The Ankota Healthcare Delivery Management Blog

Developing Leadership in Home Health Care, DME & Related Companies

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Now, on to today’s post about Leadership…

A couple of great pieces on the topic of Leadership hit my inbox today and I thought I would pass them along. Rather than analyzing or summarizing each, I will tell you what I like about the article or the site and provide the link so you can read it directly. Enjoy!

 

 

1)      10 Things Good Managers Believe  on bNet, by Steve Tobak, a well known business strategist and executive coach. bNet is part of the CBS interactive business network, focused on business issues that Home Health Care, DME, Infusion, RT and other home care related companies might find very useful.

 

 

 

2)      Tobak’s article draws from another piece that I really like, 12 Things Good Bosses Believe, by Robert Sutton. Sutton writes on leadership for Harvard Business Review and is the author of books such as his newly released Good Boss, Bad Boss (click on the book cover below to see on Amazon.com)

 

 

 

3)      Leadership & Perfectionism, by Mike Myatt, Chief Strategy Officer for N2growth. Myatt poignantly acknowledges, “This may be difficult for some to get their heads around, but perfectionism is not a leadership trait.” My natural tendency is to be a bit of a perfectionist in business, but I am much more effective and accomplish more when I’m not. Maybe you are the same way. Either way, this piece might provoke some thought.

 

Elder Care Tips from CNN Money Magazine and Ankota

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.

 

Blackberry & Home Care Businesses

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.

 

Growing Use of Elder Mediation in Home Health Care

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:

 

 

 

 

Productivity in Home Health Care, DME & Therapy businesses

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

 

 

Brightree Buys CAU: Consolidation in DME Software

Brightree’s acquisition of CAU should surprise no one. See full HME News story here

CEO Dave Cormack said it clearly, “Their customer base is right in the sweet spot of our customer base.” Cormack wants to grow by acquisition, consolidate his customer base with others, and expand his services. It is a wise strategy. Other industries have followed this path, and quite frankly, it’s about time that DME & other businesses in the home health care ecosystem do the same. 

Consolidation among DME providers will drive a similar consolidation among the companies that develop technology for them. Simply put, there will be fewer deals for the software companies to win. The ones that win will be those that provide the highest business value at the most compelling price, and deliver it in a model that is easy to implement & use. Even so, compared to other industries, DME is still highly fragmented. Just as there are many DME providers, so too are there many software companies selling to them, and none with a dominant market position. That is the definition of a market ripe for consolidation and it is still anyone’s market to win in DME. It will likely take a few years to settle.

So how will this go? The industry has focused long and hard on improving billing practices and decreasing the time it takes to get reimbursed. Companies like Brightree and Care Centric have built businesses that include both billing-related software and actual billing services. The next great opportunity is in using technology to increase business productivity. DME has seen little in the way of productivity improvement in recent years and has suffered through decreasing reimbursements while energy and labor costs continue to rise.

Resource and staff utilization is inefficient in DME, relative to other industries. For example, research conducted by Ankota, Inc. indicates that DME providers can cut operating costs such as mileage and fuel expenses by 25-35% immediately, simply through better scheduling and route planning. The same applies to home health care, respiratory therapy, rehab, and others that depend on home delivery and mobile workforces. Further, the addition of real time, mobile technologies and practices known in other industries as business performance management (BPM) will allow them to better model capacity and use it more efficiently. Technology can improve tracking and accountability, reduce mileage, eliminate paperwork, and improve quality.

The immediate business benefits include more deliveries in less time and at lower costs. Higher revenue. Lower marginal costs. That sounds simple, right? 

The software companies that help DME companies actually run their businesses better and more profitably will be the ones that win. If you are a DME company, make software companies prove that they can reduce your operating costs and improve productivity. You should be able to tell whether they have expertise in business performance management and they should be able to prove it.

Those are the ones you can bet on.

Telehealth, Home Monitoring and Home Care Business

In a related piece, the Veterans Administration Proves Home Telehealth Works for Everyone—Payors, Providers, and Patients. From Tim Rowan’s Home Care Technology Report (11/17/09): Titled "Care Coordination/Home Telehealth: The Systematic Implementation of Health Informatics, Home Telehealth, and Disease Management to Support the Care of Veteran Patients with Chronic Conditions," a report detailing results of a four and a half year study should be required reading for every home care agency owner, every clinician and especially every state and federal lobbyist. It declares without bias and without vendor influence that use of home telehealth systems had the following measurable effects for 17,025 patients over nearly five years:

1. Reduced bed days of care by 25%
2. Reduced number of hospital admissions by 19%
3. Added $1,600 per annum cost to per patient average of $13,121 for home-based care
4. Avoided $77,745 annual nursing home costs with this $14,721 investment

The paper’s onerous title notwithstanding, the lessons from the VA’s success are clear. A proactive program of home-based care and monitoring that allows the patient to spend more time at home results in

Fewer hospitalizations

Less time per visit in the hospital

Lower overall healthcare delivery costs

 

Ankota is not a telehealth company (we develop Healthcare Delivery Management or HDM technology that helps home care businesses better coordinate and utilize staff while cutting operating costs). However, telehealth and home monitoring technologies have been proven to be valuable tools in managing care at home. This VA report is the most comprehensive ever published on the topic, and provides compelling data that will certainly help advance adoption.

Without question, these technologies will be an important part of the home care ecosystem, which includes providers in Home Health Care, Private Duty Home Care, Respiratory Therapy, Home Infusion, DME and other companies that provide staff, equipment and supplies to support patients in the home.

From a simple economic perspective, these technologies offer the opportunity to scale various home care services with less overhead and infrastructure costs such as staff and travel time. In an industry that desperately needs to increase staff utilization and efficiencies, and fuel growth, this is a welcome development.

A few things to consider: As Home Health, Private Duty, and Respiratory Therapy companies—Ankota’s customers—add telehealth and home monitoring services, they should expect that this will also require some new management discipline and add complexity to their businesses. Consider that providers will have to coordinate delivery, implementation, service, and recovery or disposal of equipment in addition to providing or provisioning monitoring services. This brings a component of physical distribution that must be managed, much like a DME company faces today. Staff, delivery and fuel expenses can be optimized through HDM technology like Ankota’s. Consider also that, as these devices proliferate, so will the need to "monitor the monitors." New skills will be needed and new processes managed. Expect command and control interfaces to emerge that allow providers to aggregate disparate monitoring technologies, manage responses, and assign staff for follow up based on established best practices.

Telehealth and home monitoring technologies have been proven effective and present new business opportunities for providers. The benefits to patients and healthcare delivery models will be considerable, but will also require a disciplined approach to process management. Look for tools to help do this job more efficiently.

Related Links

Click here for Tim Rowan’s Home Care Technology Report

BeClose (Vienna, VA) Remote home monitoring, elegant simplicity for family members to monitor home activity. There is a good report on this on the Aging In Place Technology Watch website

Honeywell Hommed One of the better established telehealth companies

GE-Intel related article: http://futureofaging.aahsa.org/2009/04/intel-ge-team-to-develop-telehealth-technology/

Cariocom download a white paper titled "Ten Steps to Building a Successful Telehealth Program"

What I've Learned from Ankota CFO/COO Marc Ottinger

As Ankota has grown, many of our customers, prospects and blog readers have come to know the story of our origin.  Our CEO, Will Hicklen, was inspired by the tragic loss of his wife Sandy to cancer.  This drove him to want to improve the delivery of home care.  Will brings his experience with supply chain management and Software-as-a-Service to home care.  You've also come to know the inspiration of Hunter Young, MD and Ken Accardi to our product vision, or perhaps you've enjoyed Ken's "Home Care Software Geek" posts.

Our other co-founder, COO/CFO Marc Ottinger, might not get as much visibility outside of the company, but I've learned some great lessons from Marc, which are both worthy of admiration and worth sharing.  Marc brings his level-headed demeanor into every discussion we have.  He relies on simple principles like the reasonable man theory (modernized at the "reasonable person" in this Wikipedia Entry).  He also has prevents us from pontificating about what someone else may or may not agree to, by giving counsel like "We're entitled to ask.  They're entitled to say yes or no.  Let's ask them."

What especially impresses me about Marc is the way the people he knows are always willing to meet him, help him, counsel him and often do business with him.  When Marc asks for a meeting, nobody feels like they're threatened or exposing themselves to a sales pitch.  Marc wants to share what we've learned and to learn from others. 

So make sure that as you get to know us better, that you get to know Marc.  You'll be glad that you did.

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.

 

Home Health Leadership: Difficult Conversations & Improving Trust

Your staff gets along well, they work together, and they have solid relationships with your clients and their families. You treat them well, pay them accordingly and respect the jobs that they do. You treat your clients in superior fashion.

Even so, conflicts happen and people have to face difficult conversations from time to time.  This is an environment that can become emotionally charged, especially when clients or their family members are distressed or jobs are at risk. Home care executives, managers and staff must prepare to handle these conversations better.

A great deal has been written on the subject of difficult conversations and I will suggest two of my favorites below. Some of the keys include understanding your own tendencies in these situations as well as those of others you encounter, and devising a plan to communicate proactively now to build greater trust for later. I encourage executive management to read these, as well as agency staff in areas such as Home Health Care, Private Duty Home care, Infusion Nursing, and any specialty where you will interact with employees, clients and their families.

Here is an example of how Ankota helps agencies institute a proactive approach to communicating: If you are familiar with Ankota's FamilyConnect, you know that it automates much of the repetitive communications between home care agencies and clients' families. If you are not familiar with it, click here for a 60 second overview -Family Connect

Aside from ensuring consistent and timely communications with family members, this regular approach to keeping them informed serves to continually "bank" trust with clients' families. This proactive approach reduces anxiety and eliminates many common misunderstandings that might later become obstacles when circumstances are more difficult.

Summary:

When stress builds, trust erodes and communications shut down. Do not wait until things become difficult, prepare yourself for these situations now with any of these resources. And, think about implementing a simple, proactive family communications strategy for your agency.

 

Home Care Leadership: Forbes.com on Planning Time Away

Today's entry is somewhat different from previous posts on the Healthcare Delivery Management Blog, but it is certainly in keeping with the theme of helping our clients to operate their businesses more effectively. Whether your company delivers Medical Equipment (HME/DME), Home Infusion or Respiratory Therapy services, Private Duty Home Care, or Home Health Care, you may also struggle to find time to take time off for yourself. Knowing how to plan your own vacation, while assuring that your company continues to thrive in your absence, can be done.

According to psychologist Randy Kamen-Gredinger in a recent article on Forbes.com, "Taking an uninterrupted break from work is one of the best things anyone can do for their personal and professional life. Constant work with no down time can lead to decreased productivity, perspective and creativity. Going away gives you an opportunity to recharge and be missed on the job."

Easier said than done, right?

The article goes on to offer 11 tips for planning an extended time away from work. I found a few of them useful-maybe you will too. All 11 are in bullets below, and you can read the entire article here http://bit.ly/cLz5Yi

Feel free to comment if you have some ideas to share on the topic-

• 1) Prepare and delegate
• 2) Explore the area
• 3) Hire a freelance assistant
• 4) Get it down on paper
• 5) Take exercise breaks
• 6) Mix business and pleasure (hey, I didn't say I agree with everything...)
• 7) Join the club
• 8) Turn it off
• 9) Barter to play
• 10) Take a vacation during a slow period
• 11) Swap homes

There is also a good slideshow you can flip through quickly and which gives you some good supporting comments http://bit.ly/bunu0P

Now, I'll conclude by encouraging you to plan some time off to recharge your batteries. It will make you a better and more effective leader and you just might have some fun, too.