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 Thu, Sep 02, 2010 @ 04:35 PM
We love planning, and scheduling! We love to be organized and efficient! We pride ourselves on being in control! But we don't always get to dictate how things are going to run in our home care operations - sometimes mother nature has the last word. With Hurricane Earl running its course, it's good to prepare for home care in a hurricane...
(phote courtesy of National Geographic web site)
Here are some ways you can plan and respond for the hurricane:
- Be Proactive in Your Agency: Are there weekly visits in your plan that can be pulled ahead to avoid the heavy weather days? Are there other routine tasks like creating next month's schedule or preparing your payroll that can be done now? Do them!
- Help Your Clients be Proactive: Can you get the groceries earlier than normal? Can you make sure that your client has water, blankets, prescriptions filled, easy to eat food, a movie rented? Help them be prepared and avoid strife when the storm hits.
- Can you provide additional Services?: Do the patients or clients you care for need help with their storm shutters or making sure that their sump pump is plugged in and ready to go? Given that they need your services for medical care or help with other ADLs, there's a good chance that
- Don't start what you can't finish: If your patient is due for a 48 hour chemo infusion to go from Thursday through Saturday and the storm is supposed to be heaviest in your area on Saturday, you might want to rethink. Once you start that treatment, you're commiting that you'll be there within a 4 hour window on Saturday to turn it off. So think twice!
- Set Priorities and Back-up Plans: If you can't get to everyone in the height of the storm, know which patients are urgent and which can wait. Know who has a backup plan for ther care and who doesn't.
Hopefully you the storm will be mild when it gets to you, but if you follow the above steps, you'll be prepared for the worst. The projected path of the storm is below. Will you be ready?
As you go through this process and "weather this storm" I'd also challenge you to see if your software is helping you during the storm or just getting in your way. Can you reschedule visits easily? Can you update your worker's shifts? Can you visualize which caregivers live near which patients? If not and you're ready for an upgrade, be sure to let us know!
Related articles you might be interested in:
- Managing Home Care in a Blizzard here
- Maximizing the Value of your agency software here
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 Will Hicklen on Tue, Aug 24, 2010 @ 02:09 PM
I saw a thought provoking piece about elder mediation and home care, posted on LinkedIn this morning by Rob McClenehan of Right At Home. If you are a member of LinkedIn, you can read his post here, and perhaps also join the Home Health & Hospice Group.
The topic of elder mediation is probably most relevant to our Home Health Care and Private Duty customers, but our Infusion, Respiratory Therapy and Rehab customers might also find it useful. If you are one of these companies, take a look and consider what role elder mediation might play in the future of your clients.
Rob referenced an article called Elder Mediation by Angel Carl, which you can read here on Right At Home’s blog. Right At Home credits an article by Georgia Daniels of Mediate.com. Ms. Daniels is a family mediator and author in Pasadena, CA. From Right At Home’s blog, the article begins:
Eldercare mediation is a growing field that will increase in prominence as the number of elders increases. As parents age, conflicts can erupt between parents and their children over living situations, driving, or the need for more help with daily activities. In addition, conflicts may spring up between siblings about their parents’ aging, such as when it is time for more in-home care, assisted living, or which sibling is responsible for what aspects of a parent’s care. Mediation can also address more complex issues such as estate planning and inheritance or health care choices, and may be used to develop alternatives to conservatorship. Mediation offers an opportunity to explore options and develop the best plan possible for the elder and family. More…
The Role of Home Health and Private Duty Providers
After you have a good plan that the parties support--and a good mediator will help guide you through the planning--the follow through makes it successful. In addition to providing quality care, home care providers can help with this by providing clear and consistent communications on a regular basis. When families feel engaged and informed, tension is mitigated and caregivers can focus their efforts on their client. It's a better result for everyone. Family communications are simple & inexpensive to manage using existing technology. Ankota's FamilyConnect is an example of one simple way to do this. http://www.ankota.com/ankota-family-connect/
As a provider, you might also consider establishing relationships with elder mediators in your area. If the need arises with one of your clients, you will be in a better position to refer to someone confidently. Who knows, some mediators could even develop into referral sources for your business.
The topic of elder mediation continues to gain attention. Click on these images to learn more:
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 Will Hicklen on Wed, Aug 18, 2010 @ 12:01 PM
Let's think about PRODUCTIVITY – arguably the single greatest opportunity for your business today.
Ankota is first and foremost a process management company. We develop technology that helps organizations run their Home Health Care and related businesses more efficiently. More profitably. More productively.
What we do is revolutionary because we're the only company that has organized health care into a delivery model and optimized it for performance. That takes some high-powered technology, but all you really need to know at the moment is that it helps you run your business better and achieve immediate results.
Our customers include home health care agencies, HME and DME companies, Private Duty care agencies, and "the therapies" - infusion therapy, physical therapy, occupational therapy, respiratory therapy, and more. If you need to mobilize staff, equipment, medications, and supplies for health care, we’re the experts you trust to help optimize your business.
I would argue that the single greatest business opportunity before these companies--companies like yours--lies with improving productivity. The greatest opportunity to improve profitability lies with better utilizing staff and resources. Relative to other markets, this business has traditionally lacked a performance culture. The market has not demanded it until now, with new pressures on revenues, limited staff, and the ever increasing costs of doing business. The most immediate option is to improve productivity. That is, generate more output with the same or fewer resources. The good news is that there are many opportunities for immediate improvement, spanning from reduction in miles driven to increased utilization of staff and equipment. Downstream benefits abound, such as reduced paperwork, improved record keeping and accountability, happier staff, and so on.
We’ll discuss several of those in subsequent articles here. However, for now, your homework is simple. I’d like to encourage you to think of your Home Health Care, DME, Private Duty or rehab business in terms of productivity. Take a look at the following definition of PRODUCTIVITY and begin to consider it in the context of your business. When you examine your operations or consider new initiatives, consider also how it will impact productivity.
Note that I am not suggesting that quality of care be compromised at all! In fact, quality of care should improve or remain constant to make productivity improvements measurable and valuable. A business with a performance minded culture is one focused on constant improvement. So, while you think about PRODUCTIVITY and your business, think of it in the context of questions like
“How can we improve the consistency of care?”
“Will clients/patients and their families be better off?”
Wikipedia has a clear definition of the word PRODUCTIVITY and includes some great supporting data. Take a look and start to think about productivity in your business.
Productivity is a measure of output from a production process, per unit of input. For example, labor productivity is typically measured as a ratio of output per labor-hour, an input. Productivity may be conceived of as a metric of the technical or engineering efficiency of production. As such, the emphasis is on quantitative metrics of input, and sometimes output. Productivity is distinct from metrics of allocative efficiency, which take into account both the monetary value (price) of what is produced and the cost of inputs used, and also distinct from metrics of profitability, which address the difference between the revenues obtained from output and the expense associated with consumption of inputs.[1] click here for full article in Wikipedia
Another way to look at it... Borrowed from Accel, experts in team productivity, The Productivity Conceptual Modelbelow, takes the form of a 'productivity tree'. The roots denote the inputs to the system, the trunk the conversion process and the foliage and fruits the systems outputs. click on graphic to go to Accel's web site
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, Jul 19, 2010 @ 07:03 AM
Over the past few years, I've gotten to know a very nice and 
interesting gentleman named KC Hayes. KC is a PHD Nutritionist and a professor at Brandeis University. One of KC's claims to fame is that he invented the concept for the product "Smart Balance" which is a buttery spread that helps to balance cholesterol. KC is also a highly accomplished photographer and shares his photography, usually once a week with people on an email distribution list that he maintains. His photography also contains inspirational messages that he shares to encourage his friends and former students.
I'll need to do a few posts to adequately cover some of the nutrition advice that I've learned from KC, but here as a starter is a high level list of good advice that he has shared:
- Take a multi-vitamin and also supplement it with Vitamin D (4,000 mg a day in winter and 2,000 mg in the summer)
- Eat Smart Balance to eliminate the trans fats that come in man-made oils and balance your cholesterol
- By ingesting plant sterols with your other foods, you can block bad cholesterol from being absorbed into your system (more detail below).
- Eat berries! Berries contain anti-oxidents that keep your cells healthy and can prevent cancer
Following up on the plant sterols mentioned above, one way to get these sterols into your system is to buy Corozonas tortilla chips which are delicious and help balance your cholesterol. Note, that you need to eat the chips with your other meal (because the sterols need to be in your system during digestion). It is likely the case that if you eat 3 Corozonas chips with each meal that you can bring your cholesterol to ideal levels without medication like statins. KC also told me about a soy milk product that lowers cholesterol and he's currently working on a study that gives you cholesterol reducing benefits in a small cookie.
As a final bonus, here's a sample of KC's photography:
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 Marc Ottinger on Thu, Jul 15, 2010 @ 08:51 PM
Question -
When all is said and done what is the impact of Operational Excellence?
Summary
Today we operate in unsettled times. What will the impact of the Healthcare Bill be? History tells us in period of instability positive change results. The high-performance businesses, those that have put a premium on operational excellence, will excel and gain customers and as a result market share. For those companies that are stumbling during these difficult times, it is an opportunity to look at business processes and put in place operational excellence initiatives. Either way to achieve it takes management vision, commitment, and investment.
The focus of this series has been that high performance businesses put a premium on operational excellence. Below graphically depicts the average Return on Invested Capital (ROIC) between companies using operational excellence to excel and that of the Followers. Investing in operational excellence has great rewards.
The installments have been the five characteristic of operational excellence. These characteristics are –
1st – Identifying the “Dominant Vector.”
Revisit this characteristic by scrolling down to the July 9th blog post.
2nd – Establishing a structure to that creates an advantage.
Revisit this characteristic by scrolling down to the July 11th blog post.
3rd – Out-Executing other Home Care Providers.
Revisit this characteristic by scrolling down to the July 12th blog post.
4th – Maintaining the Balancing Act for success.
Revisit this characteristic by scrolling down to the July 13th blog post.
5th – Addressing the Journey to ensure success.
Revisit this characteristic by scrolling down to the July 14th blog post.
It is time to put in place Operational Excellence Initiatives and take advantage of instability.
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.