SUNNYVALE, CA — November 21, 2016 — Pathways Home Health and Hospice became the first home health, palliative care, hospice and private duty organization in the San Francisco Bay Area to adopt Epic’s electronic health record system (EHR). A company news release announcing the decision indicated that this will connect them “to the largest group of hospitals and physicians in the United States” and ease patient transfers from hospital to home-based care.

“My sister recently moved to the Bay Area from Hawaii. She was having complications from a dog bite that she received before moving. She couldn’t find any of her paperwork, prescriptions, or anything related to the incident from her doctor in Hawaii,” said Laurel Ashcraft, RN, a Pathways nurse. “But when we went to the doctor at Palo Alto Medical Foundation, they were able to pull up her chart in Epic. We knew all we needed to know and she got the care she needed. It was such a relief to us both and now we are able to offer the same service to our Pathways patients.”

The Epic EHR was turned on November 1, connecting Pathways to almost 2,000 hospitals and over 34,000 clinics nationwide. Better data exchange capabilities with California’s major healthcare providers will help patients keep their primary physicians informed as they recover from surgery or an illness or receive more help with daily tasks. When a patient or his or her family choose Pathways, they will be connected to this same system. [More details are provided in this article about the value of easily accessing patient records on a national level and so improving patients’ quality of care. Senior players at Pathways provide comments on the value of using the Epic system for providing patient-centered care.  Additional details about Pathways’ history and wide range of services is also provided.]

“Being able to bring patient data together from different sources is one of the biggest challenges in healthcare,” said Pathways IT Director Brad Miller. “Not having all the information available in one place can cause problems such as delays in treatment, duplicate testing or conflicting prescriptions. Epic is helping us overcome that challenge by connecting us to other health systems — regardless of what EHR they use — and consolidating all of our data into one place. It makes a big difference to the quality of care we can provide.”

“More than 12 million patients are currently on the Epic system in Northern California,” said Pathways CEO Barbara Burgess. “That’s at 19 different facilities. Now, they will be able to experience a seamless transition of care from their hospital or clinic to service at home with Pathways.”

Since August 2015, a diverse group of Pathways clinical leadership including registered nurses, physician assistants, nurse practitioners, therapists, home health aides, and hospice providers have worked with the leadership of El Camino Hospital to tune the Epic system to fit Pathways culture.

Burgess explained that patients’ health goals had to be at the center of the plan of care. “From our first conversation with a patient to our last nursing visit, Pathways makes patient wishes the core of our care.”

Other organizations in the San Francisco Bay Area that have implemented the Epic system include Palo Alto Medical Foundation, Contra Costa Health Services, El Camino Hospital, John Muir Health, Kaiser Permanente, Santa Clara Valley Medical Center, Stanford Health, Sutter Health, and the University of California Health System including UC Davis and UCSF.

About Pathways
Pathways Home Health and Hospice, a Bay Area not-for-profit founded in 1977 by a group of Stanford physicians and community members, is moving care forward with its home health, hospice, private duty home care, palliative care, and geriatric care management services. Known for its innovative pilot projects, Pathways recently launched a unique in-patient program in partnership with Stanford Healthcare.

With offices in Sunnyvale, South San Francisco, and Oakland, Pathways family of services reaches more than 5,000 families annually in five Bay Area counties. Pathways cares for patients wherever they live—at home, in nursing homes, hospitals, and assisted living communities.

Affiliated with El Camino Hospital and Sequoia Hospital since 1986, Pathways Home Health has been a HomeCare Elite Top Home Health Agencies award winner for the past four years. Pathways Private Duty has been a Home Care Pulse Best of Home Care Provider of Choice award winner for the past two years.

For more information about Pathways, or to donate, call 888-755-7855 or visit

©2016 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report. One copy may be printed for personal use; further reproduction by permission only.


by Danielle Strachan-Scott, of the London, England home care agency, The Good Care Group, producers of an award winning guide: “Dementia: Through Their Eye.,”

The Good Care Group is an award-winning, London home care agency. As a public service, the company has produced “Dementia: Through Their Eyes,” a free, 15-page guide on how to deliver person-centered care to people whose lives have been affected by dementia. Providing practical tips on communicating, eating well and improving well-being, plus advice on assistive technology and creative therapies, it provides the reader with a compelling, informative and easy to understand resource, helping people better understand how to communicate and care for people with dementia. The authors note their mission as follows:”We believe sharing this valuable and informative resource with families of affected patients would help to improve the lives of many people who have dementia, and their loved ones. Educating and providing people with useful tips on how to care for the ones closest to them could make a huge difference and change their lives for the better.” Tips for using this guide are provided by the authors, along with numerous pointers needed for better understanding this patient population.]


We believe sharing this valuable and informative resource with families of affected patients would help to improve the lives of many people who have dementia, and their loved ones. Educating and providing people with useful tips on how to care for the ones closest to them could make a huge difference and change their lives for the better.

Independent Specialist Care Awards (England and Wales)

Independent Specialist Care Awards (England and Wales)

Tips from The Guide
The Guide seeks to educate people to about different types of dementia, noting that dementia is a “collection of syndromes resulting from damage to the brain” (page 3), with Alzheimer’s being the most common type. It also covers common functions which can be affected by dementia, including memory, thinking speed, mental agility, understanding and judgment.

The Guide highlights that although these symptoms are common among most individuals with dementia, the rate of progression varies from person to person and is dependent on the type of dementia, as well as the overall health and lifestyle of the individual. The Guide encourages anyone who is concerned about dementia to seek help by talking to their primary care physician.

Feelings more important than facts
The Guide explains that it often becomes difficult for people with dementia to store new factual information. Noting that the feelings a person experiences do continue to be stored as normal. Therefore a person with dementia will always know how he is feeling, but he may not know why. The guide quotes Christine Bryden, diagnosed at age 46 with Alzheimer’s Disease, “As we become more emotional and less cognitive, it’s the way you talk to us, not what you say, that we remember.”(page 4)

In the absence of recent factual memories, people with dementia are likely to search for much older factual memories, possibly from youth, to help make sense of their current situation. The guide offers tips on how to effectively communicate with the person, mentioning the importance of creating a calm and relaxed environment, and joining the reality the person is living in rather than contradicting them.

Adopt a ‘Person-First’ approach
The guide states we must adapt to a “person-first” approach in the household. Pam Schweitzer (1998, page 4) proposes that looking through family photos, listening to familiar music and visiting memorable places may help sustain a better relationship between family and person, as well as carer. This helps the person feel at ease by reminiscing about happy memories.

Three Golden Rules developed by “Contended Dementia” a person-first approach

The SPECAL® method is a person-centered approach that can greatly improve well-being and quality of life as well as strength your relationship with your loved one through positive communication techniques.

1. Avoid asking direct questions

It is important to avoid asking direct question that require factual information, this increases awareness of their disability which in return causes more stress and grief.

2. Listen to the expert

It’s important to listen to what the person affected is saying, to base our questions and answers from their perspective; any information they receive should generate good feelings for them.

3. Do not contradict

It’s important to not argue with them, we must not sidetrack them from pre-dementia memories, as they are used to make sense of the current moment. We must support and validate what they are saying as being correct.

Assistive Technology And Examples
The Guide promotes the use of assistive technology as an aid for greater autonomy.

Helpful technology includes:

  • Taking tracking devices on walks, which allow patients to have a greater sense of independence
  • Telecare sensors to monitor the person can notify a nominated person or call centre if they have fallen or have left home during the night
  • Introducing adapted versions of household appliances such as doorbells and telephones with larger buttons and bolder colours

It is important to note assistive technology is more effective when introduced in the early stages of dementia; gradual introduction of these technologies can prevent confusion. The guide also states assistive technology is best when combined with a ‘person-centered’ care service.

Explore dementia patients’ creative abilities
The Guide notes that; “people’s aesthetic and imaginative responses remain strong, music and art can be a positive and energising experience.”

“Arts 4 Dementia” have successfully organised events with arts venues, encouraging people with dementia to take part in art, music, dance and drama events around the country. The guide states that “attendees have remained energised, happy and stress-free for sometime afterwards, with 94% still benefiting overnight and 60% benefiting for a week or more.

“The creative part of the brain can remain undamaged for years” – Veronica Franklin Gould, CEO of Arts 4 Dementia

Staying active and keeping healthy
The Guide notes the importance of physical activity for people with dementia, offering suggestions on types of activities which promote happiness and well-being. The guide explains that walking the dog or gardening helps to maintain a connection to normal life, retain skills and improve sleep, appetite, circulation and digestion.

The Guide also states that people with dementia can have a preference for sweeter foods, finger foods and regular snacks as smaller portions are often more appealing.

Bringing carers into the home
The Guide recommends that care be provided in a familiar environment such as the home; here a person can receive an unrivaled level of support through one-to-one, live in care, whilst also continuing to enjoy their independence.

The guide informs us of the type of care one would receive, stating, “Carers using a ‘person-centered’ approach will deliver holistic care, taking into account personal and emotional needs, in addition to practical and medical tasks they may need help with.

What distinguishes “The Guide ‘Dementia: through their eyes” is that it offers different ways of thinking and understanding the person with dementia, and provides information and practical tips to help support the person with dementia live better, happier and more productive lives. The guide encourages good practice and explores dementia from the perspective of the individual.

This helpful guide offers a wealth of in-depth content, that also answers questions concerning sleeping patterns, medical support, funding and have listed a number of relevant resources, and organisations to support those affected by dementia.

Click here to download The Guide

The Guide was published by The Good Care Group, London, UK.

by Audrey Kinsella, Telehealth Reporter,  Home Care Technology Report

I remember it as though it were yesterday. It was the great Gene Tischer, former Executive Director of the Home Care Association of Florida, who taught me a memorable lesson years ago, as he did many audiences large and small over the years. An audience member had asked him, “Gene, what’s the best option for eldercare now? Nursing Homes? Assisted Living Facilities? Home care?”  He said, “Adult daughters.” I walked away shaking my head. I have one son.

I was reminded of Gene’s advice last month as one of the exhibits at the Partners Health annual “Connected Health” symposium caught my eye. MedSentry™ bills itself as “The Prescription for Medication Adherence.” The Westborough, Massachusetts company offers a modular medication management system designed for patients with a high number of prescriptions. Booth personnel explained to me that the system features custom medication packaging, cloud-based pharmacist management, imaging technology, and compartments that can manage a dozen medications or more. [ New wearables and mobile technologies are effecting needed changes in today’s elderly patients who want to live at home, it’s noted, but with some needed help provided by family members. Kinsella provides details about MedSentry™ use by an elderly patient/client and her assistance provided by her adult daughter. Details about successful use of such devices like MedSentry™ in a clinical validation study that had been conducted by Partners’ Center for Connected Health and Massachusetts General Hospital are provided. A general theme provided in many presentation at the Partners symposium focused on today’s new senior population at home is this: we must embrace [the new senior population] as “technologies as a service for life.” This is the new and different patient we as an industry are soon to meet. Not the dependent, homebound person but the active, independent senior, living well at home — and everywhere else — thanks to tools that enable self-management of chronic conditions.]

When I asked whether the dispenser was mobile, they told me the story of one devoted daughter who prepared her elderly mother’s dispensary every month with 12 different prescriptions drugs that had to be taken at varying times of the day. Once filled, the mother was able to self-manage when she was at home and when she visited other family members, often for days or weeks at a time.

After telling me that story, they quoted a clinical validation study that had been conducted by Partners’ Center for Connected Health and Massachusetts General Hospital. It found a 9% hospitalization rate among MedSentry™ users and a 50% rate for all-cause hospitalizations in the control group and a 36% rate of hospitalizations for heart failure.

I concluded, after my time in Boston, that seniors who live at home, get out more often, and remain active, are becoming more common. Connected technologies are making passive seniors obsolete, regardless of their chronic conditions. Robust new wearables help them share health data with their doctors and nurses. They are able to be more engaged with their care, even while away from home.

At all times, keynote speakers and product vendors returned to the theme that the technology must be usable to be worthwhile. Ease-of-use features were constantly cited as the key to new tools helping patients educate themselves and chart their own progress as they age. As mobile health tools evolve, they move in the direction of being easily used by people of all ages. That does not mean the adult daughter is not still critical. She may be able to use the tools more confidently.

The old joke comes full circle. When mobile computers were new and CMS first began requiring electronic forms and claims submission, Healthcare at Home agency staff often balked. “I will never be able to learn how to use this gadget,” they often said. The helpful manager would often reply, “Don’t you have an 11 year-old at home? She can teach you.”

Fast-forward to 2016 and that built-in 1980’s computer instructor may now very well be the person filling the retired home health worker’s MedSentry™ dispenser.

Coaching elders in technology use and engaging them in their own care are key to teaching self-management routines and keeping them at home, where they prefer to live. Ease-of-use features benefit these adult daughters as much as they do their elderly parents with multiple chronic conditions. Consequently, keeping seniors engaged in self-management may begin with coaching adult daughters, who, as Gene Tischer taught us years ago, are becoming essential to both their elderly parents and their parents’ care team.

As presenter Lauren Costantini, PhD, CEO of Prime-Temp, Inc., indicated in his keynote address, “Wearable Sensors Expand Human Potential,” “We should not look at today’s monitoring devices as “technologies in search of a problem.” Rather, we must embrace them as “technologies as a service for life.” This is the new and different patient we as an industry are soon to meet. Not the dependent, homebound person but the active, independent senior, living well at home — and everywhere else — thanks to tools that enable self-management of chronic conditions.

Audrey Kinsella, MA, MS, is HCTR’s telemedicine reporter. She has written on home telehealthcare and new technologies for home care service delivery for 20 years, in 6 books, multiple web sites, and more than 150 published articles. Audrey can be reached at or 828-230-0895.

©2016 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report. One copy may be printed for personal use; further reproduction by permission only.


By Tim Rowan, Editor & Publisher, Home Care Technology Report

President-elect Donald Trump has nominated Georgia Congressman Tom Price, MD, to be his Secretary of Health and Human Services, and Seema Verma, MPH, to be administrator for the Centers for Medicare and Medicaid Services.

Price is well known as the author of most of the 54 House bills designed to change or repeal the Affordable Care Act and for his work with Speaker Paul Ryan to design a plan to privatize Medicare, but few outside Indiana know Ms. Verma’s name. A quick look at the Medicaid rules she set up in Indiana may give a preview into how she would run CMS. [Rowan reviews Verma’s extensive work in Medicaid reform in the state of Indiana, and notes her educational achievements. Extensive attention is given to: “Seema Verma’s Indiana Medicaid” in which Rowan  notes how Verna adapted the ACA’s Medicaid expansion provisions to include subsidized premiums and co-pays for Medicaid beneficiaries. Known as the “Healthy Indiana Plan” (HIP).  Extensive features of HIP  are provided, detailing how Medicaid recipients in Indiana  benefit from the key feature of HIP 2.0 — a Personal Wellness and Responsibility (POWER) account.]

Seema Verma

According to her web site, Seema Verma is the President, CEO and founder of SVC Consultants, Inc., a national health policy consulting company. “For over 20 years, Ms. Verma has worked extensively on a variety of policy and strategic projects involving Medicaid, insurance, and public health, working with Governor’s offices, State Medicaid agencies, State Health Departments, State Departments of Insurance, as well as the federal government, private companies and foundations.”1

Verma also served as vice president of planning for the Health and Hospital Corporation of Marion County. She also holds a master’s of public health from Johns Hopkins University.

As the State of Indiana’s health reform lead following the passage of the Affordable Care Act, Ms. Verma, under former Governor Mitch Daniels and Vice President-elect Governor Mike Pence, adapted the ACA’s Medicaid expansion provisions to include subsidized premiums and co-pays for Medicaid beneficiaries. Known as the “Healthy Indiana Plan,” the second generation of which is described below, HIP 2.0 is described as “the nation’s first consumer directed Medicaid program.” In that capacity, her firm was paid $3.5 million by the state of Indiana. Simultaneously, she was under a $1 million consulting contract with Hewlett-Packard, which landed more than $500 million in Indiana contracts during her tenure.2

Seema Verma’s Indiana Medicaid:

The key feature of HIP 2.0 is a Personal Wellness and Responsibility (POWER) account, modeled on health savings accounts (HSAs). HIP 2.0 enrollees have $2,500 POWER Accounts, which are funded annually by a combination of deposits by the state and premiums that enrollees pay into the accounts. The accounts are coupled with a high-deductible health plan that covers health care costs when the POWER Account is spent.

  • HIP 2.0 includes two types of coverage:  HIP Plus and HIP Basic. People with incomes between 100 and 138 percent of the poverty line must pay premiums and enroll in HIP Plus. Enrollees with incomes below the poverty line either pay premiums and enroll in HIP Plus or don’t pay premiums and enroll in HIP Basic. HIP Basic has significantly narrower benefit coverage — for example, it excludes dental and vision care — and charges co-pays for most services. (HIP Plus has co-payments only for non-emergency use of the emergency room.)
  • Coverage in HIP Plus isn’t effective until enrollees pay their first premium. If premiums aren’t paid within 60 days, applicants with incomes below the poverty line are instead enrolled in the more-limited HIP Basic, while those with incomes above the poverty line are not enrolled at all. People below the poverty line who enroll in HIP Plus but fall behind on their premiums are moved to HIP Basic if they do not pay the premiums within 60 days. Those with incomes above the poverty line who fall behind for 60 days lose coverage altogether — and are barred from re-enrolling for six months.
  • After 12 months, enrollees in HIP Plus can roll over a portion of any funds that remain in their POWER Account and use those funds to reduce their premiums for the following year. The amount they are permitted to roll over is doubled if they get preventive care services that are recommended for their age and gender. Similarly, enrollees in HIP Basic who get preventive care can roll over a portion of any funds that remain in their POWER Account, which they can use to reduce their premiums if they move to HIP Plus.


2 IndyS

©2016 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report. One copy may be printed for personal use; further reproduction by permission only. tar: Part of the USA Today Network, 11/29/16

Springfield, Mo. –November 23, 2016 HEALTHCAREfirst, the leading provider of Web-based home health and hospice software, billing and coding services, and advanced analytics, announced that it is hosting a complementary webinar detailing upcoming home health regulatory changes and challenges, including the CY 2017 HH PPS Final Rule. [Topics include: Rates/Payment changes, Recalibration of case mix, Outlier payment changes, and other pertinent topics of interest to healthcare at home service  providers. The free-of-charge, 60-minute we, presented by HEALTHCAREfirst (Springfield, MO) about which extensive details are provided.]

Topics include:

  • Rates/Payment changes
  • Recalibration of case mix
  • Outlier payment changes
  • Quality updates
  • Home Health Value-Based Purchasing
  • Pre-Claim Review
  • Automated denials of claims with no OASIS
  • Important home health regulatory reminders (12/1/2016)

60-minute webinar will be held on Thursday, December 1, 2016 at 1:00 pm CST (2:00 pm EST).

The webinar is free of charge, however advance registration is required.  For more information, or to register for “Home Health Regulatory Update: CY2017 Final Rule,” visit the HEALTHCAREfirst website at

HEALTHCAREfirst provides cloud-based technologies and services to support business and clinical operations for over four thousand home health and hospice providers across the United States. Based in Springfield, Missouri, the company provides agency and clinical management software, outsourced revenue cycle management services (billing, coding and chart audits), CAHPS surveys, and advanced analytics, in any combination.©2016 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report. One copy may be printed for personal use; further reproduction by permission only.
By Tim Rowan. Editor & Publisher, of Home Care Technology Report

Last month’s release of “Optima Homecare” (HCTR 10/19/16) was not merely the familiar story of another garage programmer helping out a buddy in the business, later deciding to put his homemade home health EMR software on the open market. Optima Healthcare Solutions (Palm City FL) had already made its way to the top of the therapy provider software market, boasting customers the likes of HCR ManorCare, Brookdale Senior Living, dozens of regional and national rehab facility organizations and hundreds of contract therapy companies.

Intrigued by an initial glimpse of the new product and by the caliber of the people whom Optima had attracted to design it, market it and sell it — all industry veterans we had already come to know and respect over the years in their previous companies — this reporter decided to motor down to Palm City, Florida to meet the founders and hear their story. It was not the expected story but it is one worth telling! [Rowan provides details about the two founders of the company, along with the immense contribution of two teenaged brothers, and their perfecting of software products for skilled nursing facilities (SNFs) and  work to develop products well-suited to care of the elderly. The improved/revised versions of the partners’ FoxPro product  are described, and subsequent and wide-ranging sales noted. Subsequent developments in the business and gaining significant investors both are noted.]

Chance meeting, lifelong partnership
Steve Mackie is a devoted, lifelong surfer. Raised in south Florida, he had traveled the world in search of the perfect wave. One night in the early 80’s, after putting away his board for the evening, he met single amputee Randy Wallin at a party, “back when we both had hair,” Mackie laughed. Initial admiration evolved into a friendship until one day Wallin confided that he missed surfing terribly and would love to find someone who would help him get back on a board, even if he could now only ride in a kneeling position. “I’d be honored to be that person,” his friend told him. Endless hours on the water required at least a little financing so the two went into business together, in their spare time.

Surfboard to Boardroom
The journey from avid surfers to software developers was initiated by the new Mrs. Mackie, a relationship that came after, but did not replace, the bond between the two friends. “Randy and I had started a business consulting firm,” Mackie told us, “which was perfect because it provided an income and the freedom to hit the waves almost as often as we used to. My wife, who was a nurse, told me about a new data collection system, Minimum Data Set, required of Skilled Nursing Facilities, and suggested I write some software to automate the process whereby nurses collect the data. I told her I wasn’t interested in working with old people and that I wasn’t really a programmer.”

Not surprisingly, he admitted, his wife prevailed. “I had done a little database programming so, to keep her happy, I grabbed a copy of FoxPro and managed to develop a DOS system that worked well for my wife’s friend in the SNF. After we demonstrated the finished product, he liked it so much he asked to buy it.

“‘Buy it?’ He was my wife’s friend and I thought I would give it to him as a favor to  her; I had never thought about making money on it. How much do I charge? Do I have to support it? What if the MDS changes? In the end, he didn’t have ‘a’ SNF; he had 24 facilities located throughout the East, headquartered out of Buffalo, New York. I decided to sell it to him.”

Junior achievement
Turning a simple FoxPro application into a marketable product required a software tool that Mackie and Wallin did not have and did not know how to build. So, using the technology of the time, they scoured Usenet bulletin boards until they found someone who had already developed it. “It was a marvelous little tool that we could download for free but we wanted to use it commercially so we thought we should get permission and pay for it,” Mackie told us. Getting that permission initiated a fateful series of events.

“We found a phone number for the developer of the tool,” he grins as he remembers, “and were greeted by a pleasant female voice.”

“Yes, this is Ryan Katri’s number but he is in school right now.”

“Oh, he’s still in class? What college does he attend?”

“Well, he’s not in any college.”

Steve and Randy looked at each other. “The tool that is going to save us was written by a high school kid?”

“No,” his mother said,” he is in junior high. Ryan is 14.”

The end of the story, which today is legendary in Optima hallways and part of every new employee orientation, is that young Ryan Katri finished junior high, finished high school, got a degree from Cal Poly, and is now married with children, and is the Chief Technology Officer for Optima Healthcare Solutions.

Ryan’s brother Michael was also brought aboard as the first salesman and is now Chief Product Officer. It was Michael who saw their therapy customers opening or acquiring home health agencies and suggested developing another software product for them.

And then we fell in love
Mackie and Wallin did figure out how to price, implement and support their FoxPro MDS system in the Buffalo SNF’s 24 locations, and installed the product in over 100 SNFs. It was updated when MDS 2.0 was released in 1995. In 1999, it was moved to Visual FoxPro and subsequently to Microsoft .NET.

In 2000, they were asked by another customer to build a therapy product for them. When MDS 3.0 appeared 10 years later, they opted against another re-write and sold their MDS business to PointClickCare. That was when they changed the company name from “GiftRAP” (for “Resident Assessment Protocol”) to its present name and focused their attention on the therapy market in SNFs and ALFs. Since that day, Optima has soared, providing software to more than half of the residential therapy market. To get to that level of success, however, Mackie said he first had to fall in love with the elderly.

“It was during a site visit to West Palm Beach when I admitted that I never really intended to work with old people,” he reminisced. “The owner there told me we needed to fix that. ‘Go sit with them,’ he insisted. ‘Talk to them, listen to their stories.’ So I did, and I was transformed. They were not just elderly people; they were people with incredible life stories. I talked to WWII heroes. I met the man who invented Tylenol! I-fell-in-love. Being a part of the team that brings them services, makes their caregivers more efficient and profitable, was very rewarding. That’s when we knew we were absolutely doing something worthwhile here. That experience has fueled our company’s passion ever since.”

As the post-acute market continued to shift over the years, the founders knew they could do more to serve post-acute providers, including in-home healthcare providers. Though the final chapter may not have been written yet, those that are written resulted in the company’s home health EMR product launch at last month’s NAHC Annual Meeting.

Vetting investors
About 2005, Mackie and Wallin realized how vital the Katri brothers were to the business’ future success. They had been integral to the success of the product and growth of the business, Michael driving product design and Ryan stewarding the underlying technology. Naturally, they made them partners. Recently, the team of equals that now numbered four surfers (and skiers) realized they were at the point where further growth required capital, they set about finding investors who could match their passion for the elderly. After more than 100 interviews, they found that match in Alpine Investors, a San Francisco private equity management firm that specializes in founder-operated companies. Alpine brought in Josh Pickus as CEO. Mackie took the title of Chief Customer Officer and Wallin, Chief Security Officer. Ryan and Michael Katri continue to drive the product.

As minority owners, Mackie concluded, the passion of the founders remains unwavered, “but we four partners and friends will always find time to take our boards to the beach — or hit the slopes together in winter — all the while making sure Optima continues to develop great software and treat customers as friends.”

©2016 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report. One copy may be printed for personal use; further reproduction by permission only.


By Tim Rowan, Editor & Publisher of Home Care Technology Report

Scientists from the National Institutes of Health (NIH) have identified an antibody from an HIV-infected person that potently neutralized 98 percent of HIV isolates tested, including 16 of 20 strains resistant to other antibodies of the same class. The remarkable breadth and potency of this antibody, named N6, make it an attractive candidate for further development to potentially treat or prevent HIV infection, say the researchers.The scientists, led by Mark Connors, M.D., of NIH’s National Institute of Allergy and Infectious Diseases (NIAID), also tracked the evolution of N6 over time to understand how it developed the ability to potently neutralize nearly all HIV strains. This information will help inform the design of vaccines to elicit such broadly neutralizing antibodies.[More details about the research on  the N6 and its  possible uses to curb HIV progression, and the advantages of its use over the VRC01, antibody currently being used in clinical trials.]

antib    Identifying broadly neutralizing antibodies against HIV has been difficult because the virus rapidly changes its surface proteins to evade recognition by the immune system. In 2010, scientists at NIAID’s Vaccine Research Center (VRC) discovered an antibody called VRC01 that can stop up to 90 percent of HIV strains from infecting human cells. Like VRC01, N6 blocks infection by binding to a part of the HIV envelope called the CD4 binding site, preventing the virus from attaching itself to immune cells.

Findings from the current study showed that N6 evolved a unique mode of binding that depends less on a variable area of the HIV envelope known as the V5 region and focuses more on conserved regions, which change relatively little among HIV strains. This allows N6 to tolerate changes in the HIV envelope, including the attachment of sugars in the V5 region, a major mechanism by which HIV develops resistance to other VRC01-class antibodies.

The new findings suggest that N6 could pose advantages over VRC01, which currently is being assessed as intravenous infusions in clinical trials to see if it can safely prevent HIV infection in humans. Due to its potency, N6 may offer stronger and more durable prevention and treatment benefits, and researchers may be able to administer it subcutaneously (into the fat under the skin) rather than intravenously. In addition, its ability to neutralize nearly all HIV strains would be advantageous for both prevention and treatment strategies.

J Huang, BH Kang, E Ishida, T Zhou et al. Identification of a CD4-binding site antibody to HIV that evolved near-pan neutralization breadth. Immunity DOI: 10.1016/j.immuni.2016.10.027 (2016).

NIAID Director Anthony S. Fauci, M.D., is available to comment on the research. Mark Connors, M.D., chief of the HIV-Specific Immunity Section in NIAID’s Laboratory of Immunoregulation and the senior author of the paper, also is available.

The research team included scientists from NIAID’s Laboratory of Immunoregulation and Vaccine Research Center.

This article originally appeared on the web site of the National Institutes of Health, under the heading “National Institute of Allergy and Infectious Diseases.” Reprinted by permission.


By Tim Rowan, Editor & Publisher of Home Care Technology Report

Sharon Brothers thought she would operate residential facilities for seniors for her entire career. She had prepared for it, earned a Masters Degree for it, and was good at it. Starting in the late 1980’s, she opened assisted living facilities in a number of Washington, Oregon and California communities. As the poet said, however, “Life is what happens to you while you’re busy making other plans.” Today, as the CEO of an online learning company with 58 employees, she looks back on her choices and is happy they led her here, where she is certain she is making a difference. [Rowan provides details on Brothers’ genesis of her online educational company, The Institute for Professional Care Education, LLC. Based in Vancouver, Washington, and  which today offers over 500 online and DVD courses in five categories: Home Care, Home Health, Assisted Living, Government Required Training, and Individual Professional Certifications. As it grew into a successful, full-time business, Brothers and partners sold their ALFs to Brookdale in order to be free to concentrate on education. Brothers and staff markedly started listening to educational needs of customers and potential customers; and then provided ways to provide comprehensive educational courses that were fun through learning techniques such as gamification and storytelling.]

Sharon Brothers

How fate intervened
Years ago, before “online education” and “distance learning” were common terms, Ms. Brothers invested quite a sum to take several of her Assisted Living Community staff to an education conference in Las Vegas. “It was a horrible experience,” she shuddered. “The instructors let everyone sit there and listen while they talked among themselves on the stage. It was as though their sole responsibility was to provide CEs, not a quality educational opportunity, and our only responsibility to earn those CEs was to show up.”

She put it to her staff, “Can’t we do this better? The technology is out there; why did we have to travel all the way to Las Vegas to receive mediocre information badly presented?”

That was how the seed was planted that eventually grew into The Institute for Professional Care Education, LLC. Based in Vancouver, Washington, IPCed today offers over 500 online and DVD courses in five categories: Home Care, Home Health, Assisted Living, Government Required Training, and Individual Professional Certifications. As it grew into a successful, full-time business, Brothers and partners sold their ALFs to Brookdale in order to be free to concentrate on education.The Institute for Professional Care Education, LLC.

“We started by listening to consumers and potential customers,” Brothers told us, “and building programs to serve unmet needs.” The early days, before regulators were familiar with online learning, were not without obstacles “California told us, ‘You can’t do this online. You have to be face-to-face with an instructor in order to earn CEs.’ So we challenged them, asked why not, and found ourselves in a three-year tug of war. Finally, California said, ‘OK, you can take half your courses online.'”

Since then, she concluded, IPCed has changed the way training is delivered to caregivers, which has changed the way they deliver care. “What sets up apart,” Ms. Brothers opined, “is that we do not define ourselves as a compliance training provider. We are not here to simply allow people an easy way to check the box.”

She said the Institute’s message to its thousands of learners is meant to inspire as much as encourage:

  • “What you know impacts the people you serve.”
  • “The more you know, the better care you will give.”
  • “You are more than just a minimum wage worker; you are the most important person in this industry.”
  • “View yourself as a professional; commit to lifelong learning.”

Making learning fun
IPCed’s use of learning techniques such as gamification and story-telling encourage course completion, Ms. Brothers explained. “What we are after are the ‘aha’ moments,” she laughed. “We love it when we hear them say, ‘Oh, I see, I make a difference in people’s lives when I know these things and do these things I’ve learned.’ Or ‘I know I was told to take as long as I wanted to complete this course but I finished it all in one night because I had to find out what happened to the lady in the story.'”

Her favorite, she added, is when they say, “I could never have gotten this certification without online learning because I can’t take time off work to go to a class.”

“We’re trying to create a success environment,” she concluded. “Training is a marketing, retention and recruitment tool. As agencies thrive, they build strong marketing relationships, touch more lives, and become better at providing care. When they do that, they become more stable employers, pay better, and employ people who provide a more consistent quality of care. I hope our company has moved the needle a little in the way education is changing the care we provide in this country.”

©2016 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report. One copy may be printed for personal use; further reproduction by permission only.

Vendor Watch:

[1) Thornberry Ltd and new VP of sales Robert C DeArmitt;  2) Bayada Home Health Care & Strategic Partnership with Prepared Health and DNA™ and enTouch™software programs; 3) PasswordWrench and launch of patent-pending password management solution.
Details are provided about 1) Thornberry Ltd (Lancaster PA) , its history and healthcare at home software (including NDoc®. and its use for clinical documentation and compliance in post-acute care) and hiring Robert C. DeArmitt  as VP of Sales; 2) BAYADA Home Health Care  (Moorestown NJ), the nation’s largest private provider of home-based services, and PreparedHealth (Chicago) software developer–and their strategic partnership to enable at home patients to stay well at home with use of enTouch™ and DNA™– 2 software program for at home patients; 3) PasswordWrench (Sacramento ) and launch of patent-pending password management solution.]

1) Healthcare at Home EMR Sales Veteran Joins Best in KLAS Thornberry Ltd.

LANCASTER, PA – Thornberry Ltd., provider of home health software solutions for over 20 years and an industry forerunner in both EMR certification and interoperability, announced that Raymond C. DeArmitt has joined the company as Vice President of Sales.

DeArmitt brings with him 25 years of healthcare sales experience, including leading national sales in the post-acute space for the last 15 years. Showing proven results in the homecare information technology market, DeArmitt has well-documented skills developing successful sales strategies and processes and keeping customer satisfaction high through strong partnerships.

“Home health and hospice agencies require comprehensive and integrated software that can handle all aspects of the business,” DeArmitt said. “Thornberry has tremendous offerings for both markets and has the highest customer satisfaction reputation in the industry. Their dedication to their customers and the market is one of the many reasons that this opportunity is so exciting.”

DeArmitt comes to Thornberry from his role as VP of Key Accounts at ContinuLink, where he started the national accounts program. Earlier executive positions include VP of Sales at CareAnyware, since acquired by Brightree, where he vigorously expanded the company’s deals portfolio; and VP positions at CellTrak Technologies and Allscripts Homecare, now known as NetSmart, where he significantly increased revenue and expanded the customer base at both companies.

In his new role, DeArmitt will report to Thornberry President and CEO Tom Peth, and will bring home health and hospice agencies into the future by driving sales of the company’s Best in KLAS EMR software, NDoc®.

“These are exciting times for both the homecare industry and Thornberry,” said Peth. “We are pleased that our sales organization will be led into our next phase of growth by a seasoned sales executive who is very familiar with home health and hospice. Ray is a great guy, a capable leader, a consummate professional and highly regarded in our industry.”

About Thornberry
Founded in 1992, Thornberry Ltd. is the creator of NDoc® – a complete home health and hospice management information and electronic medical record application. NDoc is a CCHIT Certified® 2011 Long Term and Post-Acute Care EHR additionally certified for home health. NDoc’s key functional elements include clinical documentation and compliance, workflow management, financial management, business intelligence and document management. Powered by rapid information exchange technology, NDoc is a connectable application able to quickly share data with healthcare providers across the continuum. NDoc is a powerful, flexible and comprehensive solution that increases clinicians’ efficiency, improves patient outcomes, provides rapid interoperability and enhances employee morale and agency profitability. “NDoc®” is a registered trademark of Thornberry Ltd.

Bayada Deploys Patient Engagement Systems

Chicago, Illinois and Moorestown, New Jersey – November 16 – BAYADA Home Health Care, the nation’s largest private provider of home-based services, and PreparedHealth, a growing healthcare engagement company, announced today a multi-year strategic partnership. The alliance comes on the heels of several successful projects in Pennsylvania, New Jersey, and Florida that proved to proactively keep patients out of the hospital and lowered overall readmissions for health system partners and health insurance companies. The two companies are currently expanding the offering of enTouch™, a social network for healthcare, and DNA™, a Digital Nursing Assistant, across BAYADA’s network of home health, personal (assistive) care, hospice, physician house calls and home-based pharmacy specialties.

DNA™ helps care providers identify clients who require timely interventions. enTouch™ is a  secure social network to bring together providers and family caregivers. Once on the network, participants can easily identify which of their patients require intervention, coordinate referrals, manage transitions, place orders, and even involve family caregivers as needed.

About PreparedHealth
A Chicago-based healthcare technology company, PreparedHealth empowers people live independently in their own homes and communities.

New Secure Password Management System Introduced

Sacramento, CA – Nov. 15 – PasswordWrench announced the launch of a patent-pending password management solution which protects individuals’ and corporations’ confidential information, reducing online identity theft. The secure password manager system helps users create and recall complex passwords, making it nearly impossible for criminals to hack information.

Currently, over 15 million people in the U.S. have their identities stolen each year and with recent hacks into Yahoo!, Dropbox, LinkedIn and other major databases. This number continues to grow, leaving over 100 million people’s information vulnerable. Increased hacks, whether via sophisticated Internet attacks or by peering over a shoulder at a coffee shop, have left corporations and individuals vulnerable. The PasswordWrench system mitigates those risks and keeps digital data safe, without storing passwords in the cloud, where events have shown they are still vulnerable to attack.

Instead, this technology eliminates weak passwords, protects against threats from keyloggers, hidden cameras, insider errors and guesswork or brute-force threats. There is a free plan for individuals and customizable packages for businesses.

©2016 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report. One copy may be printed for personal use; further reproduction by permission only.

FRANKLIN, TN – November 17, 2016 – PlayMaker CRM announced today the addition of Jennifer Artabane, MBA as Senior Director of Product and former WebMD CEO Wayne Gattinella, MBA as Board Member. Ms. Artabane will serve as Senior Director of Product.

“These additions to our company reflect our continued commitment to bringing together the brightest minds in healthcare and technology to solve the business growth challenges of the post-acute care space,” said John Griscavage, CEO of PlayMaker CRM. “We are delighted to have Jennifer join the team; her product leadership and insight will ensure that PlayMaker CRM remains at the forefront of innovation for post-acute care providers.” [Details about Jennifer Artabane‘s and Wayne Gattinella‘s  backgrounds and extensive career achievements are provided.]

Most recently, Jennifer served as Product VP for Brooks Bell, Inc., a testing, optimization and personalization consulting and services firm. In this role, Jennifer was responsible for leading the organization’s nascent software product strategy, planning, and development. Prior to Brooks Bell, Jennifer served as the VP of Business Operations and Marketing for ReverbNation, where she worked with the product development and marketing teams to build and market solutions and services to assist independent artists advance their careers. Jennifer also spent six years working on and leading the ChannelAdvisor Product Management team, specifically responsible for the marketplace integrations and core functionality of the ChannelAdvisor platform.

Jennifer earned her MBA from Duke University’s Fuqua School of Business, and her bachelor’s degree in Business Administration from the College of William and Mary.

Gattinella brings impressive pedigree to board
Also announced today is the addition of Wayne Gattinella to the PlayMaker CRM Board of Directors. Gattinella has played a key leadership role in the success of several game-changing organizations in the digital information space. Prior to joining DoubleVerify in 2012, he was CEO and President of WebMD, the most recognized brand of health and wellness information. Under Wayne’s 10-year leadership, WebMD significantly expanded its revenues and profitability into one of the world’s preeminent web properties, with a market cap over $3 billion. Wayne held previous management positions in several high growth public companies including Medco Health Solutions, MCI Telecommunications and People PC.

“Wayne has been at the helm of numerous healthcare technology success stories,” Griscavage said. “His unique perspective and experience will allow us to effectively manage the growth trajectory that we have been on for the past few years.”

Wayne holds an MBA from St. Joseph’s University and a BS from Drexel University LeBow College of Business in Philadelphia. He also serves on the Board of Directors for HealthGrades and the Advisory Boards for Drexel University College of Medicine and LeBow College of Business.


©2016 by Rowan Consulting Associates, Inc., Colorado Springs, CO. All rights reserved. This article originally appeared in Tim Rowan’s Home Care Technology Report. One copy may be printed for personal use; further reproduction by permission only.