John Damgaard is a man on a mission to revolutionize senior care. In less than five years as CEO of Minneapolis-based MatrixCare, he has directed the acquisition of LTC software company AOD, which was in turn already the parent company of home care's Soneto software, partnered with Briggs to create eBriggs for Home Care, enticed the former CEO of rival SigmaCare to become his VP of Corporate Development, and accepted the 2017 trophy for "1st in KLAS for Long Term Care software."
Most CEOs would take a breather after all that. Instead, Damgaard's company announced this week the release of a new data sharing tool he believes will change the national healthcare conversation. CareCommunity retrieves patient data from any Electronic Medical Record and delivers it to any other Electronic Medical Record. It interacts with telehealth systems and Fitbits. Patients who register with CareCommunity, at no cost to them, have unbroken access to their records as they move from facility to facility to home, even as they travel around the country. Intrigued, we joined an online product demo and afterward spoke with Mr. Damgaard in his Minneapolis office.
Meeting Customer Needs
"We were predominantly a SNF player at first," he began, "and doing well. Then our customers started to tell us, 'good job with the SNF software but we are building Assisted Living Facilities as fast as we can. What can you do for us?' That move made sense for them because it would balance their payer mix, give them better margins, etc. Besides, Baby Boomers are not going to wash ashore into Skilled Nursing Facilities first. They are going to stop somewhere along the way. We needed to respond."
First, the CEO continued, MatrixCare acquired a "purpose-built platform" for senior living facilities and added it to the company portfolio. But the customers kept moving. "'Now we're getting into home and community-based services,' they told us. So we acquired AOD and Soneto. Today, the home care division is the fastest growing business segment in the company."
Positioned to service the entire post acute spectrum, MatrixCare grew to over 600 employees, with software that touches 15% to 20% of the senior population. From that vantage point, the problem of care coordination and data interoperability surfaced.
"There is not enough money in the entire country to care for people the way we have been," he told us. "We have to find a way to move people as quickly as possible from high-cost to lower-cost care centers and to enhance patient transitions and care coordination while we are doing it. Every time someone falls through the cracks, every time a test is unnecessarily repeated, every time a medication list is inaccurate, care becomes more expensive and more dangerous." CareCommunity was introduced to address that problem.
Like a private HIE
This is the trajectory that led to the development of a data exchange system that puts the patient at the center of the equation. Once enrolled, patients or their advocates can demand, under the law, to have their health record delivered to CareCommunity, from any EHR in which it is stored. Once the system has a record, it can deliver the data to any other EHR.
CareCommunity can also be set up to automatically collect vital signs from commercial grade telehealth devices and from consumer devices such as Fitbits. Patients can add their own over-the-counter medications and supplements, which become part of the record. Families can be given access to the data. Each user type sees data displayed in a unique way.
Case managers see a list of the patients they manage or have managed, from all facilities or homes where they reside. They can drill down on one patient's data to see recent vitals, medications, diagnoses from all clinicians and all EHRs. They can send and receive secure messages to physicians.
Physicians also see their own patients' data and can see at a glance where each person is on the road toward his or her goals. They can see all medications and diagnoses, read notes from other clinicians and communicate with them and with the patient via the secure messaging system. These other clinicians may work out of different facilities and use different EHRs.
Patients see the same data, though displayed differently. In addition to records automatically added from ALFs, SNFs, hospitals, physicians and home health nurses, they also see a custom to-do list of the behaviors they must adopt and tasks they must complete in order to comply with their care plan. They see appointments with all care professionals; they see their medication schedules; and they can register their Fitbit or other wearable with the system so it will begin to read and record that data.
This is where Damgaard says his software shines. "This is not a document management system," he asserted. "We do not simply store PDF pages electronically; someone has to read through those to find the one piece of data they need. No, we tear each document apart, 'automagically,' and distribute each individual data point to the appropriate CareCommunity area. It becomes part of the record and searchable.
Dual revenue sources planned
CareCommunity will generate revenue for MatrixCare through fees to healthcare providers and payers and through targeted ads that appear on patient screens. Damgaard expects that the advertising revenue will eventually surpass the fees ($10 per month per licensed caregiver) and perhaps one day make them unnecessary. Medical and non-medical care organizations can subscribe to use CareCommunity, but patients can become users on their own.
Calling the system "a 'Private HIE' for the senior population," Damgaard said it became possible when three barriers were overcome. "The technological barrier is already down, via CCD and CCDA standards. Every certified EHR platform must be able to produce a standardized document. The political barrier was shattered by the 21-Century CURES Act. It doesn't matter anymore if care providers do not want to share Protected Health Information. It belongs to the patient and they must give it to them upon request. Otherwise there is a fine of $1 million per refusal.
"The third barrier is more complicated. We have navigated it with some of the most expensive lawyers on the planet. As a result of that, the government has finally said unequivocally that the health record belongs to the patient. It is not the 'property' of any provider or vendor. Who she chooses to grant access rights to is solely her decision. And that is the trump card that rules over all related legal rubrics. When a person is under care, HIPAA regulations are clear about how to share PHI. It is when someone is well and between care episodes and their record request would move data across state lines that it comes under the auspices of the Federal Trade Commission. Then it gets complicated. We engaged the law firm that represented Samsung against Apple and finally got the government to make a definitive declaration that the patient owns his own records."
Seniors will normally get into CareCommunity through their healthcare provider but they can apply directly. Providers using MatrixCare's home health EHR can enroll their patients today, for example. Should a senior choose to enroll independently, he submits the names of all the organizations he has ever used for care and CareCommunity requests records on his behalf. There is no cost to senior patients themselves.
Future developments are planned through MatrixCare's selection as a Microsoft Health partner. They are currently in the process of embedding the software giant's HIPAA-compliant Skype version. Another enhancement will add face-to-face telehealth visits to the hundreds of telehealth devices already connected.
©2017 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. firstname.lastname@example.org