  94 , Active PRN (As needed)  96 , Upcoming  98 , and completed today  100 , attempted, and deferred. Selection of buttons  102  is used to update the status of a task to completed, attempted, and deferred. Attempted—the caregiver tried to complete the task but for some reason were unable to do so. The user selects a reason from the drop down menu in pop up overlay screen  110  ( FIG. 5D ). If the attempted option is selected, a record will be maintained of the attempt, but the task will continue to appear in the dashboard so that the task can be attempted again later. When a task is selected as completed, the task is moved to the completed section  100  of the dashboard. The selection of the deferred option means that the caregiver was unable to complete the task during their shift. This may occur after several attempts, or it may not be achievable during the caregiver&#39;s shift for other reasons. A reason for choosing the deferred option is found from the drop down menu in pop up overlay screen  110 . If the deferred option is selected, the task will be moved to the completed section of the dashboard. 
     Tasks are typically created with a start and finish time. The dashboard  60  is organized into several task categories based on the task start and finish times. It is noted that if a task is marked “Priority”, the marked task will move to the top of the list and appear in red text. These priority marked tasks should always be considered first. 
     Tasks are categorized as follows:
         Overdue ( 92 )—If the current time is past the task planned finish time, the task will appear in this list. These tasks should be addressed immediately. The caregiver will receive periodic alerts if there are overdue tasks.   Due Now ( 94 )—If the current time is between the task planned start and finish times, the task will appear in this list. The task should be completed first, unless there are overdue tasks. Periodic alerts are issued if there are tasks due.   Active ( 96 )—If a task does not have a set time and can be completed as required (e.g., PRN), the task will appear in this list.   Upcoming ( 98 )—If the current time is before the task planned start time, the task will appear in this list.   Completed Today ( 100 )—Completed, Deferred and task Attempts will appear in this list so that may be referenced during a shift. It is appreciated that in some embodiments of the present invention, these tasks are combined into a single list.       

     These lists are organized into two screens. The caregiver navigates between the screens by swiping left or right with two fingers for the pad™, and may also press on the two dots at the bottom of the screen to switch between screens. It is appreciated that in some embodiments of these lists are integrated into a single screen. 
     As shown in  FIG. 51  for screen shot  60 B the activity tab  66  allows the caregiver to add a task that is not captured in the daily shift schedule, with a written description in comment/reason field  128 . Tapping the “[+] Add” button  129  and selecting a standard task from the available list. A free form task (e.g., a task not in the standard list) by selecting “Other” from the list and entering the new task name. “Other” may be found at the bottom of the task list. 
     As shown in  FIG. 5N and 50  incidents may be reported from dashboard display  60 E or  60 E′ with the selection of incident tab  150  and the following pull down menus:
         Incident Date ( 151 )—Tap on the field to open a calendar pop up.   Time ( 153 )—Tap on the field to enter a time.   Category ( 154 )—Choose one of the four categories presented (Fall, Injury, Medication Error, Other). This selection will be used to populate the options for Sub Category.   Sub Category ( 156 )—Choose a sub category. The options available in the drop down menu will depend on the choice made for Category.   Description ( 158 )—Add a brief summary of the incident.   Reported—Note if the incident has already been reported to the office.       

     Additional details may be added by tapping on the “+” icon  152 , which open a pop up screen  159  as shown in  FIG. 5P  and  FIG. 5Q , where the caregiver can enter more information. Tap the “+” icon  152  again to close the pop up. In operation, in particular inventive embodiments, when a minimum of information is recorded an email is automatically sent to the office staff without waiting for a sync event. 
     As shown in  FIG. 5K  and  FIG. 5L  the amount of supplies may be updated with selection of the supplies tab  140  and click on the quantity  142  for the item that needs updating. Supplies listed are specific to the client. If there is not enough of a particular supply, the Quantity Available will appear in red highlight ( 142 ). This happens when the Quantity Available is less than the Reorder Level. If the Units are mismatched, they will appear in yellow highlight. 
     The quantities on hand may be updated at any time by tapping on the “Update” button  143  to bring up overlay  60 D- 1  in  FIG. 5M  called “Inventory Check-In”  144  and entry in the new quantity  146  or update the units  148 . Tap the “OK” button  149  to finish. The program will automatically capture a task to reflect that the caregiver has updated the inventory list. 
     The timesheets review screen  60 H as shown in  FIG. 5U  may be accessed by selecting the clock icon  62 . The timesheets review screen  60 H allows the caregiver to review their past timesheets. In order to review the shift summary, the caregiver taps on the “Rpt” button  192  on the timesheets row. If the “Sign” button  190  appears in red text (or other colored text) that means that one or both signatures is absent. Tap the red sign button  190  to add missing signatures.in overlay  194  shown in  FIG. 5W . If the “Draft” checkbox  191  is checked, this means that the care management organization closed the user timesheets for a previous shift. The user should review with the office to confirm their shift times. The user can uncheck the checkbox. 
     During the sign out process, the caregiver is presented with the Timesheets Confirmation screen  60 G- 1  and  60 G- 2  of  FIG. 5R  and  FIG. 5S , respectively. To sign, tap the “Caregiver Signature” box  174 . A signature screen will appear. Sign with your finger and click “Accept” to confirm, or “Clear” to try again. This is readily accomplished with conventional software. The client signs using the same method in box  176 . If the client is unavailable to sign, check the option at the bottom of the screen labeled “Client Unable to Sign”  178 . Clicking the shift goals button  170  brings up overlay  180  in  FIG. 5U , which has a series of Yes and No question about the care of the client. 
       FIG. 5J  shows the assessment screen  60 C with the assessment tab  74  selected. Condition tabs  130  categorize patient conditions, such as pain  132  which is selected in the example.  FIG. 5R  is a contact list with the contacts tab  160  selected. 
       FIG. 5X  is a download screen  601  with link  200 , and  FIG. 5Y  shows that the download has occurred, and selecting the download icon  202  completes the loading of the software. This is readily accomplished with conventional software. 
     Embodiments of the inventive home health care management and performance platform have a GUI designed for use on personal computers (PC) in the home health care office for adding new clients and corresponding care plans and tasks that are assigned to caregivers in the field. In addition information collected by the caregivers at remote locations on their portable computing devices is received by the PC based program. The PC program organizes the gathered information and generates reports for medical and financial purposes. The PC&#39;s are connected to a server for storing the collected information in a database. Whereas field staff open a dashboard, office staff open a case list. As used herein, a PC is defined to include a desktop, a laptop, a tablet, or a smart phone, regardless of whether operating WINDOWS®, Linux, or MAC OS®. 
       FIGS. 6A, 6B, 6C, 6D, 6E, 6F, 6G, 6H, 61, 6J, 6K, 6L, 6M, 6N, 6O, 6P, 6Q, 6R, and 6S  are screen shots of a graphical user interface of the management and performance platform for home health caregivers on a personnel computer for use in the health care agency office in accordance to an embodiment of the invention.  FIG. 6A  is a screenshot of a login screen and start page. This is readily accomplished with conventional software, such as FileMaker Pro®.  FIG. 6B  is a case list view of home care clients. The add new case icon  210  is used to add new cases to the case list view, where the selection of the icon  210  adds a blank row to the case list for the entry of details related to the new patient/client. The find me icon  212  may be used to filter the cases to just those assigned to a specific user who is logged on to their account. Closed cases may be hidden from view in the list by checking the status box  214 .  FIGS. 6C  and  FIG. 6D  is a client management page showing the addition of multiple cases to a client, or the assignment of multiple case workers to a client. It is noted that that a dedicated tablet such as an pad™ is not only limited to viewing a specific client case, but may only be used by one caregiver at a time. In a specific embodiment, if there are multiple caregivers in the home at different times, they may share the tablet if the caregivers are either all HHAs or all nurses. HHAs must always use the tablet assigned to HHAs and nurses must use the tablet assigned to nurses. If there are multiple people in the home at the same time, then each person must use different tablets assigned to each of them. 
       FIG. 6D  shows a pop up overlay for adding a task selected via tab  216  on the manage cases page. In some inventive embodiments, users can add a single Standard Task (previously defined by office staff) or a Group of Standard Tasks (previously organized into a group by office staff, where  FIG. 6E  is a task detail screen. In a specific embodiment if a task is missing key information, the task may appear in a highlighted color, for example red.  FIGS. 6F and 6G  are pages related to task incidents (tab  218 ) on the manage cases page. Incidents are logged on the tablet. When the tablet user syncs, the data will be available to office staff. However, in order to avoid time lags for critical events, in a specific embodiment, limited incident details may be emailed to the office staff, once a minimum of details has been entered by the caregiver. This includes date and time, incident category, and description. Once an incident has been synchronized, office staff may review additional incident details and enter their own investigation comments. The use may click on the “+” button  219  on the incident row to view the details pop up as shown in  FIG. 6G . Incidents may be closed once they have been addressed. Closed incidents will no longer be displayed on the tablet. 
       FIG. 6H  is a document review page selected via review docs tab  220  on the manage cases page. As field staff complete shifts, the details will be available on the review docs tab  220  for clinical staff review. The review docs tab  220  includes two lists:
         Assessments (Nursing Flow Sheets) and HAH Summaries   Schedule Summaries
 
To review either of the lists, the user simply clicks on the “View” button  221  on the item row. If there is no button, then no details are available to review. Once the user has reviewed the item, the user checks the review button  223  to indicate they have reviewed the item. This action will capture the user name and timestamp the record. A PDF report will then be generated and saved to the server.
       

       FIG. 6I  is a screen shot for managing medications for a patient/client selected via tab  222  on the manage cases page. Medicines function similarly to tasks, where medicines may be added or deleted and the medicines generate schedule events on the tablets for administration. However, in specific embodiments there may be the following differences:
         1. Medicines are viewable on the tablets for only some roles.   2. Schedule events will not be generated for home health aides (HAH) on the tablets.   3. Medicine names are entered using the following format “Drug/Strength/Dose/Route/Frequency”   4. Frequency periods available for medicines are more limited.   5. Daily medicines have an option to be given at specified times (multiple per day)   6. PRN medicines do not appear on the PRN Task on the tablet dashboard. Instead, PRN medicines appear on the Medications tab on the user tablet.       

     As shown in  FIG. 6J , the view  485  tab  224  may be used to upload a  485  PDF file to the case. To do so, click on the “View  485 ” tab  224  and click the upload icon  226 . Browse to a specific file and select the file to upload as shown in  FIG. 6K . The file should be viewable in place. Supplies are added on the supplies tab  226  on the manage cases page of  FIG. 6L . In an embodiment, a user enters in a description and a reorder level. The reorder level will be compared to the quantity on hand. If the quantity is less than the reorder level, the item will be marked as “Yes” in the “Reorder Needed” column and these items will also appear on the supply reorder report. 
       FIG. 6M  is a shift activity summary.  FIG. 6N  is a screen for the manage timesheets menu option  228  in the admin menu  230 .  FIG. 6O  is a manage timesheets page. The timesheets list may be sorted by ID, user ID (employee name), or client name. The user may locate the timesheets record they wish to revise and modify the editable fields. It is noted that changes should be documented in a comments field. By clicking the “More” button  232  to access the comments field. Items marked “Draft”  234  need to be confirmed. These are timesheets that have been forced closed and the end date/time may not be correct. The user should uncheck the draft checkbox  234  once the times have been updated. 
       FIG. 6P  is a report menu. Reports are accessible from the scripts menu. In addition, some reports are available in specific tabs, as relevant. Non-limiting examples of reports include: Timesheets Confirmation Report—This report is intended for billing and payroll departments but it may be run by any user with access.
     Billing Packages—This report is intended for billing and payroll. The billing packages report may be run for a specified time period (e.g., a week, consistent with the billing cycle). The report will cycle through all active cases (those marked pending or closed are excluded) and generate separate billing package PDFs for each case on the server. It is noted that billing and payroll should process all files on the server before rerunning the report. The screen shot shown in  FIG. 6Q  is a listing of billing packages available on a service providers computer server.   Supply Reorder Report—Lists all items requiring reorder across all cases.   MAR Report—Organized by client case. Lists all medication activity for a case.   In addition, there are three reports for use in managing admin functions such as task groups and lists.
 
These include:
   Task List Report—Listing of all standard tasks   Task Type Report—Listing of all Task Types and corresponding sub types   Incident Category Report—Listing of all Incident categories and corresponding sub categories.   

     In specific inventive embodiments reports may be saved to a file that may be saved to the database or saved to folder on the server. In general, since tablets don&#39;t have access to the server, the tablets will save files to the database. Reports generated on the desktop will be saved to the server. 
       FIG. 6R  provides a task history. The screen shot shown in  FIG. 6S  is a report directory. Additional administrative functions that are readily preformed illustratively include: Manage Users, Manage Categories, Manage Task Types, Manage Groups, or a combination thereof. 
       FIG. 7  is a schematic diagram illustrating an overall view of communication devices, computing devices, and mediums for implementing a system and method for the management and performance platform for home health caregivers. 
     The system  300  includes multimedia devices  302  and desktop computer devices  304  configured with display capabilities  314  and processors for executing instructions and commands. It is appreciated that a PC can constitute a system  300 . The multimedia devices  302  are optionally mobile communication and entertainment devices, such as cellular phones, tablets, and mobile computing devices that in certain embodiments are wireless sly connected to a network  308 . The multimedia devices  302  typically have video displays  318  and audio outputs  316 . The multimedia devices  302  and desktop computer devices  304  are optionally configured with internal storage, software, and a graphical user interface (GUI) for carrying out elements of the home health care platform according to embodiments of the invention. The network  308  is optionally any type of known network including a fixed wire line network, cable and fiber optics, over the air broadcasts, satellite  320 , local area network (LAN), wide area network (WAN), global network (e.g., Internet), intra net, etc. With data/Internet capabilities as represented by server  306 . Communication aspects of the network are represented by cellular base station  310  and antenna  312 . In a preferred embodiment, the network  308  is a LAN and each remote device  302  and desktop device  304  executes a user interface application (e.g., Web browser) to contact the server system  306  through the network  308 . Alternatively, the remote devices  302  and  304  may be implemented using a device programmed primarily for accessing network  308  such as a remote client. 
     The software for the diagnostic platform, of embodiments of the invention, may be resident on tablets,  302  desktop or laptop computers  304 , or stored within the server  306  or cellular base station  310  for download to an end user. Server  306  may implement a cloud-based service for implementing embodiments of the platform with a multi-tenant database for storage of separate client data for each independent home health care agency carried out on the platform. 
     The foregoing description is illustrative of particular embodiments of the invention, but is not meant to be a limitation upon the practice thereof. The following claims, including all equivalents thereof, are intended to define the scope of the invention