by Tim Rowan, Editor
Tim Craig spends months every year searching for new, innovative technologies with home care applications. The Lincoln Healthcare Leadership Chief Content Director then invites the companies he finds to come to the annual Home Care 100 meeting and briefly present them. This year, Craig focused on six technologies with the potential to streamline workflow, make field and office staff more efficient, and help agencies better cope with their ongoing staff shortage challenges.
Jason Banks is the Senior Director of Post-Acute Sales for "nVoq," a Boulder, Colorado-based company that provides a speech recognition system, NoteAssist, for healthcare workers. He demonstrated the product and explained that it is custom designed for healthcare and streamlines creation of visit notes.
"Not only does speech-to-text save time, but our existing users, including Amedisys and Kindred, are seeing between 10 percent and 40 percent increases in the quality of the visit note, reduced QA time, and fewer claim denials," he told the audience. "The improvements in clinician satisfaction and easing of burnout that are reported to us come from saving 360 hours per year, which we determine by measuring workflow before and after NoteAssist implementation."
He added that the tool also verifies that a dictated clinical note is complete, in real time, based on customized criteria. It alerts the clinician if they have left anything out, such as PPS score, lists of ADLs, and the like. "I envision the day when nurses will dictate a note from one visit while driving to the next.
(See The Rowan Report, 9/1/21, "New Point-of-Care App Listens, Replaces Typing")
The last time we spoke with Eric Gordon, he was a VP at DeVero. Last week, he demonstrated a new AI product from "Element Five," the company he co-founded with former DeVero CEO Joe Randesi. Headquartered in the Silicon Valley, Element Five has developed a virtual robot that can be taught to perform routine tasks. We all watched as it completed an insurance authorization at lightning speed.
Element Five combines artificial intelligence and "Robotic Process Automation" to perform at least 33 percent of routine healthcare provider tasks, he added. "By turning routine tasks over to a smart robot," Gordon explained, "workflow improves and workers are freed up for jobs a robot cannot do." Tasks he believes have the potential to be automated include:
"To apply RPA in a healthcare environment," he continued, "first identify workflow bottlenecks. Then the team can collaborate to design ways to teach Element Five to perform those tasks." As a platform rather than a software application, think of Element Five like a spreadsheet; the user builds task instructions like a spreadsheet user builds formulae. Gordon added that there are other RPA platforms available, but that Element Five was built from the ground up for post-acute care.
"SafelyYou" is a fall prevention and detection system that began life as a PhD project. Company founder and CEO George Netscher developed the system at the Berkeley School of AI Research. Since then, he has raised $60 million to launch the idea as a commercial product and is beginning to move into post-acute care. "We also got approval to bill the service to liability insurance," he reported.
The SafelyYou system uses video cameras installed in the home. For privacy purposes, there is no live streaming. The system's intelligence triggers recording only when it detects a fall. "The problem with previous system," he explained, "is that they could never tell you why a fall happened, only that it happened."
He explained the difference between the limitations of medical intervention with an unwitnessed fall. "Twenty to forty percent of home care patients have some cognitive impairment. When they fall, they can't tell us what happened. To make sure they are safe, we have to put them on neuro checks or send them in an ambulance to the ER. There, they still don't know why they fell and how to keep it from happening again. With a witnessed fall, we can determine the why. Sometimes the fix is as simple as relocating a bed, adding a safety rail, or scheduling an aide to arrive in the early morning to help a patient get from the bed to the bathroom."
Netscher's AI software works with standard, off-the-shelf cameras. Its video analysis uses the same technology used in self-driving cars. Netscher concluded by reporting measured outcomes, "We are seeing 40 percent fewer falls and 80 percent fewer ER trips. Historically, 15 to 20 percent of falls end in ER visits. We are hitting two percent. This is a major relief to families that have insurance companies that refuse to cover ER costs when they say the customer is going too often."
He added that the system helps prevent wandering — he called it "elopement" — by persons with dementia as well as falls.
Neteera seems to have introduced a new generation of remote patient monitoring. According to Joseph Zaccaria, the company's Director of Strategic Relations, told the Home Care 100 audience that the Neteera 130 Digital Nursing Assistant detects change in status through a contactless monitor placed anywhere in the patient's room. A remote nurse can monitor multiple monitored patients, whether in hospital beds or in their own homes. The monitor has no buttons, is installed by plugging it into a wall socket, and requires neither maintenance nor charging. It does not use a camera and works through clothing to monitor a broad range of vital signs, including:
Zaccaria explained what makes contactless vital sign monitoring possible. "The standard electrocardiogram measures electrical activity in the heart, but "our bodies are analog," he began. "By using a ballistiocardiogram device, we detect mechanical activity of the heart, not the electrical. We bounce signals off the outer layer of the skin without touching the body, through clothing. The device sits on a nightstand or hangs on a wall; sometimes it sits on the breakfast table."
He further explained that every heart signature is unique. For that reason, the monitoring nurse can tell whether the Neteera 130 is picking up signals from the patient for from a grandson who walked through the room.
Orah partners with private-pay home care agencies to launch fully staffed remote-patient monitoring and virtual care programs. CEO and co-founder Rose Spiegel described the physician-led, Medicare-reimbursed service as an opportunity for non-medical agencies to add a new service without incurring new costs.
"Orah combines caregiver-generated patient data with human clinical teams to help agency care teams extend their care to the home. Orah is one of 18 healthcare companies listed on Forbes Next 1000 list for up-and-coming companies and well as "Medcity + AARP 50+ Innovation Leaders."
Orah includes a family portal to keep far away members in touch with their loved one's daily condition.
Brian Sagadin demonstrated a mobile imaging service from PPX, a division of Dispatch Health. The on-call service from another Dispatch Health acquisition, Dynamic Mobile Imaging, offers professional, portable x-rays and ultra-sound imaging. "DMI promotes in-home diagnostic capabilities with digital technology focused on improving quality, patient comfort and turnaround times," he said. "We currently deliver the service in 11 states and are growing rapidly."
Dispatch Health is a 32-year-old company headquartered in Minnesota. It was founded by Mark Prather and Kevin Riddleberger to provide Hospital-to-Home services, which competes with Medicare Home Health.
The final technology demonstration may have been the most innovative. Paradox is a "conversational assistant" powered by artificial intelligence. VP of Client Advocacy Joshua Secrest said he jumped at the chance to join the company after years heading up the department that manages hiring for all 37,000 worldwide McDonald's locations. He brought that experience to hiring home health and home care staff.
"Home care has several problems in the hiring process," he began. "Applications are too long. If people do not give up while filling it out, they do if they have to wait two days for an interviewer to call." He put a scare into the audience with the rest of his research findings:
"Our goal when developing Paradox was to give employers a competitive advantage when hiring," he continued. "We asked ourselves, 'How can we make the candidate experience simple, fast, and intuitive?' Our three goals at McDonald's were to be the fastest, knowing that every candidate applies to about twelve jobs; to develop intelligent software that would take over tasks and return hours back to managers; and to deliver a 'gold star' candidate experience, hoping they might like the experience and come back later even if they are not hired today."
Secrest consider those goals reached with Paradox when he was still with McDonalds. "We got application time down from three days to three minutes," he reported. "Applicant satisfaction rate increased to 99 percent." Struggling to describe the Paradox experience in words, he said to think of it like Alexa or Siri, a virtual text "person" who walks an applicant through the process and gives immediate feedback.
"Better yet," he concluded, "experience it yourself by texting 'jumpstart' to 25000." We tried it; nearly applied for a barista job right there in the demo.
Paradox has already made its way from fast food into home care, having been adopted by Bayada, Aveanna, and other home care providers, Secrest said.
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