This article is sponsored by Maxwell Healthcare Associates. In this Voices Interview, Hospice News sits down with Kody Johnston, Director of Business Analytics at Maxwell Healthcare Associates, to learn about the top tech trends agencies should be watching, as well as how they can use this technology. He also discusses some of the ways agencies can implement no-code or low-code tech, and he shares a perspective on what practical innovation looks like in the hospice industry today.
Hospice News: What career experiences do you draw most from in your role today?
Kody Johnston: I’m a nurse by trade so a lot of what I draw into my day-to-day as a director of business analytics is based on what I did in the field. I consider myself fortunate to be able to start a technology company in my previous life which lead me to the nurse informatics skill path. This merging of technology and clinical skills has been invaluable. I have knowledge of the business domain, clinical operations and quality improvement. But I also understand the information technology domains like infrastructure and data analytics, which is a unique place to be.
My passion for clinical excellence and technological innovation influences what we’re doing at Maxwell Healthcare Associates day in and day out. I want to champion these domains in the home health and hospice enterprises that comprise the larger post-acute care segment of America.
What kinds of progressive tech trends should agencies pay attention to in today’s hospice environment?
I advocate for three technology trends that every post-acute enterprise should focus on to drive enhancement, scalability and innovation. These tech trends are known as applied observability, Industry Cloud Solutions and super apps.
Applied observability is a tech trend that providers can implement for real-time data. For example, many insurance agencies use this trend when they discount your auto insurance premium for good driving by tracking your behavior and giving you a score. It is a methodology that enables organizations to gain deeper insights into their systems and processes. By using applied observability, post-acute care providers can track and monitor key performance indicators in real-time, enabling them to identify and address issues before they become critical. This approach improves patient outcomes and enhances operational efficiency, ultimately leading to better patient care and outcomes.
Next is Industry Cloud Solutions. At its core, ICS are specialized cloud-based solutions designed to meet the unique needs of specific industries. In the post-acute realm, industry cloud platforms provide tailored solutions for health care providers, including electronic health records (EHRs), telehealth and patient engagement tools. These solutions provide a foundation to streamline workflows, reduce administrative burdens and improve patient outcomes by providing more efficient and effective care. Scaling digital transformation in hospice organizations or home health, which I have firsthand experience with, means leveraging industry cloud platforms and citizen development together.
A lot of companies have robust IT departments. Maybe they’re not the biggest hospice or home health provider out there, but they have some form of infrastructure that IT manages. These IT arms are direct beneficiaries of leveraging the ICPs and citizen development processes at hand because they reduce large amounts of backlog.
If companies take these industry cloud platforms and merge them with citizen development, which is a process of letting employees with no coding experience influence the development of mobile and web applications, and do it systematically and securely with IT oversight, it allows you to scale rapidly. Not to mention save money and become less reliant on third-party technologies.
Lastly, we have what I call super apps, which are applications that provide end users with a set of core features and access to many apps within one location, with the primary goal of driving engagement. In health care, we can call it patient engagement. The human-centric factor is key to the goal of super apps, and it has been very successful where engagement and useful technologies are the primary goals.
As an example, organizations can allow patients to use a super app that taps into the ability for patients to have access to their personal health regime, see schedules, request supplies for certain therapies, and chat with AI health bots — all in one location. Patients can pick and choose what they want to make their lives easier. Empowering caregivers and patients to have more of a say in their care stands to reap patient engagement and satisfaction that some organizations are now being billed against by value-based purchasing endeavors.
How can agencies best leverage this technology?
I am a clinician first, so that is the lens through which I approach most technology utilization.
For applied observability, I would first approach it with a clinician retention model. If we use applied observability, we could take simple themes like the frequency a clinician requests to see a patient and travel to and from various locations. We can take data points and see how often a clinician is seeing the patient and meeting outcomes. By taking these raw data points, we can then tie them to enterprise goals and offer a bonus incentive that’s driven by raw data packaged into actionable insight.
Cloud solutions and citizen development are where no-code and low-code platforms shine. This is where there’s no excuse for hospice and home health to not be, quite frankly. If organizations aren’t, it is normally due to hyperinflated security concerns or a lack of trust in process and service architecture. One example of use is leveraging citizen development and no-code and low-code tech in the industry cloud platform stack to create case management for clinicians.
By using low-code tech and involving the end-users themselves through the process of citizen development, agencies can empower clinicians to spend less time searching through EHR data so they can make quicker, more effective decisions that impact outcomes and ultimately the bottom line of the enterprise.
Lastly, super apps, from a clinician’s perspective, can take logistical tasks like NVA time entries, lunch/breaks, mileage-driven or QAPI tasks and digitize them into an integrated super app. Whether that is in the back office or on the front line, the efficiency gains of super apps can increase staff retention by making their lives easier via engagement through time-saving tools.
What can agencies do to start implementing no-code or low-code tech, and why should they use it?
Especially in the post-acute care realm, the first thing agencies need to do is to look at their existing infrastructure. Does your organization use multi-cloud services? For most enterprises, you want start with no and low-code technologies with your IT personnel as the enablers from a governance standpoint.
After you have looked at native tools available to you, I would start to map out problems or operational burdens in your organization that you believe can be digitally transformed with the highest value and the lowest difficulty. Take the exoskeleton around the core business operational processes, slowly digitize those and you’re going to save millions of dollars in the process as you approach the core systems that are more mission-critical for an enterprise and can cause people to worry.
Lastly, do your research. There are a lot of do-it-yourself educational paths online that citizen developers can learn from. Ultimately, organizations have the people and technology. But they lack a clean process. This is easily remedied with citizen development and appropriate resources.
How can you safely empower non-IT users to build technical applications?
That is the biggest deterrent to post-acute care enterprises investing in no-code and low-code solutions. It’s called shadow IT and it’s a real risk. As a clinician that is blessed to have IT knowledge and informatics training, this is where you have to lean on citizen development and IT enablers in your company. There are systematic, proven processes where you bring these people together, and build these technical applications from documented processes that IT has sanctioned from the inception of implementation. Checks and balances must be maintained along with the ability to integrate with present systems.
If I have a quality professional that wants to build an app, the first thing we’re going to do is map out ideally what they want to do from a requirement standpoint. We create a business proposal that has a preliminary information point to a product vision board, enterprise architecture forms, and operational workflow diagrams. We then take this information and run it through a quantitative process and chart it against an enterprise custom standardized measurement showcasing to us, “is this app idea viable and who should build it?”. We filter it through three criteria: DIY, Integrated, or Pro-code as I call them.
For example, if the app idea lands in the integrated scoring matrix, it needs to be an assisted app build. The employee with training can build 70% of it, and IT finishes 30% of it. Feasibility assessments, looping the app back to enterprise goals follow as we lead up to the approval to build the application. So much is available to organizations that leverage citizen development.
This can all be done additionally to the parameters that IT wishes to set. An IT-sanctioned environment is literally IT creating a playground to go build mobile and web apps on. They don’t have to worry about it. They already set it up from the beginning within the platform for governance. Doing this vetting at the beginning when choosing the platform of choice is huge.
What does practical innovation look like in the hospice industry?
Practical innovation means innovating to deliver tangible solutions via tangible processes to meaningful problems. This is different as opposed to innovating for the sake of innovating, or out of a sense of obligation to stay competitive. Organizations honestly can waste lots of money via innovation that is just for the sake of innovating.
We innovate to mitigate our customers’ or employees’ burdens. If that isn’t the motive, then it should be. Sometimes, that looks like developing an app in a week or less to solve our employee’s problem, then going back and iterating upon it. For the hospice nurse, they might practically innovate by offering care in a different way because that blesses the patient the most and it’s within clinical practice. Practical innovation is not an ethereal thought. It’s not, “Oh, these are new things coming down the line that we have to invest in.” It’s something more valuable and tangible that often gets overlooked because people are looking at the pie in the sky, instead of down in the weeds where most issues actually are.
These are just an example of practical innovation to me. It would be you saying, “I have this problem in the day-to-day, and I’m tired of it. Good, I have the ability to go fix it and prototype an idea worth investing in.” Let’s go through our processes.” That is practical innovation.
Finish this sentence: “In the hospice industry, 2023 will be the year of…”
Editor’s Note: This interview has been edited for length and clarity.
Maxwell Healthcare Associates is a team of post-acute industry veterans passionate about helping home health and hospice providers thrive amid healthcare’s disruptive environment. They bridge gaps and advance care by creating solutions focused on people, processes, and technology. To learn more about Maxwell Associates’ home health solutions, visit maxwellhca.com.
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