the homecare intelligence (hci) solution - providers
TRANSCRIPT
Building CapacityValue For Money
TransparencyInnovative Technology
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0 Table of Contents
1. Executive Summary
2. Homecare Intelligence Canada
3. Context
4. The Challenge
5. The HCI Logistics Solution
6. The Benefits
7. Competitive Advantage
8. Additional Offerings
9. Conclusion
10. Contact Us
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Demand for home care is rising, and the increase in demand is putting pressure
on the ability of agencies to deliver required care within their current financial
and health human resources
Provision of home care can be viewed as a ‘logistics challenge’ to provide the
right care, at the right time, in the right place by the right provider – the current
solutions used to address this challenge leave significant room for improvement
◦ As an example, home care providers in the US travel an estimated 5 billion
miles/year
◦ In contrast, sophisticated routing solutions allow FedEx to travel only 2.5 billion
miles/year globally – without these solutions, logistics companies like FedEx would
not be able to survive
1 Executive Summary
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Our team has developed a unique solution that addresses the logistics of home
health care delivery to enable a home care agency to deliver on its care
commitments in the most cost effective way while meeting quality of care
considerations
◦ By using algorithms to identify the set of visit assignments and sequencing of those
visits, clinical, operational and other factors can be easily incorporated into each and
every assignment decision
◦ By assigning patients that are closer to one another to the same clinician, our
solution minimizing clinician travel time and costs
◦ By automating scheduling, visits sequencing and notification/reminder tasks for
scheduler and clinicians, reducing operational overhead
Together, these solutions can help home care agencies:
◦ Improve patient care & outcomes
◦ Improve clinician & patient satisfaction
◦ Reducing ongoing operational costs
◦ Enhance operational performance
1 Executive Summary (cont’d)
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Homecare Intelligence Canada Inc. (HCIC) is a dedicated group of health and
business experts focused on delivering innovative health solutions to address
health system capacity, spending and quality of care challenges
◦ We have an intimate understanding of the Canadian and Ontario home care policy
and operations, along with expertise in developing automated business solutions
HCIC has partnered with Homecare Intelligence Inc. (HCI) to provide an
innovative set of data-driven solutions specifically designed to solve healthcare
service delivery challenges
2 Homecare Intelligence Canada
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To date, the complex logistics of scheduling care in the community has not been
adequately addressed, resulting in:
◦ Use of manual processes that rely on the knowledge of scheduling staff, making
scheduling more art than science
◦ Increased care staff turnover and decreased work satisfaction from:
◦ Staff needing to work longer days/hours to bill a regular days’ work
◦ Travelling long distances to reach patients, including from rural staff travelling to
serve patients in urban areas or in opposite directions to other care providers
instead of being grouped to served closer to where all their other patients are
◦ Reduced continuity of care as schedulers focus simply on ‘just getting care’
scheduled
The sub-optimal scheduling has significant impacts for clinical staff, as they:
◦ Have to travel long distances between their home and their appointments
◦ Have large gaps between appointment times for which they are either not or only
partially compensated
◦ Encounter patients not at home upon arrival
◦ Have conflicting demands of their time (e.g. scheduling, providing care vs. charting)
3 Context
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Home health care logistics is unique and challenging
◦ Unlike for other industries where delivery can be done by any personnel, provision
of care in the home requires precision – the right care at the right time in the right
place by the right resource with the right skill sets
In other words, home care service delivery is among the most complex of the
transportation class of problems, being:
◦ Multi-depot (care providers typically start work from their homes)
◦ Capacitated (care providers have limited availability)
◦ Time window constraints (visits can have specific service times)
Identifying the optimal set of territories within a geography is also extremely
challenging due to the infinite number of solutions that are possible
The Challenge4
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Our solution is a patient-centred heuristics-based solution to clinician assignment
and routing of home care staff across a region.
5 The HCI Logistics Solution
Home of Nurse
for Agency 1
Home of Nurse
for Agency 2
Home care Patients
Current StateFuture State with
the HCI Solution:
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The home care scheduling problem is in a class of computing problems called a
vehicle routing problem (VRP) and is considered an NP-Hard problem (i.e.
effectively unsolvable)
The multi-depot, time-windowed, vehicle routing (MD-TW-VRP) problem is one
of the hardest within this category
◦ A 100 point problem could take a super-computer 3 weeks to solve, if it is even
possible
Therefore, we use an heuristics-based approach to obtain a high-quality solution
in minutes – not weeks
5 How Do We Do This?
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Simplifies scheduling of home care visits to a single automated function that
simultaneously considers:
◦ Clinical requirements (e.g. time constraints, frequency, resource skill types)
◦ Patient preferences and requirements (e.g. clinician gender, languages)
◦ Resource preferences and requirements (e.g. travel preferences, working hours and
conditions)
◦ Agency goals and preferences (e.g. minimizing travel across all resources,
preferences for using RNs vs. RPNs, salaried vs. variable pay staff, etc.)
Allows new visits to be quickly and easily fit into an existing schedule, honouring
previously assigned visits
Provides care providers with a mobile application that allows them to effectively
manage their assigned visits in real-time, through the ability to set visit times,
see the best routes to patients homes, and accept/decline last-minute
appointment requests
Includes an optional auto-dial feature to automatically notify patients ahead of
their visits or contact clinicians about changes to their schedules
5 Key Features of the HCI Solution
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5 Logistics Product Features
We have identified 5 optimization levels that can be applied to routing in home
care. The levels of optimization increase in complexity, and are based on analytical
factors and your organization’s strategic goals.
0: Mapping Taking an address and calculating its place on a map. The basis for all
geographic calculations in the system
1: Ordered Routing Calculates the driving distance and time for a set of stops in a given
order. Does NOT put the stops in the optimized sequence
2: Optimized Routing Given a set of stops, optimizes the sequence of the stops, then calculates
the driving distance and time. Optionally, can take into account event
windows (e.g. patient needs to be seen in the morning
3: Event
Recommendation
Returns a recommendation list for a particular event. Takes into
consideration the existing clinician schedule, patient location, skills and
time windows.
4: Daily
Recommendation
Takes a list of events for a given day, plus all available resources, and
calculates to best distribution of events among the resources
5: Clinician
Recommendation
Also known as “Primary Assignment”, this optimization analyzes all the
events for a given patient and returns a list of recommended clinicians to
best serve as each patient’s main clinician for the full episode of care
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Levels 0 and 1 are basic logistics calculations that serve as the foundation for
everything HCI does
◦ Correctly placing an address on the map (Level 0) is so critical to all the subsequent
levels, we use multiple redundant geocoding services to ensure accuracy
Optimized Routing (Level 2) is the first level where we make a recommendation
– by providing the fastest order to complete a set of visits for a day
◦ Included in our solution is the ability to incorporate time constraints (e.g. due to
patient availability or clinical requirement) in determining the best route for the day
5 Levels 0-2: Maps & Routing
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Event recommendation (or Best Fit Analysis) can help you adjust quickly to urgent
service requests, or if a clinician calls in sick at the last minute.
5 Level 3: Event Recommendation
Using the event recommendation
tool, you will be presented with a list
of recommended resources to choose
from, along with their score.
The score is determined by:
Distance from the Patient
Resource Type & Capacity
Patient/Resource Preferences
The lower the score, the better the
fit!
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Event recommendation comes with additional tools to help schedulers evaluate
each recommendation before selecting the final resource assignment.
5 Level 3: Event Recommendation (cont’d)
Map
Provides a quick overview of the selected
resource’s driving route for that day
Current Schedule
Shows the resource’s current schedule
including the proposed visit to be added
Driving Detail
Easily see the driving schedule for the day
before assigning the visit
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Through an automated process, the scheduling algorithm compares the services
required to the location and types of staff available to come up with the best
overall solution for the organization for that day.
5 Level 4: Daily Recommendation
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Patient Recommendation can help identify a clinician who can provide the
maximum number of visits within the required episode of care, while travelling as
little as possible.
5 Level 5: Clinician Recommendation
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Reduce scheduling effort, travel time and associated costs
Improve working conditions and retention without increasing compensation
rates
◦ Reduce unpaid time between visits & provide greater predictability in staff
schedules
◦ Reduce paid travel time
◦ More time for staff to complete required documentation in a timely manner –
improving compliance and reducing issues upon billing
◦ Greater client satisfaction with “local” care providers within their own communities
◦ Reduce coordination staff which in turn produces annual savings without reducing
effectiveness
Potential to optimize on other factors (e.g. pay type, skill, or to balance
schedules among staff)
Easy integration with existing clinical operations and billing systems, even for
those few that have automated scheduling within their silo organization
6 Operational Benefits of the HCI Solution
The HCI Logistics solution provides many operational benefits to service providers
organizations:
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PSW harmonization (scheduled to begin in 2017) will make clinician travel costs
visible to the funder
◦ Given that funders will be responsible for travel costs, they are incented to provide
volume to those agencies that can demonstrate lower associated travel costs
◦ This provides an opportunity for SPOs to distinguish themselves from their
competitors if they proactively address the issue of accurate and enhanced travel
cost management
Additionally, the HCI solution will help your agency demonstrate other
advantages over your competitors
◦ The ability to complete more visits with fewer resources enhances efficiency and
creates capacity for growth
◦ Flexible heuristics-based assignment enables the organization to ensure every
patient assignment decision works towards improving your desired quality and
operational performance indicators
◦ Real-time metrics enables ongoing proactive operational management of your
clinical staff
◦ Access to a robust business intelligence solution allows the agency to uncover new
opportunities to improve patient outcomes
6 Strategic Benefits of the HCI Solution
In a competitive environment, the operational benefits of the HCI solution can help
strategically position your agency for growth.
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Many other companies claim that their solutions will also save mileage costs.
In general, these claims are based simply on the impact of:
◦ Using simple GPS/geofencing for visit verification
◦ Calculating the distance between each sequential visit (e.g. using Google Maps or
similar), based on an order determined by the clinician with no system guidance,
and using that as the billable mileage
◦ Reduction in mileage due to the “monitoring effect” on clinician mileage behaviour
– i.e. a “fraud check” to eliminate rounding effects and clinician bias
These features alone are wholly inadequate for optimizing and managing the
complex logistics challenges that home care agencies face today.
7 Competitive Advantage
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As far as we have been able to determine, no other solution other than HCI
includes any ability to help your organization make better decisions about:
◦ Which visits to assign to which clinicians to best enable continuity of care, and to
minimize the distance between a clinician’s patients (“clustering”)
◦ How a clinician should order the visits within their day to complete them in the
most efficient manner
The HCI application and mobile application together can provide all of these
benefits and more in a single integrated solution, including:
◦ Geofencing and visit verification
◦ Visit completion and documentation
◦ Automated visit billing and mileage calculation
◦ Optimization of visit sequencing by clinicians
◦ Automated notification to patients (auto-call)
◦ Heuristics-based optimization of visit assignment over entire episodes of care
◦ Operational management dashboards
◦ And much more…
7 Competitive Advantage (cont’d)
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8 Additional Offerings
In addition to the Logistics Solution, HCI also offers a Territory Generation solution
and healthcare-focused Data Analytics Services.
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8 The HCI Territory Solution
The HCI Territory Solution supports three potential ways to divide a geographic
area into territories, each with its own set of benefits and drawbacks.
Postal codes provide a pre-defined and relatable set of boundaries, and as such
are a common method used to define territories. However, postal codes were
not designed to represent geographic areas, and many have strange shapes or
are non-contiguous
Free-form generation usually yields better territories
than postal codes but is extremely time-consuming
Algorithms can automatically generate a set of territories
that are designed to optimized for designated
variable(s), and can dynamically flex to adjust to
changing demands
Once the territories are generated, the HCI Territory solution includes an intake tool
that identifies the appropriate territory for any given address.
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8 The HCI Territory Solution (cont’d)
HCI’s territory generation solution can combine the “art” of free-from adjustments
with the “science” of the algorithms to easily yield a set of territories that are fair
and operationally efficient.
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As experts in collecting and managing Big Data analytical systems, we have
experience building data warehouse solutions for service providers, EHR vendors
and tele-monitoring companies
Our experience with the nuances of home care enabled us to create advanced,
multi-dimensional business intelligence solutions.
◦ The architectures were based on traditional DW strategies involving periodic ETL
processes and pre-processing the multi-dimensional cubes.
While traditional data warehouse architectures are well established, tried and
true methods, we feel the future of big data is not based on these architectures,
rather using new Big Data architectures.
8 Data Analytics Solutions
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9 Conclusion
HCI’s solutions can enhance existing home care assignment, scheduling and routing
processes for a home care agency, functioning as:
An Analyzer – assessing the myriad of
scheduling and routing combinations
to provide the best daily, weekly
schedule for care providers
An Optimizer - determining the best
clinician to perform visits in the best
order and on the best days to ensure
patient care needs are met ensuring
continuity of care
An Efficiency Expert – by improving
mileage efficiency, the same amount of
work can be done with fewer staff,
without the perception of staffing
shortages
A Watch Dog – to help benchmark
and measure productivity and financial
progress
A Tree Hugger – reducing home care’s
carbon footprint through reduced
travel
An HR Manager – analyzing for HHR
staffing efficiencies to create the
capacity needed to meet growing
demands
A Strategy – to improve home care
system effectiveness, reducing costs
while improving quality of care
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10 Contact Us
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Or Contact Us At:
E-mail: [email protected]: (561) 506-4613USA: 1 (800) 763-1957UK: (+44) 7464-720798
For more info, find us at:http://homecareintel.ca
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