Episode Transcript
Speaker 1 (00:02):
Welcome to the Post-Acute Point of View podcast, our discussion hub for healthcare technology in the out-of-hospital space. Here, we talk about the latest news and views on trends and innovations that can impact the way post-acute care providers work. We'll also dive into how technology can make a difference in today's changing healthcare landscape for home and facility-based workers and the people they care for. Let's dive in.
Rob Stoltz (00:35):
Hi, everyone. And welcome to another episode of the Post-Acute Point of View podcast. My name is Rob Stoltz, and I'm the Senior Business Development Director here at MatrixCare. We're excited to have Melissa Kozak, the Co-founder and President of CitusHealth here to speak with us about the importance of streamlining communication among your team, your patients, and their families. So let's go ahead and get started. Melissa, good to be talking with you again.
Melissa Kozak (00:59):
Same here, Rob. Pleasure to be with you today.
Rob Stoltz (01:03):
Awesome. Well, I think a great place to start is let's just get started kind of with the origin story. You've been involved as the founder from the beginning, so I'd love to hear how you got started.
Melissa Kozak (01:13):
Yes, happy to look back to that story. So it all began with my career as a home infusion nurse. In those days, I was providing hands-on patient care, and experienced very early on in my career a lot of challenges related to fragmented communication in healthcare. And these were things that negatively impacted patient satisfaction, family caregiver satisfaction. Also, really impacted outcomes, frustrated staff members at things like that. Happy to give some examples.
(01:47):
But the short of it is it really inspired my desire to address the issue of fragmented communication in healthcare. What I noticed out there was various providers I worked for. The electronic health record systems were in place, but there really wasn't a streamlined way for all of the care team members, and the patient, and their family members to communicate so those patients can get the best support needed. And so, I founded CitusHealth. We're a healthcare technology company. We specialize in digital communication solutions for care coordination, patient and family engagement.
(02:28):
Our focus is really on streamlining communication amongst providers, patients, caregivers, the whole team. And we support various channels like secure messaging, secure forms, real-time collaboration with the goal of improving patient satisfaction, provider satisfaction, efficiency. Our parent company is the same parent company as MatrixCare. So ResMed there is our parent company, and we work closely with MatrixCare to deliver this solution to home health and hospice providers.
Rob Stoltz (03:02):
Yeah, that's a great story because it is about patient care by the people who were taking care of them. So that's a great start. I mentioned a few ways about how you effectively communicate. But what was kind of falling short and what did CitusHealth solved after post-finding it, and some of the problems that you were running into would go away?
Melissa Kozak (03:23):
Yeah, listen. I mean, it kind of sounds simple when you think about it. But out of hospital care or home-based care is fundamentally different than acute care or care that's given in a hospital setting simply because the care team members are not under the same roof, right? When I worked in the hospitals early in my career, me and my fellow nurses and the physicians, we could just huddle right outside the patient room, and share information, and discuss the care plan. And in home-based care, it's not like that. You have staff in the field, staff in the home. You have staff in the office. You have some that are stationed in an acute setting. And everybody needs to stay very closely connected really from the moment a referral comes in through to the start of care, and then the ongoing care of that patient.
(04:15):
And that was one of the key challenges that I saw and lived through was that there wasn't one seamless way for that communication to occur. We were using a lot of telephone, phone calls, fax, insecure texts, email, just to share information with each other as the care team, and make sure that no one was really dropping the ball, and that we were moving forward with that referral, and progressing that patient. And the challenge with all these different types of systems is you're missing information. It's not integrated into the electronic health record system. So this would often result in missed updates that impacted, whether it's timeliness to the start of care, maybe some dynamic change that happened with the patient, that one care team member didn't know about.
(05:09):
And so, there was a delay to that patient receiving that care. So that was one of the real fundamental challenges was that care team coordination. And then, the other one that I would encounter on a regular basis was patient support and information. And what I mean by that is that patient or family caregiver in the home setting, they get a lot of instruction upon admission into that home health service. And a lot of times they're inundated with information and education, and it can be quite overwhelming. And they'll get their nursing visits, their therapy visits. But most of the time, they are not with a licensed clinician at bedside to help support their care.
(05:52):
And so, when they have a question or something is bothering them, they have swelling, they have a rash, their pain has increased, their device is alarming, right? Any number of things. What was available to those patients in terms of support, again, was picking up the phone, dialing a number, getting transferred to an on-call nurse. Maybe that nurse is not available, so then they have to call you back. And these were delays, and it would result in frustration, for sure. Delays in getting what that patient needed. And sometimes even unnecessary trips to the emergency department. So in addition to that care team coordination, it's really about providing patients faster access to clinicians to be able to follow through on their care plans, Rob.
Rob Stoltz (06:44):
Yeah. You know I've heard you say before, Melissa, that when you were nursing, you would be one of those nurses who gives out your cell phone number. I mean, the challenge with that is you may be visiting other people for the rest of the day, so the response may not be readily available. Whereas, if you engage the team, right? It sounds like you've got a lot better chance.
Melissa Kozak (07:03):
Yeah, that's exactly right. And I did. I'm guilty of it. And I know a lot of nurse colleagues were too. We gave out that mobile number of ours because we felt bad that... We didn't want our patients to go without having someone to help them. But you're right, then you're with other patients, you can't answer in a timely manner. So one of the things we do at CitusHealth is we set up our messaging tool, so that patient can send a message, and the message will automatically route to a team that's available. Not just to that one nurse who's that super responsive nurse and their favorite nurse, because that's problematic for the reason you said. And then also, just clinician burnout. You know?
Rob Stoltz (07:03):
Sure.
Melissa Kozak (07:44):
We can't be available 24/7 even if we want to be.
Rob Stoltz (07:47):
Yeah. Yeah, that's right. So we talk a lot about technology sometimes, but the real point of technology is somebody has to use it to make it work. And so, user experience and engagement are really the key components of it. Can you talk to us about kind of the mechanisms within CitusHealth that allow it to achieve high engagement? Because if you don't get very much participation, you can't be that effective. So you're experienced in this, and just a little insight into how you get people to engage would be, I think, very beneficial for people to understand.
Melissa Kozak (08:22):
Sure. And this is certainly in age-old challenge in software. And Rob, I know that you've been in software for many, many years, and you know this. You don't want it to become shelfware. You want your customers, those healthcare providers to purchase software and get value out of it that's there, and that they could take advantage of. But like you said, you have to have usage of the system to do it.
(08:48):
And so, we approach it at CitusHealth in a few ways. First of all, we are a team of healthcare providers that are now on the software side. So myself as the founder, as a nurse, several of the members of my leadership team, our clinicians have been in various post-acute roles, both in clinical roles and operational roles. So we really take a very consultative approach to implementing software in organization.
(09:18):
We feel that we really do understand customer workflows and we understand how to help with digital transformation. And that is a fancy buzzword, digital transformation. But in this case, what I mean is, oftentimes when people are bringing in a tool like CitusHealth, they're not going from one digital tool, and now they're switching to CitusHealth.
Rob Stoltz (09:18):
Right.
Melissa Kozak (09:40):
They're often going from manual phone calls, and emails, and text messages, and really uplifting their process to go digital. And so, it does take a team that knows both the software and the operational side. So there's that benefit. And then, the other is the product itself. We take the approach here that not every end user is going to want to engage in the platform in the same way. So some might really be comfortable with downloading a mobile app from the App Store, creating an account, utilizing all those features, and that's commonplace in their life.
(10:22):
Other users might say, "You know what? I don't really want to leave my main system of record, and I'm much more comfortable engaging out of my email or engaging out of SMS." And so, one of the things that we have done and continue to do is make the features of our platform available in multiple modalities through various browsers, through an app, no app, email, text message, that kind of thing. So that's another real key approach to it that we do. And it's really worth mentioning that this stuff can't happen in silos.
(11:02):
So integrating into the EHR and showing the staff who are going to be implementing a solution, because it's hard to kind of take the first steps of the journey of an implementation when you're already short-staffed. Everybody's got more work to do than ever. But to show them, hey, this stuff integrates. You're going to have the data there. You don't have to do dual entry and those kinds of things. So all of those together is really what we found to be successful, Rob.
Rob Stoltz (11:32):
Once you talk about that, and when you get outside of directly kind of what your EHR does, you're increasing the number of stakeholders, right? You have the healthcare providers, the patients, the families that provide that challenging. So is that kind of multiple channel approach, how you address them each separately in the place where they're at and what they're comfortable with then?
Melissa Kozak (11:51):
Yes. And actually, you just made me think another kind of core tenet within our solution is this idea of bringing in all of those partners, internal staff, external partners, family caregivers that might be hundreds of miles away. We know that partners such as prescribers, they are not going to log into another portal. They have 15 already that they have to remember their passwords for. It's just not going to happen. So it is giving them the ability to engage in the way that they want to. And then, this idea of an unlimited model is another, I think, unique factor the way that we approach it.
(12:37):
A true engagement solution can't be licensed-based. It can't be based on, okay, you can have up to this many users, and then your bill goes up, right? We really want everybody to be involved. So every sibling that's a family caregiver, all the different prescribers, and the DME partners, and the infusion partners. And so, we really allow for them all to be involved in the way that they want to either very highly engaged or more of a hands-off approach to it. But this is how we have seen that circle of care really come around to include everybody that's needed.
Rob Stoltz (13:16):
Yeah, that makes a ton of sense. I recently heard some work about people who are using your tool, and how they really focus on that interdisciplinary team communication, and have had some success that way. Maybe you could share a little bit about some ways that you've talked to your customers about and seen results from kind of focusing on that communication enhancement.
Melissa Kozak (13:39):
Sure. Absolutely. And it's all about communication, again, in the out-of-hospital care, because actually a colleague I heard say yesterday, "We're kind of on our own out there." And I really loved hearing him say that because I started out in hospitals, and then moved into home care a few years into my career. And it did feel like that like, "Hey, I'm out on my own here with this patient. And if their condition changes, I better have excellent assessment skills to figure out what's going on, and then be able to loop everybody else in really quickly to be able to take action." And so, it's all about really good communication, and not letting things slip through the cracks. And so, we enable that in our platform through... We call them patient discussion groups or PDGs.
(14:29):
And it's really a place where the whole care team can have a patient specific communication thread about that person without the patient being on it, but that whole care team. And the way that we've seen the most success with these threads is really using it as a tool to coordinate the admission into that home health service. So when the referral's coming in from that SNF or that hospital, getting on the PDG with all the players that need to share information, check benefits, figure out when can we do this start of care. Do we have all the documentation that we need? So really coordinating that admission with, again, staff members that are not under the same roof. They may be stationed in the hospital. So getting that patient onto service, right? But then I think what's been super exciting to see with some of our customers is really improved outcomes once that patient is on service.
(15:35):
So they'll continue using this PDG thread and just providing updates to it. And what this does is it keeps the whole team accountable to each other, so that if there is a change in the patient's condition, and I'm a nurse coming in to see that patient, I'm coming back on the scene, I haven't seen that patient in a while, I could just go right on that PDG thread, and find out what is the latest update about the patient. Did they get a change in their meds? What happened last visit? Without having to go into the various systems to find that. What's really nice and what we've seen in positive results is some of the organizations and locations that are using this process of patient discussion groups have actually reduced their 30-day readmission significantly because everybody is really in the know about what's going on with that patient, any changing conditions, and they can act quickly without having to search multiple places to piece that story together. So it's been pretty exciting to see.
Rob Stoltz (16:43):
Yeah. Right. I mean, those are some real tangible benefits that come out of that rather than just what we think of as kind of the soft benefits of communication, right? So that's great to see.
Melissa Kozak (16:52):
Yes. Yes.
Rob Stoltz (16:54):
So healthcare is an interesting field to do this in, right? Because there's a ton of dynamics, and patients are in a critical state sometimes where they may need to be re-hospitalized. They're having a problem. Maybe a patient's dying, right? So there's a lot of intensity and emotional dynamics involved in that. Do you have the ability to share with us any instance where maybe the communication help somebody to navigate a situation like that, so that it really was more manageable for both the patient and the caregiver who's trying to assist that patient?
Melissa Kozak (17:26):
Yeah. I mean, you're absolutely right. First of all, needing healthcare in general is a difficult thing. It's often a very stressful time in the person's life that needs it. Or let's say, it's the case of hospice care in that family, the family's life. So we try to make receiving care as easy as possible in terms of the way that we provide these tools to communicate. And to that point about situations, there's been many. I mean, what I can think of is we service hospice agencies.
(18:03):
And our tool can be used, let's say, by that nurse to have a chat with the family members of that patient, whether they're nearby or many miles away and if there's a whole group of them to be able to get on a chat, so that nurse can provide an update, even on a video chat. A more personalized, look in each other's eyes, update about what's going on. I think that's really nice, versus having to call each and every family member. There might be follow-up questions. Information is not passed from one to the other seamlessly.
(18:42):
So that's kind of one way where you build that circle. Others that I can think of, I mean, some providers will use our solution to help with medication refills or understanding tolerance or side effects to certain therapies they're on. Well, it's not always easy when you, as the patient, are in a room with other people to talk about some of the hard side effects you're going through. I can think of GI side effects. You don't want to say that out loud on the telephone call, right? When you're in the middle of a group of people.
Rob Stoltz (18:42):
Right.
Melissa Kozak (19:16):
But you can answer it on a form quickly within the Citus Solutions to say, "Yeah, I'm having this GI upset," and things like that. So it helps with discretion too, right? And privacy. So a lot of different ways I can see that it actually adds a level of compassion in conjunction with in-person care.
Rob Stoltz (19:38):
You know, Melissa, I heard recently you talking with one of your customers, and they had five family members on a video chat because they wanted to be involved with their mother's care. And I thought that's a whole new challenge for the nurse that's addressing that. But I also simultaneously thought, wow, that's four less people that they have to communicate with after this whole visit's over. Right?
Melissa Kozak (19:38):
Yeah.
Rob Stoltz (20:00):
So that's really interesting whenever I heard that, whenever I heard you talking about that as well.
Melissa Kozak (20:05):
Yes. Any nurse will tell you that if a patient has a large family who's very engaged, then you as that nurse, you don't just have one patient, you have the whole family as your patients.
Rob Stoltz (20:18):
Yeah.
Melissa Kozak (20:18):
Right? It's them that needs the information, and needs that emotional support, and needs to feel empowered to help their family member. So it is great to be able to be more efficient, right? With it.
Rob Stoltz (20:31):
Yes, yes. And also, being in technology for a long time, cringed a little bit earlier whenever I heard you say about sharing your cell phone with people, right?
Melissa Kozak (20:31):
Yeah.
Rob Stoltz (20:39):
And thinking of texting out there. Seeing my mom text the nurse openly when my dad was in an end-of-life care. And I think about data security, and all the emphasis we put on that, and really trying to understand how your solution kind of enhances the privacy and things like that that we would see from these channels that, now knowing what I know kind of made me cringe a little bit. And so, I didn't know if you had any insight into kind of the security component that it provides as well.
Melissa Kozak (21:08):
Yeah. I mean, we know that data security. It's all over. We see it all over the news, these data breaches. And besides patient safety, I would say data security is number two or tied with number one on the list. So top priority. We make sure our solution adheres to the highest standards of privacy and security regulations in healthcare, whether it's through encryption protocols, audit trails, safeguarding that PHI.
(21:36):
We're definitely compliant with all the HIPAA protections of that patient data. And then, we have all sorts of different configurations and security rules about what information can be shared with who. We're a role-based system. So if you bring a partner onto the platform to engage with the agency, it's restricted what that partner can see. So there's those types of controls as well. And then, some of the technology we use from the App-less perspective, one might not even realize it, but it's super secure.
(22:14):
It's called App-less Magic Link Technology. Rob, I know you know it well. But for the listeners, the idea that you send a text message to someone. They click on a link and it routes them into a secure browser. I mean, that's technology that financial systems, banks have been using for a long time. So we're adhering to those standards, two-factor authentication, you name it. So we're in a lot of large health systems, and other large organizations, and are constantly improving our security protocols.
Rob Stoltz (22:44):
Yeah, also important. And I'm a big fan of not having nurses give out their cell phones anymore and making their life more tolerable as well. So that's great. Look, I think that's about it. But man, I've enjoyed the discussion as I always do with you, and hearing how this keeps emerging into a different technology. And so, it's so good to understand the technology itself, the integration, how it impacts the patients and the caregivers. I just want to thank you for spending some time with us and really helping the audience to understand how that goes out. I don't know if you have any closing words. But certainly, any last thoughts on just how this is going to evolve?
Melissa Kozak (23:21):
First of all, thank you for having me today, Rob. I always enjoy talking to you because you're somebody who is always looking to move healthcare forward and introduce great solutions to customers and partners, so appreciate the conversation. And I would just say that, I mean, we all see the trend in healthcare, which is that the home is the new and more expanded place where care is going to be delivered.
(23:50):
And you couple that with patients becoming consumers of digital technology, and really being able to help support those patients in the home, and the people who provide the care to take away a lot of those manual processes, and the administrative burdens that just have driven clinicians out of the industry.
(24:15):
That's really exciting for me as a clinician and just us as a company to be able to support this growing trend of home healthcare, and making sure that clinicians really can do what they want to do, which is hands-on patient care rather than all of the other stuff going on. So thank you for having me on today. It was real nice to talk to you, Rob.
Rob Stoltz (24:36):
Yeah, it always is. And thank you for your innovation in doing this. And it gives me hope that as I get older and get more engaged in the healthcare system myself, that there's a way that potentially I can engage with the healthcare like I do with all the rest of the pieces of my life. So thank you for your innovation and leadership, and for joining us, and I look forward to our next conversation.
Melissa Kozak (24:56):
So do I, Rob. Thanks.
Speaker 1 (24:59):
That concludes the latest episode of the Post-Acute Point of View podcast. We have a lot of guests and topics coming up that you won't want to miss, so be sure to subscribe. To learn more about MatrixCare and our solutions and services, visit matrixcare.com. You can also follow us on LinkedIn, Twitter, and Facebook. Thank you for listening. Be well. And we'll see you next time.
