A year and a half ago, Kindred Healthcare Inc. (KND:NYSE) announced that it was acquiring Gentiva Health Services Inc. (NASDAQ:GTIV), sparking the usual speculation about how two large organizations will manage the challenges that naturally arise during marriages of such stature. (See HCTR 10/8/14, Gentiva Agrees to $1.8 Billion Takeover Offer from Kindred Healthcare) We were particularly interested in the technology challenges so we spoke recently with Brandon Ballew, a longtime Gentiva financial executive who is now Kindred at Home's Chief Operating Officer.
Prior to Kindred's arrival, Gentiva had already been managing an assortment of software systems. Starting in late 2013, it combined DeVero's point-of-care software with its own back office financial system in 264 home health branches. (See HCTR 1/22/2014, Gentiva Rolls Out Point-of-Care Software to 264 Branches in 10 Weeks)
Gentiva's approximately 150 hospice locations, including branches that arrived with the Odyssey Hospice acquisition among others, continued to use McKesson's financial software. And the 2013 Harden acquisition brought in Allscripts in the hospice operations and McKesson in home health. In all cases, field staff continued to document on paper.
This is the mix that became part of Kindred Healthcare, a Louisville, Kentucky-based company that is the largest diversified provider of post-acute care services in the United States, operating transitional care hospitals, inpatient rehabilitation hospitals and units, nursing and rehabilitation centers, and assisted living facilities. At the time Kindred acquired Gentiva it had approximately 150 home care and hospice offices, which were using the Homecare Homebase EMR software.
E Pluribus Unum
COO Ballew was part of the team that surveyed this complex array of software systems and crafted the strategy that would create one organization out of many. Having had a hands-on role during Gentiva's DeVero rollout, he knew what the staff thought of the Silicon Valley company's product. "I had nurses telling me they are having dinner with their families again," Ballew told HCTR, "but without a laptop or tablet on the table next to them. The DeVero software had improved their workflow so much that they were getting their documentation done during work hours for the first time."
He also knew what management thought of DeVero. "Gentiva really did roll out point-of-care to 264 branches in only 10 weeks in 2013, as your newsletter reported," he continued. "You expect obstacles to arise when you start a project that massive but it came off essentially without a hitch." Gentiva's centralized billing system also helped ease the implementation, as linkages between point-of-care and financial systems only had to be done once.
The team's decision was an easy one, do for Kindred what had been done for Gentiva. Once the acquisition was finalized on February 1, 2015, Kindred began to move its paper forms onto DeVero's electronic solution. In a 10-week period from September through November, Kindred at Home deployed DeVero to 179 hospice locations. By the end of the year, 6,200 employees had mastered the new software.
“What made the conversion easy," explained DeVero's Sales VP Eric Gordon, "is that our solution is designed with the clinician in mind. We make the clinician's experience easier than paper forms and don’t require them to go through extensive training, allowing rapid implementations at scale without interrupting patient care. Though the application is simple to use, the data drives powerful functionality behind the scenes.”
That meant a short learning curve for Kindred staff, Ballew told us. "They didn't have to learn a new way of working, just a different way to fill out the same form." Billing and financial personnel will continue their work habits uninterrupted as well, now that the DeVero system has been connected to the same McKesson billing system that has been in place at Gentiva's hospice locations.
Field staff attitudes changing
Years ago, when point-of-care software was new, home healthcare and hospice administrators would report that some staff would leave for other jobs when computers were introduced into their agencies. The opposite is the case today, Ballew verified. "Gentiva was occasionally losing people to automated competitors," he remembers. "Now, with our point-of-care software, we have seen significant gains in recruitment and retention of staff. One of the things they are telling us is how much more efficient IDG meetings are, now that they do not have to shuffle through reams of paper to update colleagues on each patient."
As with all Medicare providers these days, ADRs are more numerous. "But," Ballew quickly added, "the information at our fingertips makes them more manageable."
Mr. Ballew wrapped up our conversation with a peek into Kindred's future plans. Kindred currently operates over 500 home health and hospice locations and manages 18,000 active DeVero users. By the end of this year, the DeVero point-of-care solution will be rolled out to all remaining Kindred at Home branches, a large number of which are located in rural areas.
"It may be rare when the acquired company's software becomes the standard for the acquiring company," he concluded, "but in this case it was the right move."
©2016 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan's Home Care Technology Report. homecaretechreport.com One copy may be printed for personal use; further reproduction by permission only. email@example.com