Voices: Melissa Kozak, RN, CRNI, Co-Founder, Chief Executive Officer, Citus Health

This article is sponsored by Citus Health. In this Voices interview, Hospice News sits down with Citus Health Co-Founder and CEO Melissa Kozak, RN, CRNI, to learn about how Citus Health is leading hospice and other post-acute care providers forward with care coordination and communication technology; why this is especially critical during the COVID-19 pandemic, and the company’s decision to make its CareConnect solution free for all providers during this unprecedented time. 

Hospice News: Tell us a little bit about your background leading up to your co-founding of Citus Health.

Melissa Kozak: I’m a Registered Nurse (RN), based in New York City. Prior to starting Citus, I spent eight years providing direct care to patients receiving home infusion therapy. Through that time I experienced the communication and care coordination challenges of connecting front line clinical teams with office teams , and with family members and patients — all due to the lack of real-time, secure communication tools.


Given these turbulent times we are in right now with so many teams working remotely and in many cases families not being permitted to visit loved ones due to social distancing protocols, it’s becoming clear that uninterrupted communication and continuity of care is really important to hospice providers, palliative care and home health providers.

Given my past experience and seeing what’s going on today, we really want to do our part during this unprecedented time to make sure that families can continue to securely communicate with the caregivers of their loved ones in any setting they are in; on any device; at any time.

How did your experience as an RN shed light on the needs of the hospice care market? What specific needs did you identify?


During my bedside nursing career, I often worked closely with hospice teams, and we cared for many of the same patients. What I learned in talking to hospice nurse colleagues is that the delivery of hospice care is very complex. There is a matrix of care team members who have to constantly keep in communication because the care of a patient changes minute to minute and is very dynamic. This is true for stakeholders inside and outside the hospice space from infusion providers to durable medical equipment providers and family members who need to be kept up to date with their caregivers. There was a need there.

Seeing those family members in the dark was very similar to the experiences that I had directly as a nurse, and some of these communication gaps and manual processes were also evident in the hospice market.

How does Citus Health work to fill these gaps that hospice providers often face?

Hospice providers are looking to fill communication and coordination gaps the best they can right now. Oftentimes, they are using several different solutions. They’re all distinct solutions that don’t solve their communication challenges holistically and don’t integrate into existing workflows or their systems of record. Many are also difficult for clinicians to learn and adopt quickly. Our solution is easy for clinicians and patient families to quickly adopt and is highly integrated platform, and it looks to solve many of the gaps along the care journey.

There isn’t a time in our modern history where filling those gaps is more important than it is now. One example is updating family members on the status of how a visit went with their loved one, either using a digital touch point with one of our configurable forms or even sending a photo to a family member.

Our platform also allows the provider to send satisfaction surveys about how they’re doing. Or let family know the nurse might be running late. Or that they are going to do a video consultation instead of an in-person visit, which is something we enable on our platform. Additionally, family members with power of attorney can sign admission paperwork through our platform even if they are 3,000 miles away. Our solution can even be used as a bereavement tool after a patient has passed away among other uses.

Broadcasting educational content and messages about safety protocols is another feature that we are hearing is highly valued, particularly given the COVID-19 crisis. And we can even loop medical directors into a conversation remotely as to what’s going on with the patients.

How did your work in other care segments prepare you for the hospice market? What are some of the successes from those markets you’ve brought to the hospice landscape?

Our platform is being adopted by patients and families as they are looking for a more omnichannel approach to communicating with care providers. We see now the increased need for family members to know what’s going on, through communication in real time about care and medications being delivered, equipment being delivered, and so on and so forth.

In fact, I am proud to say that 80% of our patients and families are actively engaged in the solution. The successes we are seeing with this adoption of the platform at the high rates that we’ve experienced indicates that solutions like this are needed, especially at this time.

We designed our platform to be highly configurable so that it can adapt to hospice, palliative care and home health segments. Users can access it on Android or iOS, but we also have a web-based portal version that can be accessed on any browser.

Given the advances in health care technology, why do you think hospice organizations often fall short with respect to technology?

I wouldn’t say they are falling short. I think the reality is that most hospice organizations have done a great job adopting their electronic medical record (EMR) systems, which serve the needs of an organization from a billing, documentation and recordkeeping perspective.

But historically, hospice care is a face-to-face, personal, very high touch modality, and nurses, social workers and aides want to continue to provide that very high-touch care. From a day-to-day perspective, I don’t think technology was ever really seen as an obvious solution to enable that type of high-touch caregiving.

What we are seeing now is that technology can make that high-touch relationship more possible, productive and profitable. You can also have that intimate care virtually and not sacrifice the high-touch nature. Given COVID-19, a lot of care providers are forced into making these touch points virtual. They are discovering that and even though we are physically distanced, we can still connect through technology.

What is the feedback like from family members of hospice patients? How have they responded?

With our secure messaging, video visits and these kinds of things, the response has been overwhelming. Whether the family is in the same town as their loved one or 3,000 miles away, they can be updated on the situation in real time. Right now there is so much uncertainty, and what these families are experiencing is that through the uncertain times they can stay connected, they are up to date, they know their loved one is getting the medication, the supplies and visits they need. It’s been a relief for families to have this type of connectivity. It has been really wonderful to see. Customers tell us they have reached even greater heights of patient service, further establishing the value-based care that their patients, caregivers and families have come to expect.

How does the platform serve organizations right now during the COVID-19 pandemic? Did you ever expect your solution to serve the market in this way?

Right now, we really want to help in any way we can. I live in New York City and my practice of nursing was here. I have a lot of colleagues and friends on the front lines in post-acute care. Being of service during this time is very important to us.

What we are doing now is providing free, no-strings-attached access to our CareConnect solution — which essentially will allow any hospice, palliative care or home health provider use secure messaging and secure video chat, so that they can connect internally with care teams and externally with patients and family members.

I didn’t expect that our solution would shine during such a dark time, but I did always envision that given the consumerization of health care and the fact that almost every person today has a mobile device, that care could continue despite the fact we may not be in the same location as our patients.

Where do you see the telehealth market going based on recent developments around the pandemic? How will Citus Health support this market?

As a result of the COVID-19 pandemic there is a dramatic and rapid shift occurring in how health care providers around the world need to coordinate and provide care. We’re seeing that the need for technology is greater than it ever has been before and it’s creating opportunities across the care continuum for organizations to rise to the challenge and innovate.

This is really a tipping point for telehealth and other patient support solutions. We are transitioning from telehealth being a “nice to have” to it being a “need to have.” One of the challenges in home-based care is having the clinical people resources needed to make those home visits and be productive, and that is a real challenge when a nurse has to visit a patient and then the next patient is 30 to 60 miles away. Technology eliminates that barrier, and it’s giving time back not just to the clinicians but also to the patients and families who are waiting for that care.

One of our customers using our solution has realized dramatically reduced reliance on labor-intensive and inefficient processes and procedures. Once we make it through the pandemic, the agencies that embrace technology like ours will develop a competitive advantage as they ensure improved scores, better care, team collaboration and patient team engagement.

To learn more about Citus Health and its CareConnect offer, please visit www.citushealth.com.

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