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Housecall Providers Improves Patient Care by Cutting Documentation Time in Half and Boosting Accuracy by as much as 60% with Brightree

Housecall Providers Improves Patient Care by Cutting Documentation Time in Half and Boosting Accuracy by as much as 60% with Brightree

Case Study Snapshot


  • Previous laptop-based EHR was expensive to purchase, maintain and license, limiting usage across the hospice staff
  • Bulky laptop and clunky, slow documentation system created an unfriendly wall between the caregiver and patient, and in many instances forced the clinician to document the visit later during their own free time at home
  • Previous system required connectivity at the point-of-care, and when not available it forced offsite documentation and inherent inaccuracies



  • Improved patient care and satisfaction by eliminating the technology barrier between the caregiver and patient
  • 50-60 percent improvement in visit documentation accuracy
  • Boosted on-call staff preparedness with real-time access to agency patient database from anywhere
  • Improved overall clinician satisfaction and workflow, resulting in better clinician morale
  • Dramatically reduced solution training time from weeks to hours
  • 70 percent cost savings on hardware devices
  • Eliminated software maintenance and licensing costs, allowing 100 percent of staff to be equipped with Brightree’s point-of-care solution on the iPad

Rebecca Ashling and her staff of 35 hospice nurses, social workers, chaplains, aides and volunteers provide specialized care to about 75 patients a day throughout the city and suburbs of Portland, Oregon. They are part of the highly regarded non-profit home care practice of Housecall Providers, an experienced team of 91 physicians, nurse practitioners, physician assistants and other medical professionals serving more than 1800 in-home patients a year with everything from proactive primary healthcare to end-of-life counseling and care.

“Our hospice team is on the cusp of life and death every day in the homes of our patients,” explains Ashling, MSN, RN, and hospice program director for Housecall Providers. “You have to be a good detective in order to be a great clinician and home-based care provider,” she notes. “Does the patient have a good support system, is a family member or friend helping them shop for essentials, and is the bedroom in a quiet location? These are just a few of the clues that we constantly document along with the patient’s vital signs, overall condition and mood.”

Hospice patients are often scared, depressed, and easily agitated. The clinicians with the right technology tools and solutions at their fingertips are often the most poised to provide the best patient care.


The advancement in medical documentation wasn’t without its drawbacks and barriers to success. For starters, the portable computers simply weren’t portable enough.

“Our previous documentation solution in many ways did more harm than good when it comes to patient care,” Ashling says. “The laptops were bulky and the documentation systems that ran on them were clunky and slow to navigate. Our clinicians would open up their laptops with their big screens and keyboards and often times the interaction with their patients was negatively impacted,” she recalls. “It was like a wall had been put up between the care giver and patient, making it a real challenge to document at the point-of-care.”

The laptop-based documentation system required a good Internet connection to operate as well. Wi-Fi is not always available when clinicians need it to document in-home patient visits or when they’re on call or covering for another clinician and need emergency access to a patient’s medical records.

“Clinicians and patients can get very frustrated when the very technology that’s designed to improve documentation and streamline operations routinely gets in the way of effective patient care,” Ashling says.

Faced with detracting from their patient’s overall well-being, many Housecall clinicians opted to document their patient visits after hours, late into the evenings at their own homes. Understandably, that often led to overworked and tired staff, lost personal time, documentation accuracy and morale concerns, and a team reluctant to use the laptop documentation system at all.

On top of all that, the laptops and the documentation system installation, maintenance and per-user licensing fees combined put a major strain on the non-profit healthcare provider’s operations budget.


Driven by the pursuit of optimal patient care, Housecall Providers and its Board of Directors were in search of a new level of clinician and patient friendly point-of-care documentation capabilities. Their new documentation solution had to work seamlessly in real-time throughout the day in the life of a Housecall Providers clinician. It had to subtly blend in naturally with the patient visit and even enhance patient care. Lightning-fast navigation in a device that features a far smaller footprint and price tag and requires no Internet access were absolute musts.

“We set the bar extremely high when we set out to find the best EHR documentation solution for Housecall Providers, and Brightree® Hospice software was clearly the breakthrough we needed to help empower our hospice team and elevate our overall patient care,” Ashling says. “Because Brightree Hospice is an application-based point-of-care solution versus browser-based, we can run it on far less expensive iPads®. In fact, we’ve reduced our hardware costs by 70-percent with Brightree, which allows us to equip our entire hospice staff with Brightree on iPads.”

Housecall Providers points to the intuitive design at the core of the Brightree Hospice software solution as perhaps the biggest breakthrough of all.

“Brightree Hospice makes it so easy and natural for our clinicians to move seamlessly and effectively through the documentation process,” Ashling says, noting that Brightree has opened the door to enormous benefits. “Our clinicians have come to trust and rely on the nimbleness and flexibility of the Brightree app and their newfound ability to effectively and subtly integrate charting into patient visits in real time at the point-of-care. That changes everything for the better, for our patients and clinicians and our bottom line.”


Improved patient care tops the list of benefits that Rebecca Ashling and her hospice team at Housecall Providers attribute directly to the Brightree Hospice software solution.

“We are now able to provide the best possible calming patient care and document the visit with an innovative solution and device that enables our clinicians to complete the vast majority of our documentation at the point of care. The more we can document in-home care observations real-time, the more accurate those charts will be,” Ashling reports.

She estimates that the speed and reliability of Brightree on the iPad has led to a 50 to 60 percent improvement in documentation accuracy across her team.

“Not only did the walls come down with patients when we moved to Brightree, our clinicians’ resistance to what had been a laborious and slow documentation effort has been replaced with trust and confidence in the Brightree platform,” Ashling says.

Ashling cites the ability to quickly move from documentation to built-in iPad apps like Skype calling and iTunes music and videos as an important part of the agency’s approach to personal touch hospice care.

And not only have technology and hardware costs been cut by 70-percent, the easy-to-use Brightree solution has nearly eliminated the need for training.

“Our old system used to take clinicians as much as eight weeks to learn. That’s valuable time taken away from patient care,” says Ashling. “Most of our clinicians can train on Brightree for a few hours and they’re ready to go. In fact, one of our care professionals had never used an iPad before and was documenting a patient visit less than a day later.”

The intuitive nature of Brightree Hospice software makes it easy to learn and easy to integrate into an in-home care setting.

“It now takes far less time to successfully document a patient visit and those visits are far more engaging and revealing with Brightree at our fingertips,” Ashling says, noting that the entire team is now equipped with the cost-effective Brightree solution on the iPad.

Even in emergency situations, when a patient’s trusted clinician is not available, an on-call care giver can instantly tap into the Brightree system and fill in without missing a beat. They simply sync up with the agency’s database and gain immediate authorized access to the affected patient’s medical care documentation for a complete healthcare picture before arriving at the hospice patient’s home.

“All of a sudden an on-call clinician is faced with caring for a patient they’ve never met and in a matter of minutes get all the documentation they need before they hit the patient’s door,” Ashling explains. “That’s a huge advantage in what could be a life and death scenario. That’s the level of responsive, compassionate care that sets us apart at Housecall Providers, in large part thanks to our alliance with Brightree,” she says. “It’s exciting to be able to provide cutting-edge patient care with a personal touch.”

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