Posted by Will Hicklen on Wed, Sep 01, 2010 @ 12:55 PM
I usually leave this type of information to the Home Care Software Geek to report on, but some news is just too good not to pass along right away.
You can now get Blackberry Enterprise Server Express for free.
So what? Well, let me first say that we are not taking a position on one mobile device vs another. We at Ankota like to profess that we are device agnostic, choosing instead to make even our most advanced technology available via web browsers and common mobile devices that our customers have readily available. Frankly, we don’t want to force new infrastructure or hardware requirements on our customers. That just wouldn’t be efficient...and those of you who know Ankota know that we are efficiency zealots.
A more pragmatic description of our position is that we are in favor of anything that helps mobilize technology for our customers and does so securely, productively, and affordably. Blackberries have proven to be excellent mobile devices for many of our customers. Our customers include Home Health, DME, Private Duty, Infusion, Respiratory Therapy and other companies that we say make up the “Homecare Ecosystem.” In the past, the cost of purchasing mobile devices like this (& their service plans) has been a deterrent to many. As devices and plans continue to get cheaper, more and more of our customers will buy them. This announcement helps make it cheaper and easier for our customers to manage their mobile staff and their Blackberries.
Blackberry Enterprise Server Express synchronizes wirelessly with Microsoft Exchange, calendars, contacts, and provides remote file access & access to your intranet. It will run on your existing mail server whether you run that yourself or have that managed for you by another company.
Of course, schedules, calendars, POC forms, and even optimized route plans created in Ankota HDM can be pushed to Blackberry devices in real time. You can still utilize Ankota's telephony interface as you would with any other mobile phone.
Click on this image to view key features:
Ankota provides software to improve the delivery of care outside of 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 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 Mon, Jul 26, 2010 @ 07:41 AM
One of the bloggers I enjoy is a guy named Seth Godin. He has a great skill for making a compelling point in just a few words. Often when I share an article or research with you, I try to give an executive summary or perhaps share a few of the most compelling key points, but in this case I share the full article with all credit (and links) to Seth Godin's blog.
A hierarchy of failure worth following
Not all failures are the same. Here are five kinds, from frequency = good all the way to please-don't!
FAIL OFTEN: Ideas that challenge the status quo. Proposals. Brainstorms. Concepts that open doors.
FAIL FREQUENTLY: Prototypes. Spreadsheets. Sample ads and copy.
FAIL OCCASIONALLY: Working mockups. Playtesting sessions. Board meetings.
FAIL RARELY: Interactions with small groups of actual users and customers.
FAIL NEVER: Keeping promises to your constituents.
The thing is, in their rush to play it safe and then their urgency to salvage everything in the face of an emergency, most organizations do precisely the opposite. They throw their customers or their people under the bus ("we had no choice") but rarely take the pro-active steps necessary to fail quietly, and often, in private, in advance, when there's still time to make things better.
Better to have a difficult conversation now than a failed customer interaction later.
As we at Ankota strive to innovate, we're never afraid to make mistakes early in the process so that we can get things right when we make promises to our customers and to the industry. And as we've shared, we are dedicated to working with the industry to pioneer new and better ways to deliver care. If you have some ideas and want to partner with a software company that enables your innovation rather than slows you down, let us know - even if you're afraid that your innovation might fail.
Social Media note: In the world of blogging, it is generally acceptable to borrow from articles and blogs of others, but the key is to give credit and provide links into the originating blog. When I borrow from another home care blog, I get permission first, but in the case of a large blog like Seth Godin's blog, I just go for it - making sure to give credit. It's like a "retweet" but bigger.
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, Jul 20, 2010 @ 08:48 AM
According to this new article in the Harvard Business Review blog, 
there's a quiet revolution unfolding in many industries. We may be completely unaware of it because we can't see it in the streets, nor watch it on the news. This new revolution is actually happening inside the heads of the leaders running your rival firms. We would be wise to presume that home care, private duty care, DME and other forms of care delivery outside of the hospital are part of this revolution.
The article goes on to explain that "reframing" the market or industry is the key to unleashing this disruptive innovation. Examples are given of three leaders and industries where this is going on, including at PepsiCo (where they are starting to think about nourishing people rather than feeding them), at GE Healthcare (where they are launching the "More for Less for More" initiative MLM), and at Tata in India (where they are conceiving the $2,500 car).
The above examples might not apply directly to our plight in care delivery, but it goes to show that the movement is widespread.
The key behaviors described in the article are as follows:
- Reframers dare to question well-ingrained business truisms and industry paradigms
- Reframers think not only with their minds but also with their hearts
- Reframers catalyze massive social innovation
To prove that this reframing and innovation is happening in home care, we don't need to look any further than our own blog. Some of the mini-revolutions we're observing are captured in these articles:
So the bottom line is that this is not the time to be complacent, and we can't always define what we do based on what we've always done in the past...
If you're innovating in home care delivery and you're software isn't keeping up, perhaps Ankota can help. Please contact us!
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.
Posted by Marc Ottinger on Wed, Jul 14, 2010 @ 09:35 PM
Question -
What journey have you chosen to achieve Operational Excellence in your Home Care Agency?
Preface
This fifth characteristic may be the most difficult, because it is about leadership. Why? Without leadership the competitive advantage goes away and the associated cash benefits do as well. Without leadership operational excellence and the opportunity to increase quality, reliability, flexibility, speed, and customer value tend to flash away. This is the fifth of six blog posts hiliting the five characteristics that facilitate operational excellence.
Creating Operational Excellence
Remember the big picture of operational excellence: Is the business set up to achieve established goals and is the work organized and executed. This is the fifth and final characteristic that facilitates this operational excellence -
5. Choose the right journey; meaning know were you plan on taking your company. How you choose will have significant bearing on your companies future positioning. In theory one journey will be most appropriate for your company’s culture; however, in practice market complexities, customers, etc, mean there could be different approaches.
The focus of this series is that high performance businesses put a premium on operational excellence. The installments have been –
1st – Identifying the “Dominant Vector.”
2nd – Establishing a structure to that creates an advantage.
3rd – Out-Executing other Home Care Providers.
4th – Maintaining the Balancing Act for success.
This fifth installment addresses the journey to ensure success of your Home Care Agency. To learn about this Characteristics of Operational Excellence click 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 Marc Ottinger on Tue, Jul 13, 2010 @ 09:57 PM
Question -
What in the balancing act you need to execute to ensure the success of your Home Care Agency?
Preface
You have your “dominant vector,” the structure to support it, and you are out-executing all your competitors. Now comes, shall we say …, the tight rope of high performance businesses with operational excellence. This needs to be carefully walked to maintain a competitive advantage and generate the associated cash benefits. In today’s difficult economic times operational excellence offers the opportunity to increase quality, reliability, flexibility, speed, and customer value. This is the fourth of six blog posts hiliting the five characteristics that facilitate operational excellence.
Creating Operational Excellence
Looking at the big picture of how the business is set up to achieve the established goals, and how work is organized and executed may have the most impact on this the fourth of the five characteristic focuses. This is the Feng Shui to facilitate operational excellence -
4. Balance structure and execution by identifying and articulating that “dominant vector.” The real challenge comes in determining that balance between structure and execution. Companies need equilibrium. Companies that focus to heavily on execution develop processes that create quality and productivity, but sometimes not customer value. While companies that underplay structural advantage lack agility and resource flexibility to respond to rapidly changing market opportunities.
The focus of this series is that high performance businesses put a premium on operational excellence. The installments have been –
1st - Identifying your "Dominant Vector."
2nd - Points out the need to establish a structure to that creates an advantage.
3rd – Out-Executing other Home Care Providers. The link for this is http://bit.ly/9dFRw8.
This fourth installment addresses the balancing act to ensure success of your Home Care Agency.
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 Mon, Jul 12, 2010 @ 10:23 PM
Question -
Do you have the understanding, drive, and alignment to out-execute Home Care Competitors?
Preface
Now your “dominant vector” has been identified and the correct structure is in place to ensure execution; however, you can not just go through the motions of execution to have operational excellence. Why? Going through the motions does not create a competitive advantage nor does it generate the true potential cash benefits. This is the third of six blog posts hiliting the five characteristics that facilitate operational excellence.
Creating Operational Excellence
There is a reason for the saying, “You can not see the forest for the trees.” You are in the trenches and cannot see the big picture of how the business is set to achieve the established goals, and how is the work organized and executed. This third characteristic is the most dynamic one to ensure operational excellence -
- Seek to out-execute competitors by simplifying, standardizing, and the eliminating waste, which includes wasted time. Emphasis needs to be on executing correct business processes to achieve significant and measurable performance improvements by improving flexibility, speed, quality, reliability, and customer value. Those companies that out-execute rivals –
- Understand what customers’ value and what customers are willing to pay.
- Drive asset productivity, using return on invested capital to guide value creation for the customer.
- Stress process excellence.
- Ensure close alignment of business strategy, goals, metrics/measurement, and initiatives. Remember you can not improve what you can not measure.
The focus of this series is that high performance businesses put a premium on operational excellence. The first installment in creating operational excellence was identifying your company’s “dominant vector. The second points out the need to establish a structure to that creates an advantage. The link for this is http://bit.ly/bsjKp8.
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.