This article is sponsored by MatrixCare. In this Voices interview, Home Health Care News sits down with Navin Gupta, Senior Vice President, Home and Hospice Division at MatrixCare, to learn about the push for technological innovation in home health care as a result of the pandemic. He explains how technology leaders are creating new solutions to keep patients and their families safe and engaged in the home care setting.
Home Health Care News: Navin, you came to MatrixCare in 2016, and you’ve had several roles there. What did you see in MatrixCare that made you want to join the team?
Navin Gupta: Prior to MatrixCare, I held a technology leadership role with Philips Healthcare. I also spent a decade in technology, innovating in telecommunication part of the evolution from narrowband to DSL to passive optical networks. Philips was my first foray into health care and more specifically, acute care and patient monitoring. A big problem within acute care is alarm fatigue for nurses.
Almost 85% to 95% of alarms from monitors, vents, pumps and other devices may not be actionable. Innovating around smarter alarm management and actionable insights for nurses is what I was doing. It was a sequence of events. I was recruited into MatrixCare and had numerous conversations with the leadership team about what they were doing within the post-acute space.
That was fascinating for me. The blend of technology and health care, and the ability to impact the lives of seniors was interesting, and I was keen to be a part of the team.
What career experiences do you most draw in your role today?
Gupta: There have been two pivotal points for me, and coincidentally, they’re both related to the CEOs of Microsoft. I remember reading the book, The Making of Microsoft in the ’90s, as a young computer engineering student, and was absolutely inspired by how that early team innovated in personal computing.
That fueled my passion for innovation and technology. About five years ago — maybe a year or so into my journey at MatrixCare — I was reading a book by the current Microsoft CEO, Satya Nadella, called Hit Refresh. He talks about his life story, the personal challenges he faced, his focus on culture, the risks he took and the impact he made and continues to make.
These two career learnings sparked my passion for human flourishing and inspired me to innovate in the health care segments MatrixCare participates in. We are all about improving the lives of seniors and patients, and I felt a sense of urgency waiting on the sidelines. Today, I am in the game and able to impact it in a meaningful way.
COVID-19 disrupted the health care system and continues to impact the industry at large, how well do you think home health care providers and agencies are coping, and is there anything that has surprised you?
Gupta: In the last 18, 20 months, I think the greatest challenges in health care have been exposed. Health care is primarily built around the delivery of care within hospitals, dependent on episodic, fee-for-service reimbursement. A lot of that care is provided in emergency rooms. In a major national payer study, two thirds of cases could potentially be treated safely in lower acuity settings.
Since this model of care is often reactive, it’s very expensive as well. If you step back, national health care spending is truly unsustainable. In 1970, major health programs accounted for about 5% of the budget. We’re now close to a point where one-third of the federal dollars not spent on interest will go toward health care spending, and it’s a completely unsustainable model.
And it’s not just the growth. Higher quality and higher acuity care can be provided very safely in the home. Home care, home health, hospice and other community-based service providers have demonstrated in this very difficult season their value and ability to influence and drive quality care in the home. It’s accelerating what was already happening. COVID has forced this conversation.
Care provided in a patient’s home is expected to increase considerably over the next few years. What are the most interesting ways this trend is impacting technology?
Gupta: In the Medicare population, four in five people are managing more than three chronic conditions, and one in three have some ADL needs. If we are talking about patients managing chronic conditions in the home, there is a great need for new technology.
The first that comes to mind is remote monitoring, where providers can use wearable devices to collect data insights remotely. The second is adherence and compliance to managing chronic conditions. We need to find ways for technology to prompt patients and assess the chronic conditions based on disease states to specific pathways. That’s how providers will create timely interventions.
The third leg is patient and family engagement. It could be simple things like notification on visits or enabling full visibility for the loved ones being cared for.
Beyond that, there’s a lot of data being collected through all these different pieces of technology. Insights will be derived from these monitoring devices to further predict change in conditions and predict adverse events. Whether it’s the likelihood of a fall happening or even mortality, all these components are part of the medical record. We will see true innovation happening in AI and machine learning that will help prevent readmissions and keep people safe in the home.
As more care is delivered in the home, caregivers, providers and payers are relying on remote patient monitoring. How has family and patient support for the technology shifted during the pandemic, and what are you expecting to see next year?
Gupta: We’ve had constant communication with our providers throughout the pandemic. We partner with a great remote patient monitoring organization and overall, the growth rate has been astronomical because facilities and institutions were locked down. From a technology perspective, wireless devices in the home will continue to make up the remote patient monitoring ecosystem.
From a patient perspective, there’s already been consumerization and personalization of digital health in the last decade. The senior population has been exposed to digital technology and has been using it across multiple facets of their lives already.
Look at the way they interact, shop and use transportation: technology is not new to them. I think they will be demanding more and more personalized services in the home, and the same thing goes for family members. We should be able to see quick, frictionless, personalized, and on-demand services made available to seniors being cared for.
What impact does RPM have on patient engagement?
Gupta: People are distracted more than ever. The first priority in patient engagement is the value it brings to them. If you can help them with scheduling, managing chronic conditions or engaging the clinical team in a timely fashion, the patient will see the value. They’re more likely to follow protocols including medications or exercise, so the engagement piece is critically important.
From a clinician’s perspective, it’s about facilitating quality care between the interdisciplinary teams. If a patient experienced a crisis or adverse event, the ability to coordinate care and enable the right team members to intervene is critical to keeping people in the home.
The second thing related to caregivers is that clinician burnout and attrition remain a huge problem. It’s the number one problem. A well-crafted caregiver engagement strategy, which allows for better workflows for triaging, escalations, after-hour requests and inquiries helps manage workload and utilization. This benefits the patients, the family, the caregivers, the providers and the payers as well. MatrixCare supports caregivers and patients in their quest to increase engagement.
The COVID-19 pandemic remains top of mind for most of the world. What do you expect the top three challenges to be for home health agencies as we enter 2022?
Gupta: First and foremost would absolutely have to be labor and workforce. We just went through the conference season for home and hospice and staffing shortages are, by far, the number one issue. I just read a report that said almost half of U.S. nurses are at least somewhat likely to reconsider a profession in non-patient-facing roles. In some cases, they’re leaving health care altogether.
There’s the issue of minimum wage, the issue of immigration laws and the issue of, “What does technology do to help solve some of the labor challenges that providers are facing?” You can use more voice technology versus typing at the point of care. Or you can use smarter scheduling algorithms versus the manual entries. Improving workflow efficiency, gamification, and engagement have driven labor to number one, and I firmly believe technology will act as a labor multiplier.
The second is economic hardships. Will reimbursement keep up with inflation? Will it keep up with cost? We think from a technology perspective, it’s important to understand how we can help providers deal with economic hardships.
The third is the shift to value-based reimbursement and taking on risks. It’s inevitable, even if you just look at the Medicare Advantage population versus the traditional fee-for-service population. Providers need to take risks, whether they’re clinical risks, patient safety risks, readmission risks or financial.
There are a number of risk-based models out there, and this year there were conversations around the CMMI programs with a direct contract as the primary care first, and VBID as well. With value-based purchasing being rolled out nationally, providers have no choice but to operate in value-based programs. Their dependence on traditional fee-for-service revenue will be challenged.
Entering this year, no one knew fully what to expect in the home health industry, what has been the biggest surprise to you in the industry this year? What impact do you think that surprise will have on the home health industry in 2022?
Navin: Again, it has been the acceleration of focus toward home and community-based services. We will see a larger patient population flow to the home and community as opposed to institutional discharges. There’s always going to be a role for institutions, and what we really need is greater post-acute care. If we look at the stats, almost 40 to 50% of patients discharged from hospitals don’t receive any post-acute care.
We’ll see growth there, but there will be a movement toward the home and community. We’ll see greater consolidation of providers, more M&A activity and a greater shift to risk-based contracts. Providers that essentially have no choice will take on risk, and they will need to find ways to be efficient, balancing the workforce challenges while delivering greater care.
From a MatrixCare perspective, we firmly believe technology has a role to play. We believe that operational and labor dollars can and will need to be either augmented or substituted by technology. Realistically, providers that don’t embrace the shift to innovate and co-create with the technology partners will struggle.
Editor’s note: This interview has been edited for length and clarity.
MatrixCare is the only EHR provider to focus on the entire senior care continuum. To learn more about how MatrixCare can help your organization, visit MatrixCare.com.
The Voices Series is a sponsored content program featuring leading executives discussing trends, topics and more shaping their industry in a question-and-answer format. For more information on Voices, please contact sales@agingmedia.com.
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