by Tim Rowan, Editor Emeritus
Catherine Zhang was thriving in product engineering while Mayur Pandya held a similar leadership role for Silicon Valley’s Workday. Their futures were predictable and bright until Catherine’s close friend unexpectedly passed away, changing her career goals as profoundly as her heart.
Over a cup of coffee, Zhang and Pandya learned they both had close family working in health care. The conversation turned to how they might apply their product development expertise to, as they put it today, “improve patient outcomes, empower care teams, and reduce the cost of care in the U.S.”
Their first task was to identify which healthcare sector had a pain point that needed their talents most. Naturally, they found their way to the $129 billion Home Health sector. Ms. Zhang told us they were taken aback by the severity of the harm done to Home Health by Medicare Advantage plans.
“We learned that over 600 HHAs had closed their doors in the previous five years. MA reimbursement ranges from 60% to 70% of what Medicare pays, and the administrative burden imposed by MA plans is seven to eight times what it is for traditional Medicare. Making matters worse, or perhaps because of these pressures, we found the turnover rate among HHA nurses to be 31%.”
Fast Forward Two Years
Working together, the pair attracted investors, additional coders, and, most importantly, experienced Home Health advisors and product designers. What began as an idea to ease the workload on the nurse in the field grew into a full-fledged electronic medical record system, complete with AI-enabled intake, scheduling, revenue management, physician signatures, and quality control. Naturally, created in the 2020’s, the new system is built around Artificial Intelligence tools. They dubbed it “Narrable.”
“What we wanted to do,” Ms. Zhang continued, “was to harness the power of AI to eliminate the inefficiencies we were learning from owners and nurses within HHAs. Some spend hours completing assessments and visit notes in the evening because ‘it is too hard to document in the patient’s home.’ Many told us that intake, scheduling, chasing physician signatures, and productivity tracking are too unpredictable or too complex for their existing EMR and they resort to multiple spreadsheets.” One HHA owner told Zhang that he “spent $500,000 last year on double data entry.”
Narrable Features We Saw
Narrable’s roots are in the field nurse’s experience. Ms. Zhang explained that the system’s clinician-centric design can eliminate tens of thousands of “invisible” clinician work. In the product demonstration she walked us through, we were able to understand how an AI engine might save work by eliminating both steps and errors.
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- Scheduler analyzes each clinician’s capacity, ability to accept an additional patient, and geographic location, automatically recommending the best person to take a new case. Still, a human makes the final decision.
- OASIS assessment answers are automatically checked against referral documents and internal logic quality checks are performd.
- Clinical notes benefit from AI pre-filling demographic data, reminding the clinician of OASIS determinations and goals stated on the Plan of Care.
- Eligibility is checked against payer data and prior Home Health admissions
- Physician PECOS integration auto-fills fields, eliminating repetitive data entry
- Claims management includes:
- alerts to find uncompleted tasks that may delay billing
- automated claims submission
- automatic monitored and posted remittances
Lastly, Narrable offers a suite of configurable management reports that check for maximum allowable PDGM revenue, HHVBP outcomes that may affect adjustments, and real-time financials. A configurable financial report displays paid vs expected revenue, A/R, adjustments, and denials.
Our Narrable Recommendation
At last month’s inaugural conference of the new National Alliance for Care at Home, we witnessed a virtual AI explosion. Every established tech company and a plethora of startups are diligently experimenting to identify the appropriate role for artificial intelligence in Home Health and Hospice. As with all breakthrough technologies, there will be a race to the finish line, with the large, established companies enjoying a head start and others scrappily inventing and innovating with no legacy products acting as a ball and chain.
In this writer’s opinion, Zhang and Pandya have come up with something different. Any HHA thinking about launching an EMR search and evaluation project would not regret the time invested in giving Narrable a look.
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Tim Rowan is a 30-year home care technology consultant who co-founded and served as Editor and principal writer of this publication for 25 years. He continues to occasionally contribute news and analysis articles under The Rowan Report’s new ownership. He also continues to work part-time as a Home Care recruiting and retention consultant. More information: RowanResources.com
Tim@RowanResources.com
©2024 by The Rowan Report, Peoria, AZ. All rights reserved. This article originally appeared in Healthcare at Home: The Rowan Report. One copy may be printed for personal use: further reproduction by permission only. editor@therowanreport.com
