Understanding Policymakers’ Frame of Reference Crucial to Hospice, Palliative Care Advocacy

Axxess founder and CEO John Olajide discovered a passion for both business and technology at an early age, and in time, saw opportunities to leverage those interests to help modernize health care.

Born in Lagos, Nigeria, Olajide’s first job involved handling money for his family’s wholesale and retail distribution business. Consequently, matters of management and finance were a frequent topic of dinner-table conversations among his parents and siblings. And, as he worked his way through school, he became increasingly fascinated with the potential of computers and associated systems.

He turned his attention to health care after immigrating to the United States, where in time he matriculated at the University of Texas in Dallas. To get by, he took a job in the IT department of a nursing home, where he quickly realized that health care technology could use an upgrade.


In 2007, Olajide established the tech firm Axxess with a mind toward improving the efficiency of health care delivery to allow providers to devote more time and resources to their interactions with patients. Today, the company operates in all 50 states and internationally.

In recent years, he’s prioritized building new lines of communication with policymakers on driving more care into the home and where technology fits into that movement. Olajide spoke with Hospice News about these efforts at the recent Home Care 100 Conference in Orlando.

You’ve spoken about having a vision for health care’s future. Could you describe that vision?


Health care in the home provides tremendous opportunities to increase access to quality services in a way that other delivery options do not provide. There aren’t enough resources anywhere in the world or in the United States to increase access to quality health care services within the traditional models. So we need to figure out ways to leverage everything that exists. 

Of course, we technology organizations start with technology to eliminate distance, eliminate friction and get to people where they are. So how can we make sure people wherever they are get high-quality health care, leveraging all the right tools? How do we get policymakers to understand how important this is?

I’ve had lots of conversations with policymakers on both sides in Congress, and they all agree that health care at home is where we need to go. But I had always wondered why the policy positions were at odds with this concept. Why aren’t we moving things forward?

In my conversations with them, I learned that whenever we’re having conversations with them, what they’re thinking about is the solvency of the entitlements, and it’s important as an industry to make sure we understand their frame of reference as we look for all the places where we can leverage technology, public policy, leadership in the industry to make sure that vision is realized.

In those conversations with lawmakers, how do you bridge that gap between Capitol Hill and the bedside — to build a bridge from that macro-issue of Medicare solvency to the level of an individual in pain with no one there to help them?

Every lawmaker that I’ve talked to understands the value of care at home. And they can tell you different stories about maybe a couple in Maine, for instance, where the only person that comes to see them every day is that at-home professional.

But the challenge is that there are finite resources. There’s a solvency issue at the back of their mind, and they want to know where we can find the resources. So, they agree but don’t know which levers they can pull from a policy perspective to get things done. They’re open to solutions in a bipartisan way, they say. They’re open to solutions to extend solvency, and there’s no getting around that. That’s the big question.

It’s important to understand the frame of reference that our policymakers have so that we can think strategically as all the congressional cycles go through, and ensure we have a long-term, game plan in place.

Typically, when we hear about value, it’s about saving money for payers and Medicare. Of course that’s critical, but how should we define “value” for the patient?

It’s about providing holistic care, making sure it’s not wasteful, because, at the end of the day, we’re all contributing to this as taxpayers. We should care about it. So for instance, as taxpayers, should we have professionals spend hours every day driving around town, and only spend a few minutes a day really caring for patients? That’s not value.

The question is: How can we make sure we can get people home, or wherever they need to be, in the most efficient manner? Or if it’s hospice, for instance, how do we make sure we get appropriate care to people at the right time?

The setting that patients prefer also happens to be more cost-effective than any other health care delivery setting. We have this rare opportunity where value and cost align, and we need to drive a lot more of that and make sure that more people have access.

What types of innovation will be necessary to move that needle?

There’s no reimbursement yet, but we need even more policy innovations on telehealth. We’ll have a more integrated system where — even on the policy side — saying all the different health care delivery silos and all the technology platforms should be more interoperable.

You need integration across the board, interoperability, public policy, telehealth, the workforce and issues around training. How do we train and empower and educate the workforce at scale? These are real issues. How do we better manage routing and scheduling? So we need innovation across the board.

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