Posted by Will Hicklen on Tue, Sep 07, 2010 @ 12:00 PM
Home Health and Private Duty agencies might share this with their clients or repost on their own web sites.
Caring for an elderly parent consumes tremendous time and effort and is often an emotional and financial drain. No matter how devoted they are, family members have limited time and proximity is often a challenge.
Here are some helpful ideas from CNN Money magazine, “4 Tips for Caring for Mom and Dad,” and ways to manage family communications from Ankota. Additional resources are listed below.
It is estimated that 7 million Americans care for an elderly relative from a distance. 48% of them have to use sick or vacation days, and 38% report that they have to stop or reduce their savings during this time, according to the National Alliance for Caregiving (NAC). The same study reports that long-distance caregivers spend an average of $8700 per year providing support, roughly twice as much as nearby relatives.
CNN Money Tips:
1) Know Mom’s Needs. Things to look out for: “You’re looking for significant changes from normal patterns,” says Donna Wagner, a gerontology professor at Towson University.
2) Create a DIY Plan. Identify local friends or family who can help, and put together a checklist . Local grocery delivery might be useful, for example.
3) Get Low-Cost Help.
4) Bring on a Professional.
More on getting help or hiring a professional: Personal Care or “Private Duty” Aids range from $15-30/hour and are ideal for helping with things like cooking, housekeeping, baths, and so on. Nurses can be hired through Private Duty and Home Health care companies in your area for those who need medical care.
For more comprehensive help, a geriatric care manager can be hired. You might check out Caring For Your Parents by Elinor Ginzler of AARP. Ginzler’s article The Cost of Caregiving on AARP’s website is also an excellent resource.
Ankota Tip About Caregiver-to-Family Communications:
In focus groups sponsored by Ankota, a recurring frustration among family members is the inconsistency of communications from caregivers to family members. This should not be left only to phone calls and the bill should not be a primary means of communication. Family members should insist on regular electronic updates. Technology like Ankota’s FamilyConnect ensures secure and consistent, proactive communications that leverage text messaging and email, and provide a family portal.
By staying informed and on top of things, family members can alleviate some of the stress that comes along with caring for an aging parent.
Resources:
FamilyConnect from Ankota automates repetitive communications between caregivers and family members. All home health and private duty agencies should use some form of communicating like this.
Informal Caregiving by and for Older Adults by Donna Wagner, Professor of Gerentology and Health Sciences, Towson University, Towson, Maryland.
Lotsa Helping Hands is a free, private, web-based community that can also help organize family and friends.
The Cost of Caregiving an article by Elinor Ginzler on AARP’s web site
Caring for Your Parents a book written by Elinor Ginzler
Learn more about using checklists in these two recent Ankota articles: The Checklist Manifesto and Checklists Improve Quality of Care
BeClose Simple, unobtrusive home monitoring provides real-time, remote activity monitoring in the home.
Posted by Ken Accardi on Tue, Sep 07, 2010 @ 08:11 AM
We often blog about "Aging in Place Technologies" and the reason is that we beleive that these technologies represent an opportunity for home care companies to do two things: 1) keep abreast of what's available (and often marketed direct to consumers and their families) and 2) Look for ways to grow your businesses with this technology. As an example, two weeks ago we did a blog post entitled Wired Homes for Tracking the Elderly: A private Duty Differentiator that you can read here. That post talked about home monitoring solutions that families are considering in lieu of private duty care, but then outlined a way that you can in fact grow your business by embracing the technology.
Today we bring you an update from Laurie Orlov, who is an expert consultant in all matters related to aging in place. She publishes a blog at http://ageinplacetech.com. Below is a sample of her research and writing with information to connect you to her site.
Aging in Place Technology Watch August Newsletter
by Laurie Orlov
August was a bonanza of buzz, buzz, buzz. Usually August is a snoozer (and a slow news month) in the business world, what 
with vacations and organizational regrouping. But beginning with the August 3 Intel-GE Joint Venture announcement that fueled hope and speculation about accelerating intentions, more activity and media tracked right behind. During August, Great Call announced a new Jitterbug medication reminder service, Healthsense received a round of investment led by Radius Ventures, a $1.3 billion M-Health market sizing got Qualcomm and AT&T excited. Or maybe that that was 'mHealth' -- Best Buy (re)surfaced with health-related stuff in stores. Within the general what's-it-all-mean confusion, more press followed last month's NY Times series -- this time NPR offered up a series on aging and technology as well. Never one to shut up, I offered my own 'bah humbug' assessment of the assessment.
Alzheimer's hype, hope, oops...reality. Speaking of saturated media coverage, August was a month in which the unsuspecting might actually think an Alzheimer's revolution was at hand. Following July's news of amending (expanding) criteria as to what consitutes the disease, next came identification of biomarkers as possible early warning indicators. But stay cautious about remedies and prevention: see yesterday's NY Times published the NIH jury and Duke 'meta' study -- a study of all previously published studies about what's proven and what's not. The short answer about the various prevention and remedies studied to date -- the answer: NOT PROVEN. Implication? New criteria potentially broadens the population beyond the current 5 million, diagnosis is potentially going to be at an earlier age, and nothing has been proven to work at staving off or curing the disease. To me, this signals an opportunity to create or re-purpose smarter GPS and geo-fencing apps (not just technologies) to prevent wandering, not just find those who are lost -- and while we're at it, let's see some studies that prove which ones work best and under what conditions. We're going to need them.
And how long before the iPad solves everything? Ah well, sigh, I guess it will be just a bit longer, judging from the Nielsen study noting that only 15% of iPad buyers are over age 56. I bet that even those (no demographics to prove) are not that much over, either. And will the smart phone be the remote monitoring and fall detection device of choice, meaning all others rest? Not in the near term -- seniors aren't buying or using them either. So for all those who ask about this -- I doubt it. Remember, Apple doesn't even want admit to marketing to baby boomers!. And carriers express interest and even dabble a bit here and there, but invest little or nothing in marketing. So in the meantime, keep on keeping on with solutions for the foreseeable future. When there's a big change, you can read it on this site early and often.
And for those who might be running around here and there like I will be in the fall -- look on the left side of the website at http://www.ageinplacetech.com for a list of events.
For any of you who are interested in aging in place technologies and who will be in the Boston area on September 23rd, Ankota helped organize a great event featuring Laurie. You can learn more and sign up at http://silvertsunami.eventbrite.com/.
Ankota provides software to improve the delivery of care outside the hospital. Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care. To learn more, please visit www.ankota.com or contact Ankota.
Posted by Ken Accardi on Mon, Aug 30, 2010 @ 12:39 PM
When people "follow" me on Twitter, I'm always interested to learn 
what they do and how it connects to our mission at Ankota. Last week, I was "followed" by Dr. Mary E. Jackson, whose twitter name is DrCares4Seniors. Dr. Jackson is a geriatric clinical pharmacist with 28 years of medical experience. Dr. Jackson just released a new book entitled Lower Prescription Costs: An Easier Pill To Swallow. The book is available on Amazon by clicking here or on the book cover.
A synopsis that Dr. Jackson shared with me is as follows:
- Exclusively focuses on medication costs
- Compares medications within a drug class including those available in $4 generic discount programs
- Includes a savings tips section for each drug class
- Designed for easy use (Dr. Jackson tried to make it as simple as possible since it is primarily for the elderly who may have cognitive impairment)
- Uses system similar to hotel & dining guides (e.g. $ = 0 to $25, $$ = $25 to $50, etc)
- Provides an example of a medication regimen, offering an alternative regimen that saves nearly 90% - $4,370 vs $470/year (and that's with Medicare D coverage).
Savings on medication costs is a huge opportunity for seniors, and with the help of Dr. Jackson's book, your home care nurses can provide a great service to your patients.
Ankota provides software to improve the delivery of care outside the hospital. Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care. To learn more, please visit www.ankota.com or contact Ankota.
Posted by Ken Accardi on Fri, Aug 27, 2010 @ 10:15 AM
Today's post is reprinted with permission from Home Health Care Today. Copyright 2010 Stephen C. Tweed. To receive a FREE subscription to this newsletter, log on to www.leadinghomecare.com.
Well, it's official. After five months of discussion, questions, 
debate, seminars, workshops and webinars, the bottom line is that Health Care Reform is here, it's huge, and it will have a major impact on all of health care in America. We've continued to study the law and monitor the development of regulations needed to implement the law. Here are a few things that have happened that may affect your home health agency, hospice, or private duty home care business.
The 1099 Rule
A little-noticed provision in the Patient Protection and Affordable Care Act is suddenly generating a lot of attention. The new rule requires all businesses to file 1099 forms if they purchase $600 or more in goods or services from another business during a year. While the rule was largely overlooked in the early analysis of the health-care law, a recent uproar has put it in the spotlight, and efforts are now under way in Congress to repeal the measure.
Formerly, only unincorporated businesses that purchased services greater than $600 in a year were required to file a 1099 with the Internal Revenue Service and with the provider. The new rule extends the requirement to all companies, charities, and state and local governments. It also expands the provision to include purchases of goods or products.
For example, if a business buys more than $600 in office supplies from Staples over the course of a year, it will now have to send a 1099 to Staples and file another one with the IRS. Or, if you buy an airplane ticket to fly to the NAHC convention and it costs more than $600, you'll need to get the taxpayer ID number for your airline, figure out where to send the 1099, and file a copy with the IRS.
We suspect that this provision of the law will be revised, as neither the Congress or the IRS fully understood the unintended consequences of this tiny provision in the law. I'm sure we'll find other provisions like this that have major unintended consequences.
American confidence in ability to pay for Healthcare declines.
Americans' confidence in their ability to pay for and access health care has fallen by 5 percent since December 2009, according to a Thomson Reuters poll of consumer confidence released Monday, (8/23/10).
The monthly survey questions 3,000 consumers about their ability to pay for health care. According to Reuters, "On every survey question, responses were more pessimistic in July than they were in December."
New York state now has an active Pre-existing Condition Insurance Plan (PCIP), the NY Bridge Plan.
In July, New York officials said they were hoping the New York PCIP program premiums would be less than $600 per month. The actual premiums will be just $362 per month in upstate counties and $421 per month in downstate counties, including counties in New York City, officials say.
The initial plan design includes a $20 office visit co-payment, a $500 co-payment per inpatient stay and a $100 emergency room co-payment, officials say. The package also includes pharmacy benefits and vision care benefits.
The NY Bridge Plan administrators will process applications on a first-come, first-service basis, officials say. The earliest coverage can take effect is October 1. Once the NY Bridge Plan reaches capacity, administrators will set up a waiting list.
The federal Affordable Care Act (ACA) - the legislative package that includes the Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act - allocated $5 billion to the PCIP to fill in coverage gaps that will exist before a ban on medical underwriting takes effect in 2014.
The PCIP program is supposed to provide "uninsurable" individuals access to coverage at rates comparable to individual rates in the commercial market. The program is open to individuals with serious pre-existing conditions who have been uninsured for at least 6 months. Some states are letting the new federal Office of Consumer Information and Insurance Oversight run their PCIP programs, but a majority will be running their own risk plans. New York is expecting to use $297 million in PCIP funding to provide temporary coverage for about.
Only two people enroll in New Jersey Plan.
New health plans for the sick and uninsured that became available as a result of federal health care reform have been slow to enroll patients: just two people in New Jersey will begin receiving coverage today, the first day the plans take effect.
Called NJ Protect, the health plans are available to people who have been without insurance for at least six months and submit evidence of pre-existing health conditions, such as diabetes, hypertension or cancer. New Jersey is to receive $141 million in federal subsidies to cover claims that exceed the premiums paid by the beneficiaries.
Most small businesses in California qualify for Tax Credit.
Garnering little to no press attention when released in July, a report undertaken by Families USA and the Small Business Majority found that 80 percent of California's small businesses with 25 or fewer employees will qualify for federal tax credits under the Patient Protection and Affordable Care Act starting this year.
This means that of the state's 571,200 small businesses, 465,500 are eligible for the tax credits in 2010. Of those, 30 percent - or 135,900 - qualify for the maximum tax credit amount.
Stay tuned to Home Health Care Today and Private Duty Today for more new developments in the implementation of the Patient Protection and Affordable Care Act.
Ankota provides software to improve the delivery of care outside the hospital. Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care. To learn more, please visit www.ankota.com or contact Ankota.
Posted by Ken Accardi on Tue, Aug 24, 2010 @ 07:28 AM
Non-Medical Home Monitoring Technology is starting to get media attention as distant Family Members search for better and more affordable ways ways to track how mom and/or dad are doing.
We've been following great stories about these trends in the New York Times, the Wall Street Journal, Laurie Orlov's Aging in Place Technology Watch and Time Rowan's Home Care Technology Report. If you want to get quickly up to speed, review these two posts:
This week more coverage is available, this time as a four part series on NPR. The first article spoke about the emergence of "Villages" like Beacon Hill Village and a rapidly growing list of others that are essentially support groups to help with aging in place. The next two, talk about non-medical remote monitoring technologies. Here's a link to today's article (which has links to the first two in the series). You can also access it by clicking on the picture below.
So now that we've established that this technology is out there, the question we need to answer is whether it poses a threat to our home care private duty agency or an opportunity? The pessimist would say it's a threat - that families are working around us. But the smart entrepreneurial agency sees this as an opportunity, and a way to provide differentiating service to win more business. Here's a specific idea for you:
- Offer a service to evaluate for a home monitoring system. Your evaluation can evaluate how the client is doing, check for safety issues in the home, and determine what monitors would make sense for this client and their family. (To learn more about the monitors available, check out the demo videos at www.beclose.com). Note that you generally provide this service for free to a prospective client - in this case you can charge.
- Install the System and Train the Family: It is guaranteed that someone in your caregiver community has a spouse or friend who can do a great job providing this installation service. You can charge a nice margin here.
- Couple it with a short weekly visit and an assessment using Ankota FamilyConnect: This technology makes it easy for you to let the remote family members know how their loved one is doing. learn more here.
- Grow with the Client: The above three items will be a great service to the client and their family, and will make you some money. But looking at the bigger picture, you've also gained a client and family who will turn to you when they need more help.
Ankota provides software to improve the delivery of care outside the hospital. Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care. To learn more, please visit www.ankota.com or contact Ankota.
Posted by Ken Accardi on Tue, Aug 10, 2010 @ 05:04 PM
When discussing home care technology, this blog is on the leading edge, but unfortunately on the subject of nutrition, I often find myself behind the curve. So writing about nutrition is intended not just for our healthy caregivers initiative, but for self-learning too.
Recently there's been a lot of talk about which is the best 
antioxidant. Is it the wild blue-berry or the red bean? But nobody explains why it matters. So here it is in simple English... Antioxidants help prevent your cells from dying. This means that they can help prevent or delay cancer, heart disease and some effects of aging. Pretty big deal! When cells oxidize (as an aside, rust is a form of oxidization) they release free radicals that are able to cause more oxidization thus leading to a chain reaction. The antioxidants combat this by being oxidized themselves and in the process they remove the harmful free radicals.
There are lots of debates about what the best antioxidant is. Some studies have touted rare and specialty items like Abut it doesn't really matter which is absolutely the best. The important thing is to be aware of the types of foods that provide antioxidants and figure out how to incorporate more into your diets and the diets of the people for whom you provide care. My nutritionist friend KC Hayes recently forwarded me a scholarly article concluding that many affordable berries like strawberries, blueberries and red raspberries may prevent cancer just as well as those in studies (early studies used black raspberries). Here's a link to the story (from the Ohio State University Medical Center). And as you'll remember, KC is a phenomenal photographer so here's one of his recent photos that he shared.
My wife's favorite choice for incorporating antioxidants into her diet is to drink a glass of red wine daily (and here's an article from the Mayo Clinic website backing her up). I think I'll go get her one now...
Ankota provides software to improve the delivery of care outside the hospital. Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care. To learn more, please visit www.ankota.com or contact Ankota.
Posted by Ken Accardi on Thu, Aug 05, 2010 @ 07:25 AM
The conversation on telehealth has shifted quickly... Just one year ago the question was "does Telehealth deliver value?" Over a very short period of time and backed by many studies showing positive results, the question of the value of telehealth seems to have been answered with a resounding yes... Now the question is "Who should 'do' telehealth?" What I mean by who should 'do' it, is the following:
- Who should make the case to an individual patient/client about the value of telehealth for their situation?
- Who should buy and own the Telehealth unit?
- Who should perform the monitoring and follow up?
It would seem that home care agencies would be very well equiped to do telehealth, but there are other contenders - most notably hospitals/doctors and families.
One of my favorite bloggers, Tim Rowan from HCTR (Home Care 
Technology Report at www.homecaretechreport.com) wants homecare to do telehealth. He has been evangelizing telehealth as a primary focus in his writing for over a year. But more recently, Tim has been cautioning and lamenting that market forces (specifically telehealth device manufacturers) aren't bothering to target home care. They're having more success with hospitals and families. See specifically this weeks feature article entitled "With or Without Home Care Agency Involvement, Remote Patient Monitoring Moves Into Consumers' Consciousness" at this link.
We've been trying to do our part to educate the home care market 
on telehealth as well and I'd direct your attention to Will Hicklen's article "Telehealth, Home Monitoring and Home Care Business" and my follow up "Telehealth, Home Monitoring and Home Care Business - Part II".
The core issue here comes down not to who will "do" telehealth, but rather who will pay for it. For an interesting take on this, I'd highly encourage you to look at the post "Healthcare Reform without Permission - A Recipe" inspired by a presentation by Dr. Randall S. Moore who is president of American Telecare - a maker of telehealth devices. Dr. Moore compells us to focus on the 
value (savings) delivered by Telehealth and to collaborate with the effected players to find the money (e.g., if care for a CHF patient will cost $15K less per year with Telehealth than without, then the insurance company would be silly not to pay for the telehealth).
So presuming that you want your home health or private duty agency to do telehealth, what should you do about it? Here are a couple of thoughts:
- If you're in home health, you can go to the hospitals, doctors and insurance companies and make the case that you can do it better and cheaper.
- If you're in private care, you might grow your business significantly by helping families get started with telehealth early (this way, as care needs increase you'll be the obvious choice to fill the gap)
- In either case, waiting for CMS to come forth with "we'll pay you if you do this" isn't going to put you in a leadership position
Ankota provides software to improve the delivery of care outside the hospital. Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care. To learn more, please visit www.ankota.com or contact Ankota.
Posted by Ken Accardi on Wed, Aug 04, 2010 @ 07:19 AM
As we grow Ankota's business, I try to read a lot about successful 
growing businesses and apply their lessons. Today I read a compelling article about Brightstar, a Chicago-based home care franchise, and some lessons learned by their CEO Shelly Sun. As always I encourage you to read the original article, but here are some of the highlights:
- A survey taught them things that the numbers didn't reveal: In this case they learned that franchisees were unhappy
- Listening to Customers yielded Great Results: In this case the customers were franchisees, but we can all learn through customer feedback (good and bad)
- Less is More: By sponsoring less initiatives but doing them very well, the company improved satisfaction.
- Growth is not Good Enough: Home care is a rapidly growing market, so doing better than last year might mean that you're still losing pace and losing share. In Brightstar's case they're on pace to grown from $51M in 2009 to $115M in 2010 - over 100% growth.
- Improving the Technology yields strong Returns: One area where Brightree gained success and satisfaction from their franchises was in the technology improvement initiatives.
Whether you run a large or small home care business, there are things to learn from Brightstar's course corrections and the positive results they've yielded.
Note that if you enjoyed this post, you might also enjoy this story, inspired by Pat Drea, COO of Visiting angels.
Ankota provides software to improve the delivery of care outside the hospital. Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care. To learn more, please visit www.ankota.com or contact Ankota.
Posted by Ken Accardi on Mon, Aug 02, 2010 @ 08:59 AM
Will Hicklen's blog article "Telehealth, Home Monitoring and Home Care Business" from July 7th attracted a lot of attention as he shared compelling results from a 4.5 year unbiased Veteran's Administration study showing tremendous savings from Home Telehealth. Home care technology analyst and pioneer Tim Rowan has been ahead of the curve and evangelizing about this topic as his main message since launching HomeCareTechReport a year ago, and now even the mainstream media is catching on - both the New York Times and the Wall Street Journal have featured pieces on home telehealth in the past weeks, interestingly however one focused on remote monitoring by healthcare professionals, while the other focused on remote monitoring by family members. Let's explore...
The Wall Street Journal Article, entitled "The Do-It-Yourself House 
Call", by Avery Johnson on July 27th looks at the case for telehealth monitoring of Congestive Heart Failure (CHF) patients. CHF has been the issue of choice in many initial studies of the value of home telehealth and rightly so, because the value can be measured in significant savings and significantly improved patient quality of life. This particular article focuses on "phase II" where the remote devices include a wireless scale and a wireless blood pressure cuff, making the patient experience easier and more comfortable. Click on the image below to read the full article.
The New York Times story, entitled "Technologies Help Adult Children Monitor Aging Parents" (July 28th by Hillary Stout) talks 
about families keeping better track of their loved ones using remote monitoring technologies. This further validates that family members are looking for better ways to stay in touch with their aging loved ones. This same trend is what inspired Ankota to offer FamilyConnect, which enables agencies to communicate more effectively to the families of those for whom you provide care. Click on the image below to learn more about FamilyConnect.
Ankota provides software to improve the delivery of care outside the hospital. Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care. To learn more, please visit www.ankota.com or contact Ankota.
Posted by Ken Accardi on Fri, Jul 30, 2010 @ 07:25 AM
Daniel H. Pink is the author of four provocative books about the changing world of work — including the New York Times bestsellers, A Whole New Mind and Drive, which together have been translated into 28 languages. His research and books are about motivation, and more specifically about debunking the conventional wisdom that money is the best motivator. Instead, he creates a compelling case that the most important motivators are as follows:
- Autonomy - the urge to direct our own lives
- Mastery - the desire to get better at something that matters
- Purpose - The yearning to contribure to something larger than ourselves
If these are the motivators, than we can understand clearly why Home Care can be a fantastic profession.
Dan lays out a fairly compelling set of proof of his argument including the results of scientific experiments and real world examples. One example he uses is about online encyclopedias where he compares and contrasts Microsoft's Encarta - a well managed initiative with pay bonus and incentives, with Wikipedia - an encyclopedia that you contribute to if you're passionate about it and for which you receive no compensation. In Dan's words, "Ten years ago, no sober economist would have predicted that Wikipedia would beat out Encarta", but as we know, it did.
This first video is my favorite of the two. While Dan speaks, a cartoon animator depicts his story. It's 10 minutes long and you can see it by clicking on the picture below.
The second version is a stage presentation given by Dan which is 18 minutes below.
Ankota provides software to improve the delivery of care outside the hospital. Today Ankota services home health, private duty care, DME Delivery, RT, Physical Therapy and Home Infusion organizations, and is interested in helping to efficiently manage other forms of care. To learn more, please visit www.ankota.com or contact Ankota.