Year of the Caregiver

by Kristin Rowan | Dec 19, 2024 | Admin, Caring for the Caregiver, Clinical, Editorial

by Kristin Rowan, Editor

Year of the Caregiver

Medical and non-medical caregivers in home health, hospice, palliative, and home care are the life-blood of the industry, without whom Care at Home would not exist.

Agency owners are limited in their capacity to compensate caregivers, working with CMS reimbursement rates, PDGM, and VBPM. However, Agency owners also know that caregivers are selfless, caring, empathetic, and dedicated. They also spend hours upon hours on documentation, drive billions of miles per year (literally), and adapt to changing industry regulations regularly.

So, how do you, as an agency owner, executive, or manager, care for your caregivers in a meaningful way to express your appreciation for all that they do? How can you impact the high turnover rate? Pay raises are limited by CMS and insurance companies. Benefits are expensive for an already low-margin industry. Extended vacations limit the care you can provide your clients.

The Advantages of Employee Recognition

When your employees are engaged and feel appreciated, they are more loyal. Loyal employees are less likely to leave for another job, even if the pay rate is slightly higher. Employee recognition helps retain your best employees, increases their engagement, encourages best practices, and can be used as a recruitment tool when you need more staff.

A 2023 study highlights the importance of employee recognition. Employees who are likely to be recognized are more than twice as likely to go above and beyond their regular duties. Hearing a sincere “thank you” from the boss yields a 69% increase in extra effort. Personal recognition would encourage 37% of respondents to do better work more often.

Simple Start

Employee recognition programs don’t have to overhaul your organization, take a lot of time, or cost a lot of money. Start simple and see where it takes you.

Celebrate Major Achievements and Small Wins

It’s important to recognize major achievements like gaining a new licensure, getting a referral for a new client, a positive online review, or a great star rating. How long an employee is with the company is an easy milestone to celebrate. Accolades for 30, 60, & 90 days, one year, five years, 10 years go a long way.

Equally important is celebrating smaller victories like completing a training, submitting accurate documentation, picking up an open visit, and birthdays.

Peer-to-Peer Recognition

Giving your employees the opportunity to recognize and celebrate each other creates a culture of appreciation within your agency, even when your employees are rarely together. Picking up a shift, trading a day off, helping answer a question, or simply encouraging a new employee during training are things you might not see, but your employees will. Give them an outlet to celebrate each other.

Peer-to-peer recognition can be done with group text messages or an internal IM system like Slack or Microsoft Teams. For employees who are in the office, you can create a message board for notes, encouragement, and thanks. Create a monthly gift and let employees nominate someone for an act of kindness or helpfulness.

Organizational Change

Once you’ve established a Culture of Caring, ask your employees what they want and need. If recognition isn’t meaningful, it may not have the desired effect.

Scheduling

A study out of the Leonard Davis Institute of Health Economics, 30% of registered nurses and 25% of licensed practical nurses left their positions in a home care agency in the course of one year. Part of the reason for the high turnover rate is schedule volatility. Another study concluded that high schedule variability in just 30 days increased the risk of turnover by 20%.

No change will eliminate client cancellations or immediate starts-of-care under the acceptance-to-service policy. But, that doesn’t mean you can’t minimize the volatility of a schedule.

Automating the scheduling process using existing technology now allows home care agencies to offer open appointments in a “gig economy” style. Caregivers are notified by AI of a visit that needs to be covered, giving them the option to change their schedule. That autonomy reduces the feeling of stress caregivers have over schedule changes.

Stand-alone software options for automated scheduling and reduced schedule changes include Axle Health and Caring on Demand for home health and CareSmartz360 for non-medical supportive care. AI powered scheduling inside EMRs and agency management software include AlayaCare, HomeCare Homebase, CareVoyant, Axxess, Careswitch, and AxisCare, among others.

Documentation

Some sources suggest that home health workers spend up to three hours per shift at home finishing documentation. Visit times increase when employees are documenting on paper or on a device during the visit.

One of the latest innovations in care at home software is AI powered talk-to-text scribe tools. Mobile applications using artificial intelligence record visits and transcribe conversations. The documentation tool scans the transcript as well as all patient data from the EMR and creates the needed documentation. Once a visit is over, the AI tool can finish documentation sometimes within minutes, requiring just a quick review by the visiting caregiver before submitting for QA.

Talk-to-text scribe tools are both stand-alone voice capture and integrated documentation tools. Some of the best talk-to-text scribe tools we’ve found are Athelas Scribe, Ybot, Andy, and Nvoq. OASIS and documentation automation reduces the burden on caregivers even more, almost eliminating the additional time spent at home reviewing charts and documentation. Some of the best OASIS and documentation automated software we’ve reviewed are Andy, Enzo, and Brellium. The Rowan Report will have reviews of these products in 2025.

Communication and Connection

Care at home workers are a disparate group, rarely being in the same place at the same time, missing out on company culture, office parties, trading stories around the water cooler, and engaging with fellow employees, managers, and executives. Access to colleagues and management is an integral part of employee engagement and satisfaction.

Before you share the personal cell phone numbers of your entire agency, remember that all communication between employees, management, and clients should be secure and HIPAA compliant. Agencies have already seen the consequences both to their bottom line and with government agencies for failure to comply with secure messaging requirements.

Luckily, there are plenty of secure messaging platforms available for agencies to use. Employing messaging technology not only increases employee engagement, but also provides a level of security between caregivers and their patients and families. If you’ve now realized that you’ve been communicating on insecure platforms, check out Buzz, Qliqsoft, and Zingage.

Final Thoughts

Whether you start with a simple calendar to remind yourself which employees have been with you the longest, or invest in every AI tool available, the key here is to recognize that your caregivers are giving their all every day for their primary purpose of excellent patient-centered care.

No matter how you decide to do it, make 2025 the Year of the Caregiver and show your appreciation for all that they do for you. We couldn’t do what we do without them.

# # #

Kristin Rowan has been working at Healthcare at Home: The Rowan Report since 2008. She has a master’s degree in business administration and marketing and runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in event planning, sales, and marketing strategy. She has recently taken on the role of Editor of The Rowan Report and will add her voice to current Home Care topics as well as marketing tips for home care agencies. Connect with Kristin directly kristin@girardmarketinggroup.com or www.girardmarketinggroup.com

©2024 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in Healthcare at Home: The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com

Vendor Watch: VitalCaring Cognitive Care Pilot

by Rowan Report | Oct 18, 2024 | Partner News, Vendor Watch

FOR IMMEDIATE RELEASE

Contacts: Nancy Lecroy
VP, Marketing & Communications
VitalCaring
O 469.839.3777
Nancy.lecroy@vitalcaring.com

Kelly Faville
FourSeventeen Communications
On behalf of Constant Therapy Health
M 978-621-6667
kelly@constanttherapy.com

VitalCaring’s AI-driven Cognitive Care Pilot Shows Promising Results

National leader in home health and hospice care to extend AI-enabled speech, language, and cognitive therapy initiative across its network

DALLAS and LEXINGTON, Mass., September 12, 2024 – VitalCaring, a leading national home health and hospice care provider, has unveiled the results of a seven-month AI-driven cognitive care pilot program that delivered enhanced personalized therapy to patients living with cognitive disorders. Through the pilot, VitalCaring deployed Constant Therapy’s digital speech, language, and cognitive therapy platform as part of its home-based services for select patients.

Significant Cognitive Gains

Patients in the program showed statistically significant cognitive improvements, including:

• A 35% increase in Montreal Cognitive Assessment (MoCA)* (average score)
• A 33% increase in Saint Louis University Mental Status (SLUMS)*(average score)
• Improvement by at least one cognitive level (55% of patients)
• Achievement of normal cognitive functional score by discharge (35% of patients)

“This pilot program was tailored to fast-track our patients’ journey to regaining independence safely in their homes. Adding innovative tools like the Constant Therapy platform to our existing care plans for cognitive issues and neurological disorders extends the exceptional work of our therapists.”

Janice Riggins

Chief Clinical Officer, VitalCaring

A valuable complement to clinician-supervised therapy

Patients’ ability to independently access Constant Therapy’s therapeutic exercises at home has proven to be a valuable and meaningful complement to clinician-supervised therapy. The aim of the VitalCaring Cognitive Care pilot program was to determine how additional therapy tools could accelerate recovery and maximize cognitive functioning for VitalCaring patients with dementia-related diseases or those recovering from stroke or other brain injuries. On average, each patient in the pilot program was able to access an additional 11 hours of digital therapy on their own. Due to the success of this pilot, VitalCaring will explore opportunities to extend the initiative across its network.

“VitalCaring stands at the forefront of home healthcare innovation, transforming patient experiences and outcomes with advanced technological and analytical approaches,” said Veera Anantha, Founder and CEO of Constant Therapy Health. Our platform supports their practice of providing outstanding, individualized treatment to patients affected by neurological conditions or brain injuries.”

What Caregivers and Family are Saying

“Thanks to the AI therapy, my uncle regained his motor skills. He can now operate mobile phones and stay connected with loved ones.” The patient’s MoCA score improved from 14 to 26 – moderate cognitive impairment to normal cognitive ability.
“My mother’s ability to hold conversations with friends and family improved significantly after using the AI-driven tools.” The patient’s MoCA score rose from 16 to 27 – moderate cognitive impairment to normal cognitive ability.
“Our family noticed remarkable cognitive improvements in my grandfather. He’s better at following events and recalling important information.” The patient’s MoCA score jumped from 17 to 25 – moderate to mild cognitive impairment.

# # #

About the VitalCaring Cognitive Care Pilot Program

The pilot program ran from October 2023 through May 2024 and included 52 patients aged 54 to 92, with an average age of 77.45. Patients had various primary diagnoses, including cerebral infarction, brain tumors, dementia (including Alzheimer’s disease), Parkinson’s disease, encephalitis, encephalopathy, and mild cognitive impairment (MCI). Patients’ performance was measured by: the Montreal Cognitive Assessment/MoCA and the Saint Louis University Mental Status/SLUMS cognitive screening.

About Contant Therapy Health

Constant Therapy Health is a next-generation digital health company whose technology is clinically proven to improve the efficacy of cognitive, speech, and language therapy, as well as increase access to and reduce the cost of therapy. Constant Therapy, an award-winning mobile program, uses patented AI technology to deliver personalized exercises that rebuild cognitive and speech function for individuals recovering from stroke or traumatic brain injury (TBI) or living with aphasia, dementia, and other neurological conditions. Built by a team of top neuroscientists at Boston University, Constant Therapy is used by tens of thousands of patients as prescribed by their clinicians, helping to create the world’s largest brain rehabilitation database, and providing insights that can improve the effectiveness and efficiency of brain rehabilitation.

About VitalCaring

VitalCaring delivers compassionate, high-quality home-based healthcare to patients in the comfort of their own homes. By bringing together like-minded people who are called to care and supported by a positive organizational culture, VitalCaring is positioned to deliver an exceptional patient experience at every encounter. VitalCaring is a national leader in the home health and hospice industry, serving patients throughout the Southern United States, including Texas, Oklahoma, Louisiana, Mississippi, Alabama, and Florida. From its base in the South, VitalCaring is expanding to serve even more communities nationwide.

This press release was originally published by VitalCaring and is reprinted with permission. For more information or to request permission to reprint, please reach out to the media contacts listed above.

Product Review: AI Comes to Data Analytics

by Kristin Rowan | Aug 16, 2024 | Product Review

by Kristin Rowan, Editor

Artificial Intelligence has existed in basic forms for many years and has recently advanced to include augmented intelligence and generative intelligence. The Rowan Report has provided several examples of quality AI usage and even more examples of AI applications that are fraudulent, improperly applied, and/or poorly executed. As we continue our journey of AI discovery, we are seeing more companies researching how to effectively use AI to enhance existing software solutions as well as new solutions entirely based on AI. We’ve reviewed AI software for point of referral, talk to text documentation, employee recruitment and retention, and now data analytics.

The Rowan Report recently met the founder of a data analytics AI software solution, Skyra.ai. “Our goal is to advance the industry to be technology forward,” said Skyra founder Mickel Mirchandani, “we imagined a future were technology empowers home care agencies to focus on what matters – serving patients.”

Data Analytics: From What to Why

Care at Home agencies have no shortage of access to reports through various tech solutions. Hours worked and earnings from payroll reporting, average length of visit and number of patients per week from EMR and EVV reports, average daily census, employee turnover rate, and the list goes on. These reports are useful in telling us what is happening within our agency, with our staff, and with our partners. Once you have this information, what do you do with it? Does it tell you why your top clinician saw five fewer clients last week? Does it explain the decrease in referrals from area hospitals and physicians? Can the reports tell you whether the recent trends will continue? Why are these things happening in your agency? And what’s more, how do I fix them?

Give Your Home Health Agency a Much-Needed Tune-Up

Like the warning light on your dashboard, data is meaningless until it is diagnosed. That warning light that tells you your referral numbers dropped last week might indicate new competition in your area, a drop in confidence in your agency by hospitals and physicians, too many NTUCs on your scorecard, or simply a glitch in paperwork or your website. The data tells you the numbers have dropped. Skyra.ai tells you why.

Skyra is a data analytics solution that connects to your EMR, payroll, accounts payable, scheduling, and quite literally almost any other piece of your tech stack that has useful data you want to see.

With a standard dashboard containing the most relevant and popular queries, and the ability to create custom insights, Skyra makes understanding the volumes of data collected simple and easy. Once you understand the “why” behind the numbers, you can make adjustments in your operating, scheduling, ordering, and operations to improve the overall health of your agency.

Features

Standard Dashboard
Insights for each Team (Sales, Executive, Clinical)
Two-Month Data Trends
Custom Insights Page
Pinned Query that refreshes itself daily
Understands multiple languages
Zero Percent Hallucination
HIPAA Compliant with multiple security layers applied vertically and horizontally

“Ask Sky” – the Generative AI assistant you can tap into for custom insights into your agency
Compliance Monitor to avoid payment penalties by ensuring accuracy and timeliness of submissions
Control Tower for key metrics and alerts

Platform Agnostic

Data analytics is difficult enough without using multiple tech solutions. Even worse is when you’ve decided that a particular solution no longer works for your agency and you find yourself shopping for a new payroll, scheduling, or EMR solution. How do you preserve the years of data from your legacy systems without interruption?

Skyra.ai’s unique process stores all your data as though it comes from the same source, in the same language. Switching from solution to solution is a seamless process that keeps your data intact and reduces the opportunity cost of changing systems.

Future Plans

The team at Skyra is not content with one of the most advanced AI applications in the space. With a recently redesigned website, and new partners, Skyra is now looking to the future. Look for a two-way communication solution over a secured system with encrypted messages. The messaging system will connect caregivers to patients, patients to care teams, and caregivers, to care teams. The solution will reduce triage costs, reduce rehospitalizations rates, assist with marketing efforts, and increase CHAP scores. Skra Connect will launch sometime in 2025.

But, first, Skyra is focusing its development efforts on an application for sales teams and marketers. An alternative to a traditional CRM that requires large amounts of useless data input and doesn’t help close a deal, Skyra’s sales solution will provide a CRM solution that sales people actually want to use and will free up their time to spend on customer-facing activities.

The Rowan Report will provide a separate review of each of these new products as they become available.

Overall Impression

A Familiar Problem

Skyra.ai found Mickel tells a familiar story about the idea for his solution. Familiar, at least, to those of us who grew up in the 80s. When our favorite band released new songs, we ran to the nearest music retail store to buy a cassette tape. If your favorite song on the tape was track 3, you know the pains of fast forwarding and rewinding to get the tape to the perfect spot at the beginning of the song, only to have to do it all over again when the song ends. Today, we ask “Alexa” or “Siri” or “Google” to play our favorite song and it starts at exactly the right second every time. Mickel strove to make accessing and understand data as easy as asking Alexa to play your favorite song. Ask Sky removes the fast forward and rewind buttons and lets you understand your data faster.

A Consolidated Solution

As a small business, and even as an individual, I know how many applications I have to log in to daily to see my business analytics and personal information. Skyra houses all of your business information in one place for easy access and provides an open-ended query so each agency gets the information they need most to help the agency operate at its fullest potential. The possibilities that will exist as the AI technology advances is near endless.

As we have mentioned before, there are a lot of misuses for artificial intelligence, and a lot of misunderstanding. Now, it seems, we have found at least one more company doing AI well.

# # #

Kristin Rowan has been working at Healthcare at Home: The Rowan Report since 2008. She has a master’s degree in business administration and marketing and runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in event planning, sales, and marketing strategy. She has recently taken on the role of Editor of The Rowan Report and will add her voice to current Home Care topics as well as marketing tips for home care agencies. Connect with Kristin directly kristin@girardmarketinggroup.com or www.girardmarketinggroup.com

©2024 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in Healthcare at Home: The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com

M&A: Commure Acquires Augmedix

by Rowan Report | Aug 1, 2024 | Artificial Intelligence, M&A, Partner News

Acquisition Creates Large AI Software Provider

by Tanay Tandon, CEO, Commure

Today I’m excited to share that Commure is signing to acquire Augmedix (NASDAQ: AUGX) and take the company private. Combined, we believe we’re creating one of the largest, most comprehensive, and fastest-growing artificial intelligence software suites in healthcare.

AI Scribing

Augmedix is a pioneer in the space of Ambient AI-powered medical scribing, with technology and personnel serving over 20 major health systems and hundreds of sites of care. Together, we believe we can dramatically boost the productivity of every physician in America using language models that transcribe appointments, autonomously code them, and supercharge back-office operations for billing teams.

The companies together are on track to power over 3 million physician appointments using artificial intelligence, ambient scribing, and revenue cycle automation this year. Commure Scribe, and Augmedix Go on average save a physician 2 hours of documentation time a day, reducing documentation time by more than 80%, and help generate billions of dollars in productivity savings for providers across the country.

(Left to Right): Tanay Tandon, Ian Shakil, Hemant Taneja, and Manny Krakaris

Powerful Combination

Augmedix and Commure both partner closely with the country’s premiere hospital systems. Augmedix’s progress in deploying LLM-powered technology within those systems has been genuinely amazing.

Commure today processes billions of dollars worth of healthcare payments, and has the fastest growing Ambient AI scribe + documentation tool deployed within hundreds of health systems and private practices. Our technology suite helps power over 250,000 providers nationally. And with the Augmedix acquisition that number will grow even further.

As I’ve gotten to know Ian and Manny – founder and CEO respectively at Augmedix – it’s become clear they share a common passion with Commure for deploying artificial intelligence to supercharge provider operations and boost the productivity of the US economy.

In line with the health assurance vision, we believe this combination further unlocks an ecosystem of companies that can collaborate to transform healthcare. In partnership with Augmedix, Commure is poised to become the single, AI-powered interface for providers, accelerating innovation and our shared goal of creating a more proactive, accessible, and affordable system of care.

In the coming months, we hope to announce much more about how the combined company’s product suites will help transform provider operations at all the systems we partner with.

# # #

About Commure

Commure, Inc. is connecting disparate datasets, surfacing meaningful insights, accelerating performance through a suite of intuitive applications, and enabling seamless innovation across the healthcare industry. Commure’s mission is to empower every person in the health ecosystem to deliver exceptional care. Commure’s original applications include solutions to improve staff safety, enhance clinical workflow, and bolster revenue operations. Currently, the company enables more than 160,000 clinicians and staff across more than 500 care facilities to advance care through collaboration. With Athelas in the portfolio, Commure will add thousands of clinicians and over 100,000 patients to its national network. Combined, Commure and Athelas is backed by General Catalyst, Sequoia, Lux, Human Capital, 8VC, Greenoaks Capital and Elad Gil. Learn more at commure.com.

Generative AI Comes to AlayaCare

by Kristin Rowan | Jun 27, 2024 | Artificial Intelligence, Caring for the Caregiver, Product Review, Vendor Watch

by Kristin Rowan, Editor

Generative AI and Artificial Intelligence are taking the world, and the care at home industry, by storm. Not surprisingly, there are only a few companies that are doing AI well. We’ve started reviewing the best of of them. So far, each company doing AI well has a unique solution to a pain point in home care. No two companies are approaching or using AI the same way. This week, we’d like to re-introduce you to a company we’ve reviewed before that has a new Generative AI app launching soon.

History

Practically a household name in home care, AlayaCare is a 10-year-old software company that started as a mobile workforce platform. Like many of us, once Adrian Schauer, Co-Founder and CEO, spend some time in the care at home world, he was hooked. He shifted the focus of AlayaCare to the care at home space. With parents in their 80s, Adrian found a lack of inspiring software in the industry in Canada and he felt like that was an important problem to solve.

“Care workers are doing God’s work, and they are not getting the support they deserve,” says Schauer. In Canada, where AlayaCare started, agencies combine home health and supportive care. Because of this, the largest patient base on the AlayaCare platform is on the supportive care at home side, but they now operate within home health as well. Since 2021, AlayaCare has added hospice to their network with the acquisition of Delta Health.

AI Comes to AlayaCare

Through many iterations of the software, AlayaCare has advanced with new technological capabilities. Now, AlayaCare is embracing artificial intelligence; more specifically, Generative AI. Schauer explains that the purpose of their new AI technology is “to enable the type of care we want our loved ones to receive at home.”

The new GenAI app was demoed in September of 2023 and is still in Beta testing. AlayaCare is anticipating an end-of-summer launch of the product.

Introducing...Layla

Layla is an in-app digital assistant, built on top of GenAI. It’s large language model allows the user to conversationally interact with the data in the system. It also includes a constrained internet search component. From the conversation, it can determine whether the user is seeking internal or external information.

Layla’s data exploration does more than just extracting data. The GenAi platform allows Layla to provide operational support around key metrics for employee retention.

Agency Support

AlayaCare has determined some key factors in employee retention:

Utilization
Quality shifts
Qualified Hours
Recurrent shifts
Average weekly clients
Weekday hours vs weekend hours

Focusing on these factors, Layla provides improvements in onboarding, scripting information, data migration, and scheduler use of time.

Features

Visit Optimizer

AI generated, automated scheduler that takes into account route management, skill matching, daily hours, and schedule optimization to optimize care and reduce time from referral to first appointment.

The scheduling automation includes push notification capabilities to send schedule updates to clinicians in real time. As each week’s schedule is created, Layla can send a push notification to each clinician. It asks them to verify their availability and confirm the next week’s schedule.

Additionally, Layla considers environmental factors such as pets, neighborhoods, and other family members in the home. According to AlayaCare users, the Visit Optimizer offers up to a 98% decrease in time required to fill visits, 35% improvement in visit fulfillment, and 35% improvement in data quality.

Notable

Notable transforms notes from patient visits, forms, and client records. Then, it uses AI to review, compile, categorize, and tag all the notes.

From this information, Notable compiles an activity of daily living (ADL) for each client, including whether and why a task was completed. This information is also moved to the risk dashboard. The risk dashboard shows the whole population, the risk of that population, identifiable trends, risk level, and whether the risk has remained stable over time. All of this information is compiled into a single risk dashboard with customizable reports.

Additional security measures for Notable include a grounded model to reduce the risk of AI hallucination and ensuring no PHI leaves the dashboard.

Employee Retention Dashboard

Several factors impact employee retention. Among the top reasons for employee dissatisfaction are pay and benefits, inconsistent hours, and safety concerns. The current workforce shortage means keeping your best employees is more important than ever. With a quick snapshot of your employee satisfaction and engagement, you can address concerns earlier and improve turnover rates.

The employee retention dashboard highlights satisfaction scores, client capacity, scheduled hours, number of unique clients, overall turnover rates, turnovers by location, and more.

“Having a tool to predict employees who may be disengaged or dissatisfied prior to this happening is invaluable,” said Lee Grunberg, President & CEO, Integracare. “With the dashboard and algorithm behind it, we can see a caregivers’ satisfaction or engagement trend over time, and deploy preventative measures to reduce the likelihood that they’ll resign. It has empowered our coordinators to be much more retention-driven.”

On Deck for Layla

I spoke with Adrian Schauer, Co-founder and CEO of AlayaCare, during the online demo. “My passion project is…Layla. The people in your agency should be building relationships and making decisions. Anything else should be done by automation.”

AlayaCare is currently in a high growth mode to build marketshare across the personal care and skilled sides of the marketing. Schauer’s goal is to elevate a level above their existing capabilities with home based care providers. This includes how payers are set up, how EVV is operating, lobbying, and advocacy.

For Layla, AlayaCare is working on the GenAI capacity for chart completion by voice. Layla would use the conversational language model it already has to recognize and understand the conversation during a home visit and transcribe the conversation into notes, visit documentation, care plans, and codes.

Final Thoughts

As AI becomes more commonplace across care at home, we are scrutinizing AI platforms for safety, identity protection, accuracy, and ethical use. If you are looking for an AI solution for your business operations, we caution you to use discretion in your use of AI and thorougly vet the AI platform prior to adoption. We will continue to provide updates when Layla launches later this year. But, for now, it looks like we’ve found one more technology platform that is using AI the right way.

Kristin Rowan has been working at Healthcare at Home: The Rowan Report since 2008. She has a master’s degree in business administration and marketing and runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in event planning, sales, and marketing strategy. She has recently taken on the role of Editor of The Rowan Report and will add her voice to current Home Care topics as well as marketing tips for home care agencies. Connect with Kristin directly kristin@girardmarketinggroup.com or www.girardmarketinggroup.com

©2024 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in Healthcare at Home: The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com

Florida Hospice Teaches Dementia Care by Simulating Dementia

by Tim Rowan | Jun 13, 2024 | Clinical, Hospice

by Tim Rowan, Editor Emeritus

“This [virtual dementia] tour opened my eyes to the reality of what a dementia patient lives with every day. It is completely different when you walk in their shoes. I highly recommend this program for caregivers.”
“I can’t tell you how the dementia tour workshop has impacted my daily journey with my husband. He is 64 and suffers from a combination of Lewy Body and Frontal Temporal Dementia. We have been navigating this as a family for 7 years. I thought I understood his struggle, but the virtual tour has opened my eyes completely. It was a very emotional experience for me. You have changed our lives.”
“Thanks to this training, I will be a better caregiver starting today!”

These are a few of the comments from caregivers and family members who were trained by the Hospice of Marion County (HMC) in Ocala, Florida. HMC offers training based on research conducted by P.K. Beville, geriatric specialist and founder of Second Wind Dreams®. Second Wind is an international organization offering services to caregivers. Known as “The Virtual Dementia Tour,” the training is a patented, evidence-based, scientific method of building a greater understanding of dementia for clinicians, caregivers, and family members.

Virtual Dementia Tour

Trained facilitators outfit trainees with patented devices that alter their senses. They then guide participants while they try to complete common everyday tasks and exercises. The Virtual Dementia Tour enables caregivers to experience for themselves the physical and mental challenges those with dementia face. This experience helps to provide better person-centered care.

HMC began The Virtual Dementia Tour in 2020 following an endowment from the widower of an Alzheimer’s patient who had been under MCH care. Named after his late wife, the Nancy Renyhart Dementia Education Program offers trainings through the hospice. The training is not only for hospice patient families and care teams, but to others who request it.

Meet the Team

DJ Ryan, Dementia Education RN, is certified by Second Wind Dreams as a Certified Dementia Practitioner. He has been with HMC since 2015 and provides trainings at the hospice offices and in the community. Chief Medical Officer Mery J. Lossada is dual certified in neurology and psychiatry. She has been with HMC since 2007. She works with local police, EMS providers, the department of Children and Family Services, and mental health providers to coordinate healthcare services to the community, including dementia patients and their families.

In its first three and a half years, the Nancy Renyhart Dementia Education Program has provided dementia education to 9,968 people. This number includes 926 first responders and 482 caregivers who have gone through the Virtual Dementia Tour® in the last two years. It also includes 2,026 healthcare professionals and first responders who have gone through the Tour since the inception of the program in January, 2021. 6,534 people have attended 167 dementia presentations. HMC provides all these services at no charge to the individuals or their employers.

Dr. Lossada told us, “We are a non-profit organization, and we have identified the three most common diagnoses leading to admission to hospice care: cardiological, pulmonary, and dementia. We have a specific program for each one of those disorders, each one intended to improve quality of life for the patient and the caregiver. We have seen that these dementia disorders are causing the most distress. Our training program helps with that.”

Outcomes

Nurse DJ Ryan said the reduction in hospitalizations, emergency department visits, and transfers to residential memory care facilities is impossible to translate into a mere financial advantage. He is more familiar with the impact of the training on individuals and families. “In the case of Lewy Body Dementia, which includes hallucinations, we have seen people believe they were being watched, attacked, or had bad guys coming in through the heating vents. One person called 911 475 times one year. Once we get involved with our part of the task force, we get them the resources that they need and get them connected with support to reduce those 911 calls. And the numbers are astounding.”

Ryan told us he has been receiving calls from all over the country inquiring about participating in or duplicating his training program. This interest comes without having engaged in any promotional efforts outside of the HMC web site. DJ can be reached via the HMC web site, hospiceofmarion.org/dementia.

# # #

Tim Rowan is a 30-year home care technology consultant who co-founded and served as Editor and principal writer of this publication for 25 years. He continues to occasionally contribute news and analysis articles under The Rowan Report’s new ownership. He also continues to work part-time as a Home Care recruiting and retention consultant. More information: RowanResources.com or Tim@RowanResources.com

©2024 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in Healthcare at Home: The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@homecaretechreport.com

AI before AI

by Rowan Report | Jun 13, 2024 | Artificial Intelligence, New Tech, Partner News

by Tom Herzog, COO of Netsmart

Navigating the Next Era of Tech-Enabled Healthcare

While the talk is about Artificial Intelligence, the immediate opportunity is Augmented Intelligence.

Some thoughts from Tom Herzog and Matthew Arnheiter

We are living through one of the most exhilarating times in healthcare, a journey made possible by significant milestones over recent decades. As healthcare technologists deeply committed to the cause + communities we serve, we’re excited by the promise of the upcoming era of technological empowerment. This phase is set to showcase and expand upon the extensive work done in digitizing healthcare, highlighting the relentless pursuit of innovation that has characterized our field. In conversations with colleagues and clients, we have recognized the need to explore these developments as we progress collectively. Matthew and I thought a series of reflections on these conversations would be helpful for all of us, providing insights into technology’s transformative impact on healthcare and the critical initiatives currently underway. We envision this dialogue as a series of posts throughout the year, sparking discussion and reflection as we navigate forward.

Back to the Future

In 2015, we envisioned a future where the concept of navigation as we know it would be obsolete, advocating for a universal search that is nearly autonomous, informed by the known context specific to every role. By 2019, we were discussing workflow automation, using the example of Lane Departure Warning systems in automobiles as a metaphor for technology that enhances outcomes through precision responses. The pace at which these technologies are evolving is astounding, moving beyond mere speed of thought to how we can iterate at the speed of innovation itself. Before we achieve the aspirations of true Artificial Intelligence, we must start with Augmented Intelligence, which may very well be the most significant technological innovation in my lifetime.

The Gentle Guidance of Technology: Augmented Intelligence in Healthcare

Artificial Intelligence (AI) and Augmented Intelligence stand as beacon forces driving innovation forward in this fast-evolving technology landscape. Drawing an analogy to driver assistance systems in modern vehicles, we explore the nuanced differences between these concepts, simplifying their understanding and underscoring the distinct roles in enhancing human capabilities.

Artificial Intelligence: The Autonomous Navigator

Imagine AI as the driving force behind fully autonomous vehicles, adeptly navigating complex terrains without human intervention. This epitomizes the grand aspiration of AI: to emulate or even transcend human Intelligence in specific tasks, thus granting machines the ability to function independently. It’s a prospect that is as exhilarating as it is intimidating, reminiscent of scenarios depicted in futuristic films. Such advancements bring to light profound questions about the limits of technology and the ethical considerations it entails. While we marvel at the potential, apprehension about the unknown shadows our enthusiasm. As we venture into this era, it’s imperative that we tread thoughtfully, balancing our ambitions with caution, as we unlock new realms of possibilities. Together, we must navigate this journey towards outcomes that are not only innovative but also meaningful and ethically sound.

Augmented Intelligence: The Co-Pilot’s Nudge

Conversely, Augmented Intelligence mirrors the driver assistance systems in vehicles – providing “nudges” or guidance while ensuring the driver remains in control. These systems bolster safety and efficiency, complementing human Intelligence with technological support. This partnership epitomizes the collaborative synergy between technology and human skills for a safer and more efficient driving experience.

The American Medical Association (AMA) aligns with this vision, emphasizing Augmented Intelligence’s role in enhancing human Intelligence rather than replacing it. The AMA advocates for the use of AI in healthcare as a means to augment the capabilities of medical professionals, not to substitute their critical thinking or clinical judgment.

Augmented Intelligence in Healthcare: Enhancing the User’s Ability

Reflecting on the transition from conceptual frameworks to tangible applications, we’ve initiated the Augmented Intelligence family. These solutions are meticulously designed to support clinical, operational, and financial workflows across all healthcare roles. Aimed at simplifying user experiences, these tools provide the best available context and automate information for validation and use as needed. This initiative marks a significant step in harnessing the potential of augmented Intelligence, enabling transformative shifts in healthcare practices and outcomes.

Michelle Donelan MP, reflecting on the U.K.’s commitment to AI in healthcare, highlights the transformative impact of augmented Intelligence, “AI will revolutionize the way we live, including our healthcare system. That is why we’re backing the U.K.’s fantastic innovators to save lives by boosting the frontline of our NHS and tackling the major health challenges of our time”. Donelan’s statement emphasizes the government’s support for utilizing AI to enhance healthcare delivery and address pressing health issues.

Augmented Intelligence promises to extend the partnership between human capabilities and technological advancement to medical professionals. Vincent Liu, MD, from Kaiser Permanente, elucidates this synergy, stating,

“There is a stage at which regulations can stifle some of the innovation [that AI might advance] … There is a role for providing a safe harbor [from certain regulations] so that we can use our best data to improve our patients’ care.”

This perspective underscores the potential of augmented Intelligence to enrich patient care by integrating comprehensive data analysis within the regulatory framework.

From the inception of conversations at our annual user conferences in the early 2000s to the present, we’ve witnessed the evolving landscape of healthcare technology. The decades-long journey of healthcare digitization has set the stage for today’s advancements, where Artificial Intelligence and Augmented Intelligence solutions leverage data to significantly improve care and operational efficiency.

Navigating Ethical Considerations

The integration of Augmented Intelligence in healthcare navigates through a maze of ethical considerations. Upholding the sanctity of the caregiver-patient relationship, ensuring patient privacy, and addressing potential biases in AI algorithms are paramount. The objective is to leverage Augmented Intelligence in a manner that respects these ethical boundaries while enhancing patient benefits.

A Future of Collaborative Care

Looking ahead, the promise of healthcare augmented by Intelligence offers a landscape where clinicians are equipped with unprecedented tools and information. This era does not diminish the essence of human judgment or the significance of the human touch in medicine but serves as a potent ally to these irreplaceable elements of care.

A Journey of Human-Machine Collaboration

Augmented Intelligence in healthcare symbolizes the collaboration between human Intelligence and artificial capabilities. This collaboration is not about relinquishing control but about enriching human expertise to tackle modern healthcare challenges. As we continue to integrate this technology, it heralds a future where healthcare is more personalized, predictive, and precise. The path forward, illuminated by the gentle guidance of Augmented Intelligence, promises a realm of endless potential for improved health outcomes for all.

Our immediate focus is three-fold 1) providing the communities we serve with the benefits of Augmented Intelligence, 2) ensuring we achieve Meaningful AI for every role, and 3) doing so through incremental progress so that AI now is a reality.

Final Thoughts

If you are reading this, you are likely one of the pioneers helping forge the path we are on today. If it were not for the initial efforts to digitize the ecosystem, we would not be talking about this today. Thank you for making this happen, for your perseverance and tenacity to find a way. Now we are at the transition from AI as a futuristic concept to its current role in shaping healthcare practices marks a remarkable chapter in the ongoing story of innovation in healthcare. It reaffirms the importance of digitization as the foundation upon which AI and other emerging technologies are built, enabling a future where healthcare is more informed, more empowered, and, ultimately, more human.

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Augmented intelligence Tom Herzog Tom Herzog is responsible for leading solution and technology strategies focused on person-centric design to optimize workflow, efficiencies and outcomes. His teams work in collaboration with both clients and partners to deliver comprehensive solutions for the human services and post-acute care communities.

Tom oversees multiple business units, including Netsmart consulting organization, solutions, development, engineering, technology, innovation, product development, IT, support, human resources, legal and operational functions.

Tom’s additional experience includes leading teams to automate systems and integrate financial, document management and information systems. He has been recognized for his ability to create innovative approaches and strategies that deliver results through vision and building strong teams.

Tom earned a bachelor’s degree in business management and human relations from Mid-America Nazarene University. He serves on the boards of the Overland Park Chamber of Commerce and the United Community Services of Johnson County.

WellSky® and Ava Launch Groundbreaking Solution to Combat Staffing Crisis for Home-Based Care Agencies

by Kristin | May 30, 2024 | Partner News

Provided by Business Wire

May 30, 2024 6:00am

WellSky® and Ava Launch Groundbreaking Solution to Combat Staffing Crisis for Home-Based Care Agencies

The new innovation helps improve healthcare employee retention and engagement through incentive-based rewards

WellSky, a leading health and community care technology company, today announced the release of WellSky TeamEngage powered by Ava, a new innovation for home-based care providers aimed at increasing employee retention, reliability, and recruitment through gamification. The solution incentivizes and rewards caregivers for completing targeted activities and achieving performance goals, fostering a culture of appreciation while improving staff retention rates and agency differentiation.

WellSky TeamEngage

The solution comes at a time when home-based care providers face a growing workforce shortage crisis. The turnover rate for home care providers is 77%, challenging agencies to meet a growing demand for services with a shrinking supply of caregivers. This can result in higher rates of referral and client case rejection. With WellSky TeamEngage, agencies can implement customizable, data-driven incentives to attract and retain talent at scale, while shifting focus toward other operational priorities and providing exceptional care.

Using WellSky and Ava’s integrated technology, Griswold — one of the country’s largest home care franchises with more than 170 locations in 32 states and over 9,000 caregivers — reduced the turnover rate in its eight company-owned offices by 13% in just seven months and helped a large majority of caregivers reach key goals, such as clocking in and out on time and meeting minimum weekly hour requirements. The company has since rolled out the technology to its franchise network and expects significant adoption.

“We have seen tremendous benefit from using WellSky TeamEngage powered by Ava, both in the retainment of talented staff members and in the differentiation of our agency,” said Caitlin Griffith, Director of People & Culture at Griswold. “Our organization believes that care professionals are the foundation of our success, with innovation being key to improving the lives of those we serve. We have been pleased with the adoption and staff satisfaction with the solution, and we look forward to further benefiting from a comprehensive set of insights to guide our approach to workforce engagement strategies.”

Ava acts as an AI-powered Chief Engagement Officer

Its average customer improves employee retention rates by 45% in six months. Ava improves employee engagement so healthcare providers and administrators can redirect attention to scaling their businesses. Now in partnership with WellSky, the organizations will extend this technology to providers across the U.S., with the Ava platform integrated within WellSky electronic health records (EHR) technologies and the WellSky TeamInsights solution. TeamEngage will provide a comprehensive flow of data between systems and a seamless end-user experience.

“Ava works to remove the burden of administrative work and reconnect caregivers and home care administrators with why they chose a healthcare career in the first place,” said Victor Hunt, chief executive officer and co-founder of Ava. “We are excited to lend Ava’s Enterprise AI technologies to TeamEngage and, in doing so, tackle one of the greatest crises facing healthcare.”

Leveraging data directly from WellSky Personal Care

WellSky TeamEngage incorporates specific caregiver actions, such as taking open shifts and performing timely clock-ins, into the agency’s defined incentive model, which stores all actions and awards points that caregivers can redeem for monetary or other agency-defined rewards. These day-to-day behaviors combined with pulse survey results, gamified referrals, and other engagement metrics are all tracked within WellSky TeamInsights for Personal Care, where powerful algorithms help predict caregiver turnover risk to proactively guide retention strategies.

“The staffing crisis facing our clients and the industry at large is a major concern, both for people seeking care in the home and for agencies trying to meet that need,” said Wes Little, chief analytics officer at WellSky. “We are thrilled to bring WellSky TeamEngage to our clients to not only provide them a tool to incentivize and reward caregivers, but to also gain the insights needed to run their operations at scale in today’s challenging environment.”

To learn more about how WellSky is powering agency staff retention and engagement, visit WellSky.com.

About WellSky®

Wellsky and Ava WellSky is one of America’s largest and most innovative healthcare technology companies leading the movement for intelligent, coordinated care. Our proven software, analytics, and services power better outcomes and lower costs for stakeholders across the health and community care continuum. In today’s value-based care environment, WellSky helps providers, payers, health systems, and community organizations scale processes, improve collaboration for growth, harness the power of data analytics, and achieve better outcomes by further connecting clinical and social care. WellSky serves more than 20,000 client sites — including the largest hospital systems, blood banks, cell therapy labs, home health and hospice franchises, post-acute providers, government agencies, and human services organizations. Informed by more than 40 years of providing software and expertise, WellSky anticipates clients’ needs and innovates relentlessly to build healthy, thriving communities. For more information, visit wellsky.com.

About Ava

Wellsky and Ava Ava is an enterprise AI platform helping healthcare providers streamline administrative busywork so that they can get back to care. In an industry where employee engagement and retention are crucial yet increasingly challenging to maintain, Ava provides an effective AI-driven solution that’s beneficial for clients, caregivers, and providers. Integrating seamlessly with Electronic Health Records (EHRs), Ava offers an engaging experience for caregivers and clinicians while providing administrators with a robust suite of tools for business intelligence, employee management, and gamified incentives. For more information, visit joinava.com.

WellSky Media Contact
Emma Neal
Phone: 617.401.3131
Email: emma.neal@allisonworldwide.com

Ava Media Contact
Deanna Carbone
Phone: 914.523.7865
Email: ava@hirschleatherwood.com

Curantis Solutions Partners with Amazon HealthLake

by Kristin Rowan | May 30, 2024 | Admin, Artificial Intelligence, Vendor Watch

by Kristin Rowan, Editor

Having a lot of data can help grow your business, streamline processes, improve efficiencies, and make your agency more profitable. But, if you don’t know how to use the data, or simply don’t have the time and man-power to analyze the data, then those hidden treasures waiting in all that data remain hidden. Understanding the value of that data, Curantis Solutions partners with Amazon HealthLake to help you harness it.

Curantis Solutions is a Texas based company delivering value to hospice and palliative care agencies. Their cloud-based management solutions help you increase operational and financial efficiencies while still offering well-coordinated and high quality patient care. The platform works to address two common pain points in our industry: siloed data and software systems that operate separate from each other. Curantis Solutions re-imagines workflows to reduce hours spent on tasks outside of direct patient care.

The Impetus for Change

New CMS regulations and the HL7 Fast Healthcare Interoperability Resources (FHIR) create standards that providers and health care plans must meet. This could help home health and hospice agencies with clinical data issues. FHIR imagines a unified EMR system for greater interoperability. Facing FHIR compliance, Curantis Solutions turned to AWS to help centralize their data. Using Amazon HealthLake, a fully managed FHIR service, Curantis was able to make their client data interoperable.

The Solution for Curantis Solutions

Using Amazon’s Working Backwards process, Curantis found a customer-centric solution. AWS helped Curantis work through:

Business objectives
A free, introductory program, “Gain Insights”
Cloud set-up and solution design

Curantis also implemented Amazon Kinesis to help collect, process, and analyze real-time data. All of Curantis’s data is now easily accessible, opening the door for AI, analytics, and business intelligence.

Curantis Solutions and Amazon HealthLake Data Processing and Analytics

Using Amazon, Curantis Solutions can build visual dashboards and reports. The visual reports help agency administrators understand and apply the data at a glance without spending hours analyzing the data points. The integration allows data analysis in almost real time. The Amazon suite of services aids Curantis in growth and enhanced data processing for their clients. It also allows Curantis to highlight powerful industry and patient data trends. These key indicators will help with critical decision making for continued high quality patient care.

This new platform adds expanded abilities to meet customer needs:

Enhanced partner integrations
Diverse way to prensent a patient-focused view
The power to make predictions about a patient’s decline based upon chart data
The ability for customers and internal stakeholders to easily explore data

About Curantis Solutions

Curantis Solutions was born from a desire to put hospice and palliative care first. With a genuine culture of caring, our team is dedicated to creating a refreshingly simple software experience that utilizes emerging technology, smart design and a cloud-native/serverless architecture to create an experience that is congruent with the technology you utilize in your everyday life. It’s time for hospice and palliative care software to make life easier vs creating arduous workarounds and added frustration. It’s time you experience Curantis Solutions!

About Amazon HealthLake

AWS HealthLake is a HIPAA-eligible service offering healthcare companies a complete view of individual and patient population health data using FHIR (Fast Healthcare Interoperable Resources) API based transactions to securely store and transform their data into a queryable format at petabyte scale, and further analyze this data using machine learning (ML) models. Using the HealthLake FHIR-based APIs, healthcare organizations can easily import large volumes of health data, including medical reports or patient notes, from on-premises systems to a secure, compliant, and pay-as-you-go service in the cloud. HealthLake offers built-in natural language processing (NLP) models to help customers understand and extract meaningful medical information from a single copy of raw health data, such as medications, procedures, and diagnoses.

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Kristin Rowan has been working at Healthcare at Home: The Rowan Report since 2008. She has a master’s degree in business administration and marketing and runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in event planning, sales, and marketing strategy. She has recently taken on the role of Editor of The Rowan Report and will add her voice to current Home Care topics as well as marketing tips for home care agencies. Connect with Kristin directly kristin@girardmarketinggroup.com or www.girardmarketinggroup.com

©2024 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in Healthcare at Home: The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com

Telehealth and AI in Home Care: An Interview with Dr. Pamela Ograbisz

by Kristin Rowan | May 23, 2024 | Artificial Intelligence, Clinical, Telehealth

by Kristin Rowan, Editor

Telehealth’s evolution includes the dramatic shift to at-home and hybrid healthcare models post COVID-19 as well telehealth’s role in program management and staffing. From telehealth’s earliest models to today’s automated systems, Telehealth and AI have future implications for care at home. I recently sat down for an interview with Dr. Pamela Ograbisz, a nurse practitioner with expertise in telehealth spanning almost two decades.

The Rowan Report:

First off, thank you for taking the time to talk with me today. Can you give our readers a brief introduction about you and your background?

Dr. Pamela Ograbisz:

I have been in telehealth for about 19 years now. I’ve been a nurse practitioner for 25 plus years. My specialty is cardiothoracic surgery and critical care. I have it was started out as a nurse in CT surgery, went back to school, became a nurse practitioner, then worked in CT also my entire career in critical care. We had an opportunity roughly 17 years ago when I was working in a cardiothoracic unit where we were connected by bridges and tunnels and water.

RR:

And, how did you come to be involved in telehealth?

Ograbisz:

We covered seven different sites and we weren’t able to get to all of our patients in a timely manner. We were struggling. We were trying to figure that out. A nurse reached out to us and was on a flip phone. She was taking photos and sending things and we were able to piece together a plan because of that. We literally all sat down that night after around and said, we need to do something like this. And we were attached to a medical school. And so we got them involved as well. And we built one of the first ICU bunkers in the classroom for telemedicine. And it was really sort of the beginning of something amazing. And I saw how well it worked. And I had the privilege of going around and building more of those programs.

RR:

And this eventually brought you to LocumTenens.com?

Ograbisz:

I was recruited by LocumTenens.com. When I first joined them, they had roughly 7% of their business was tele[health] and it was all behavioral health and they were really trying to expand their footprint. And of course, this was prior to COVID, we were still dealing with a lot of legislative issues and not everybody necessarily believed in it. It was still very scary for people and we were trying to sort of showcase what we could do. And so I came in and wrote a lot of policy and procedure and then COVID happened and we had to flip everything over it and we were poised to do so, which was fantastic.

So overnight we started turning on just loads of programs, 100% virtual. And then honestly, a lot of them never went back or they’ve come to a hybrid model. So now you can then convert those programs from traditional boots on ground all the time to more, you know, expandable, flexible models that have a hybrid option that includes telehealth.

RR:

Are you still operating the telehealth programs for LocumTenens.com?

Ograbisz:

My role now is I run LT Telehealth, which is a company inside of LocumTenens.com. We’re not a stand alone, but we do run all of the telehealth programs inside of the company. I also oversee all APP (advanced practice provider) relationships and how we’re growing that business and then our legislative arm.

RR:

LocumTenens.com is a full service staffing company, right? How are you finding the workforce shortage right now?

Ograbisz:

So, I would say that probably for a while, we commiserated with the health systems. But, filling the gaps from workforce shortage is our business.

I will tell you this, I graduated school a long time ago when I got out, it didn’t matter if you were a doctor or a nurse practitioner or a PA, your goal was to join a practice. You wanted to become a partner and you wanted your name on that building and you wanted to own a piece of that building. Nobody was owned by the hospital groups. I felt like with the evolution of the electronic health record, everything changed. People were asked to do a whole lot more. All of a sudden it became a lot of boxes to check a lot of things to tick. You sat on more and more committees. It became more and more about the paperwork. And then of course, with the advent of EHRs, billing changed; CMS codes changed how you got paid. People started bucking the system. And so what we saw then honestly was a shift. Now people coming out [of college] are like, yeah, I’m not joining a practice or I’ve left my practice. This gives me a new creative way to be part of medicine with flexibility which no one ever promised you when you got out of school. Right? No one ever said, “You want to be a cardiothoracic surgeon? Work, life balance is for you!” No, right? 80 hour weeks and sleeping in the hospital. You signed up for it; you knew it. And now people have been given a glimpse of what it can be and what it could be. And so I think that the physician shortage 100% exists, but COVID forced the gig economy. And so what we’re seeing is people wanting to work on their own terms and 1099 contracting does that for them.

RR:

How are you seeing telehealth working in care at home?

Ograbisz:

So, we’ve been working on the medical hospital-at-home pieces trying to figure out how we can sort of fit into that model. We’ve seen a lot of really wonderful pilot programs come out of Mayo and Hopkins and what they’re doing. I think the biggest problem right now is they’re not reimbursed well. That is making it very hard for other systems that don’t have deep pockets like those two facilities to scale those programs to any kind of large extent. What we would say is we know that it’s better. If a patient is too ill to leave home, we can facilitate a visit with the doctor right from the house. We’ve found it is especially helpful in the oncology program we launched when a doctor has to deliver bad news. The pushback we got was the patients are not going to be able to adapt and get that kind of news through a screen. But the patients really proved that wrong. It was the patients who said, “If someone’s going to tell me that I have six months [to live], I don’t really want to hear that in a sterile, cold, doctor’s office. I really am much happier if I could be in my own environment and process that information.”

RR:

What is standing in the way of a robust telehealth system for hospitals, physician groups, and home health?

Ograbisz:

I mean, CMS obviously needs to catch up with the telehealth. They were doing it during COVID. We need to extend that so that those payments, as long as the coding is all there, those payments need to come through for telehealth. But when you combine it with home health and hospice, you have that in person touch point. So the whole visit then is reimbursable, which is why a lot of hospitals and physician groups are partnering with home health, hospice, and palliative care or organizations now because you get that in-person visit, but everything is sent back to the physician to oversee changes in care, oversee changes in medication. At home care and physician care combined, the reimbursement goes into place because you have that touch point there, a face-to-face visit. They can verbally and visually see everything that’s going on, but then it goes back to the physician and they can then also get reimbursed for that. So there’s a lot of that with telehealth that is crossing over. Home health and hospice agencies need to start using telehealth and they need to be partnering with the ACOs and they need to be partnering with physician groups and now they have to partner with payers, especially as we move to the value based system. They have to partner with them because there’s only a certain amount of money that each patient is going to get. Some of it’s going to go to the hospital, some of it’s going to go to the physician and some of it’s going to go to the home health company and if there’s no partnership then there’s no money. So, you know, they have to take on some of that risk, but telehealth is the way to do that.

RR:

We’ve been talking a lot the last year or so about the rapid advancements in AI. What we’re seeing is that AI is impacting interoperability, telehealth, direct patient care, and so much more. What do you see happening in health care with Ai?

Ograbisz:

Yeah, I think it’s a huge unknown. I think everyone’s afraid to commit. I think there’s more scary stuff than there is positive stuff. So right now, what we’re worried about is someone taking on my identity, somebody being able to give advice in my voice with my likeness and put that out somewhere. So I think when you talk to providers, they see more of the scary side and how are we going to control it? But then you look at the most amazing pieces which is I can use AI to help me form a better diagnosis, to cultivate more ideas for how to treat things for each how process and procedure, right? How do we go about garnering information, which is what I think AI will help us do better in the telehealth space. I think it will be interesting to see where all of the programmatic goes. I think more towards like holographs and literally like Star Trek lead people into rooms, you know, life size images where it’s not just we go from just a 2D flat screen to really look at 4D, you know, being able to really see and perhaps even with scans and patient monitoring and you can hold the scanner up and I can see your liver, who knows? I think the possibilities are endless. But I think right now in all honesty, I think it’s fear…until we figure out a little bit of the regulatory side of it.

RR:

You’re also working on advocacy for telehealth on state and national levels. Will you follow up with us on how the next round goes as far as extending the reimbursement for telehealth?

Ograbisz:

Absolutely! I’ve written a lot of pieces that I’ll share with you. We’re always happy to collaborate.

RR:

Thank you, again for your time. Your insights were wonderful.

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Kristin Rowan has been working at Healthcare at Home: The Rowan Report since 2008. She has a master’s degree in business administration and marketing and runs Girard Marketing Group, a multi-faceted boutique marketing firm specializing in event planning, sales, and marketing strategy. She has recently taken on the role of Editor of The Rowan Report and will add her voice to current Home Care topics as well as marketing tips for home care agencies. Connect with Kristin directly kristin@girardmarketinggroup.com or www.girardmarketinggroup.com

©2024 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in Healthcare at Home: The Rowan Report. One copy may be printed for personal use: further reproduction by permission only.
editor@therowanreport.com

For more information on Locum Tenens visit: https://www.locumtenens.com/

Pamela Ograbisz

Vice President of Clinical Operations

Pamela Ograbisz, Associate Vice President of Telehealth for LocumTenens.com. With 20 years of experience in cardiothoracic surgery and internal medicine, she is passionate about delivering quality healthcare in a timely manner. Dr. Ograbisz is confident that telehealth programs are the key to improving health and the overall patient experience