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

The department of Health and Human Services Office of Civil Rights is charged with enforcing HIPAA privacy and security rules. Since the passage of the HITECH Act (2009) and the subsequent implementation of the HIPAA Breach Notification Rule, OCR has prioritized investigation of reported breaches of protected health information, investigating all reported breaches involving the PHI of 500 or more individuals.

Regional Offices also investigate reports of smaller breaches (involving the PHI of fewer 500 individuals), as resources permit. [A short listing is provided of recent settlements of cases where investigations of smaller breach reports where undertaken.  Rowan an notes  that as of August 2016 Regional Offices of OCR will more widely investigate HIPAA breaches.  A listing of some factors that Regional Offices will consider is provided.]


Recent settlements of cases where investigations of smaller breach reports include:

Beginning this month, OCR, through its Regional Offices, has begun an initiative to more widely investigate the root causes of breaches affecting fewer than 500 individuals. Regional Offices will still retain discretion to prioritize which smaller breaches to investigate, but each office will increase its efforts to identify and obtain corrective action to address entity and systemic noncompliance related to these breaches.  Among the factors Regional Offices will consider include:

  • The size of the breach
  • Theft of or improper disposal of unencrypted PHI
  • Breaches that involve unwanted intrusions to IT systems (for example, by hacking)
  • The amount, nature and sensitivity of the PHI involved
  • Instances where numerous breach reports from a particular covered entity or business associate raise similar issues

Regions may also consider the lack of breach reports affecting fewer than 500 individuals when comparing a specific covered entity or business associate to like-situated covered entities and business associates.

More information about OCR’s compliance and enforcement work with regard to breaches is available online at The OCR Twitter handle is @HHSOCR.

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


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

We have written in the past about the ZOE® Fluid Status Monitor and how it is being used in the home with CHF patients. (See HCTR 6/4/14: “Stabilizing Health and Reducing Hospitalizations via Noninvasive Zo Measurement“) Now we have learned that ZOE has sunk, literally.

Dr. Marc Ó Gríofa, an Irish-trained Las Vegas physician, is a former triage doctor for the shuttle program at the Kennedy Space Center. Currently, he works with the “NASA Extreme Environment Mission Operations, cleverly referred to as NEEMO. He spent eight days in July nearly 20 meters below the surface of the ocean inside NASA’s Aquarius Undersea Reef Base off the coast of Florida. The base is used to simulate conditions astronauts might encounter during long space missions or on the surface of other planets. While there, he monitored the entire NASA crew frequently with ZOE. [Details are provided about Dr. Ó Gríofa’s research scope and the ZOE Fluid Monitor’s research applications in the study of Alzheimer’s and Parkinson’s diseases and genetic disorders like Duchenne’s Muscular Dystrophy.]


ZOE Fluid Status Monitor

“The ZOE Fluid Monitor provides the capability of a portable, repeatable, objective indicator of fluid status that can be used in any conventional or unconventional clinical environment for the monitoring and management of any patient with fluid management problems,” Ó Gríofa told us. “Assuring accurate technology utilization, even when the home environment transitions to 90 feet underwater, is an expected clinical commitment to best care.”

ZOE uses two electrodes on the thorax, noninvasively assessing Zo (ohms) by passing a 2 milliamp current between the electrodes for thirty seconds. Within three to five minutes, it reports the amount of vascular fluid stability and whether it is on the increase or decrease.

One of the key reasons O Griofa is on the NEEMO mission is to see how Zoe performs. He will oversee the collection of multiple samples from each crew member to evaluate the impact of the NEEMO mission on telomere length. This research will be used to study Alzheimer’s and Parkinson’s disease and genetic disorders like Duchenne’s Muscular Dystrophy.

The ZOE® Fluid Status Monitor was developed by Noninvasive Medical Technologies Inc.

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


by Tim Rowan, editor and publisher of Home Care Technology Report

It is a familiar experience for many. First, you get a taste of the healthcare at home field. The next thing you know, you are hooked. This is exactly what happened to Chelsea Stoner, Duncan Gills, and their colleagues at Battery Ventures, a private equity fund with operations in San Francisco, Boston, and Israel. First they engineered and underwrote the acquisition of CareAnyware by Brightree (HCTR, 1/4/13). A few years later, they exited the Brightree investment when that company was acquired by ResMed (HCTR, 2/17/16). Before long, they longed to get back into home care.

Today, Battery Ventures announced it found a way to satisfy its longing. 


SAN FRANCICO, CA – August 24th, 2016 – ClearCare, the San Francisco-based software company with an EMR platform used by over 3,000 non-medical home care agencies, today announced a $60 million growth-equity investment led by global investment firm Battery Ventures. The company also announced that noted technologist Bala Krishna (Balki) Nakshatrala, former vice president of engineering at Mastercard, has joined ClearCare in the same role.

The company will use most of the investment to continue to develop its core platform and to explore new strategic partnerships, CEO Geoff Nudd told us, though some of it was used to replace earlier investors. As part of the financing, Battery Ventures General Partner Chelsea Stoner and Vice President Duncan Gills will join ClearCare’s board. [Details are provided about Chelsea Stoner’s background in working with healthcare at home software and views on promise of ClearCare to effect further change in senior health market.  Geoff Nudd (CEO of ClearCare) presents his views on expectations to lead senior healthcare at hiome market as a result of his company’s recent partnership with Battery Ventures. Bala Krishna (Balki) Nakshatrala, former vice president of engineering at MasterCard and now in same role at  ClearCare.]


In addition, Ms. Stoner comes to ClearCare with experience in the software and healthcare-technology markets. Previously, she served on the boards of Brightree and Data Innovations, a provider of software for medical laboratories that was acquired by Roper Industries in February 2015. She will continue to serve on the boards of WebPT, a Web-based, electronic medical record (EMR) solution for physical, occupational and speech therapists; Avalara, which sells cloud-based, sales-tax software; and Intacct, the cloud-based ERP provider.

“We have been big admirers of ClearCare from afar since 2012,” Ms. Stoner told us. “When we invested in Brightree, we got to see home care up close. What we saw is that technology is driving change and we wanted to get back in through a technology leader. ClearCare was the obvious choice. It is our mission to support strong companies like that.”

The company’s end-to-end platform includes point-of-care tracking, integrated payments, family portals and quality of care monitoring. ClearCare serves four of the largest five national home-care enterprises, and six of the largest 10, representing roughly 250,000 caregivers and 150,000 seniors under care. (Editor’s note: for additional ClearCare background, go to and type “ClearCare” into our search field.)

“We are excited to partner with Battery Ventures as we aggressively pursue new opportunities to grow our market leadership,” stated ClearCare CEO Geoff Nudd. “Battery’s expertise in the home care market makes the firm an ideal partner for this next step in our growth story.”

He did add that some streamlining had to happen to put the company on a strong financial footing and that there were a small number of layoffs. “But there were also several new positions created, including the VP of Engineering (mentioned above),” he was quick to add.

“This sector still has a long way to go to fully serve our senior population,” Nudd summarized. “The Rand Corporation estimates that there are as many as 18 million seniors that need the support of home care in order to remain independent. Our customers serve about 150,000 of them. We will continue to support our growing customer base and to build exciting products for them.” 

About ClearCare
ClearCare Online is a cloud-based home care software platform supporting private-duty home care companies for efficient, cost-effective aging at home. ClearCare’s web and mobile platform helps home care agencies operate efficiently, scale services and improve the quality and documentation of care on behalf of their patients.

About Battery Ventures
Battery strives to invest in cutting-edge, category-defining businesses in markets including software and services, Web infrastructure, consumer Internet, mobile and industrial technologies. Founded in 1983, the firm backs companies at stages ranging from seed to private equity and invests globally from offices in Boston, the San Francisco Bay Area and Israel. 
Twitter: @BatteryVentures
Find a full list of Battery’s portfolio companies here.

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


by Audrey Kinsella, Home Care Technology Report’s Telehealth  Reporter

A new wound care service company, Corstrata, based in Savannah, Georgia, is using advanced tele-techniques well beyond simply capturing clear pictures of wounds and assessing their progression. “A picture is worth a thousand words” does not come close to expressing the clarity made available by teletools, nor the advantage of having them delivered to home health clinicians and analyzed by Corstrata’s certified wound care nurses. [Details are provided about the size of today’s woundcare  patient population in the U.S., and its need for advanced and precise wound care imaging and treatment.  Corstrada’s specific plans to extend telewound care delivery via hub sites operating throughout the country is described in the last paragraphs of this article.]

We recently interviewed CEO and cofounder Katherine F. Piette on the company’s first anniversary about her vision for the company, which is to push at-home wound care to higher levels. Corstrata is doing this with telecommunications-ready videography and a wide geographical delivery of needed care.

Old/New wound photo comparisonNeeded indeed
Currently, the U.S. wound care industry costs $33 billion per year, and it serves over 6.5 million patients, many living with complex, non-healing wounds. It is a population projected to grow to 8.7 million.

Piette’s focus on using telecommunications-ready tools and board-certified wound care experts is key to achieving its vision of providing expert wound care anytime, anywhere. These nurses will demonstrate the use of telehealth-focused services to:

  • achieve earlier detection of difficult-to-manage wounds;
  • prevent non-healing wounds’ progression; and,
  • develop new means for affecting curative techniques of complex wounds.

Reaching these ambitious goals requires that focused, tele-wound care educational segments be put in place, Plette asserted.

Educational segment 1
Corstrata-affiliated wound care experts teach healthcare at home nurses advanced wound care management techniques for targeting care for specific non-healing, complex wounds. Teaching tools used include:

  • Videography and still photographs, discussed and color-correlated over time, presented via a cloud-based telehealth platform.
  • Expert discussion about uses of telehealth techniques to address wound care solutions.
  • Focus on managing current non-healing, complex wounds actually suffered by trainees’ patients.

Educational Segment 2
A second tele-wound care educational segment must involve training in-home nurses in advanced wound care management techniques. These are wounds that include diabetic and venous ulcers, pressure sores, and other conditions. Videos and still photographs of a range of wounds are presented and discussed with learners by the experts.

Work in wound exacerbation prevention must also be covered. Trainees, for example, are shown where and how often body temperature of a diabetic patient’s foot should be measured and steps that need to be taken to prevent development of pain and the need for amputation.

Directions ahead for alternate site tele-woundcare
We can say with some certainty that Corstrata has the potential to move telehealth into the mainstream of wound care. Dozens, perhaps hundreds of earlier home telehealth projects were limited to relatively short-term, grant-funded demonstration projects, with small groups of persons with particular chronic diseases.

This is not the path that Corstrata intends to follow. Instead, the company’s leaders plan to develop hub tele-wound care sites with multiple agencies providing expert education and services, using their own trainers and
practitioners. Hub site participants will not spend valuable time seeing if tele-wound care “works,” but will instead be learning from proven cases where tele-wound care has been shown to work. The ultimate aim is to relieve the pain and wound progression of patients currently living with diabetic ulcers, pressure sores, and other wounds.

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.


Summarized by Tim Rowan, Editor & Publisher of the Home Care Technology Report

CMS has scheduled a special Open Door Forum on the subject “The IMPACT Act and Improving Care Coordination.” 

The conference call will be held Thursday, September 15 at 2:00 to 3:00 pm, EDT

The purpose of this Special Open Door Forum (SODF) is to provide information and solicit feedback pertaining to the Improving Medicare Post-Acute Care Transformation Act of 2014 (commonly referred to as the IMPACT Act). The IMPACT Act mandates the standardization of patient assessment data across post-acute care settings including Skilled Nursing Facilities, Home Health Agencies, Inpatient Rehabilitation Facilities, and Long Term Care Hospitals in order to improve quality of care and quality of life.

This SODF will offer discussion on the goals of the IMPACT Act, the expected outcomes of the Act, and potential roles post-acute care providers can play in improving coordinated care. This SODF will serve as a platform to update providers, consumers, stakeholders, researchers, and advocates alike on the work around the IMPACT Act and to solicit input on the ways the IMPACT Act can help you improve care coordination.[Details are provided about means for participants to join the Forum.]

]CMS invites questions, comments, and ideas from providers, patients, consumers, researchers, and advocates in advance of or during the Forum.

To submit questions comments, and ideas in advance, write to:

PowerPoint slides that will be used during the call have been posted to:

Special Open Door Participation Instructions will be provided within 1 week of the call.

A transcript and audio recording of this SODF will be posted to the Special Open Door Forums website under downloads section as well as the IMPACT Act Downloads and Videos webpage.

©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.


Medalogix applies analytics to care planning

Almost without taking a breath after the last product release, Medalogix has figured out another practical way to use the vast amounts of data the Nashville-based company has been collecting, mostly through its synergistic alliance with Homecare Homebase. We spoke with CEO Dan Hogan this week to get the inside details on the new product.

“SunLeaper,” as it has been dubbed, represents a leap forward to applying Big Data to healthcare at home uses, he told us. “We needed to answer the question that continues to come up over and over, ‘This is great information; now what do we do with it?’ The need that rose to the top was a clinical application.”[Hogan describes how the role of “SunLeaper”  help move healthcare at home users from patients’ descriptive data analytics to prescriptive data analytics. The goal SunLeaper users ought to aim for is using the system to plan specific, as-needed patient visits and so save costs significantly.]

As Medicare contract auditors focus more and more on finding documented evidence of medical necessity, care planning is no longer simple, he reasons. “Individual care analytics are the wave of the future. When there are not enough human and financial resources available to visit every patient every day, you have to know what care plan is best for every individual patient. You can no longer thrive on ‘one size fits all’ care plans. You can no longer say, ‘Oh, CHF; 10 visits.’ If one patient absolutely needs 12 you bite the bullet and accept the cost of 12 visits. If another patient can get well and self-manage after 7 visits, you cannot give that patient 10 just because your standard CHF protocol calls for 10.”

The role of SunLeaper will be to bring massive amounts of data to bear to enable a clinician to customize every care plan to each individual. “COPD may not be the same in Portland, Maine as it is in Portland, Oregon. We have pointed our clients to the top 10% of patients at risk of hospital readmission with our other products. Now, we can apply data analytics to show how to apply interventions, to whom and when, on what frequency and via what discipline and in what order. SunLeaper represents our expansion from predictive analytics to prescriptive analytics.

“This is a product that is anchored to value-based purchasing models. New clinical practices are required in the face of new payment systems. In early tests, we have compared our results to CMS models. Of the six they have published, we are more accurate on five of them. We are within 1.5% on the sixth but we are working on it.”

Hogan is upbeat on the work CMS has done to build a platform of ordinal answers to a set of questions that provide value-added clinical tools. “OASIS is a data set that provides value-added clinical tools. It has enabled us to combine predictive analytics with operational analysis.”

Today, SunLeaper is in the early stages of field testing with one of Medalogix’ largest clients. “These tests will show us how we need to train future users to use the tool,” Hogan explained. The product is set for general release during the second quarter of 2017. It will be available as a monthly subscription.

“What we have built for healthcare at home is much like what cities do in terms of formulating traffic plan,” Hogan concluded. “They study data to know where to put traffic lights, how to adjust their timing for traffic pattern variables such as time of day and days of the week. It is always about the data.”

He added that Medalogix is growing and recruiting data scientists.


Libman Education Announces ICD-10 Code Update Courses
BEDFORD, MASSACHUSETTS – August 17, 2016 – To help coders and facilities prepare for the first ICD-10 update since last year’s ICD-10 implementation, Libman Education has released ICD-10 Code Updates authored by nationally recognized ICD-10 expert Lynn Kuehn, MS, RHIA, CCS-P, FAHIMA.

The extensive upcoming ICD-10-CM changes include 1,943 new codes, 422 revised codes, and 305 deleted diagnosis codes — as well as changes to CC and MCC. The upcoming ICD-10-PCS changes include 3,827 new codes, 491 revised titles, and 12 deleted codes — as well as significant changes to Cardiovascular coding. The ICD-10 Code Updates courses provide an efficient process for coders to prepare for the update.

“It’s update time and the updates are huge!,” said author, Lynn Kuehn. “The ICD-10-CM and ICD-10-PCS Code Update courses provide coders with the information they need to prepare for FY2017. The courses are interactive and contain audio and video clips of my explanations, along with activities and quizzes. The ICD-10-CM course even identifies the CCs and MCCs for the inpatient coders.” [Details about Libman Education, Inc.  and its online training courses for the healthcare workforce are noted in this article.]

About Libman Education
Libman Education Inc. provides training for the healthcare workforce. Libman Education offers self-paced online courses designed and developed by leading industry experts in Health Information Management (HIM) and Medical Record Coding. Courseware is designed for individuals as well as health care providers and institutions, public and private workforce development training programs, and professional and volunteer associations interested in preparing their employees and members for the challenges facing the HIM workforce.


©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

Companies that provide in-home care services, including hospice, plus the vendors that provide products and software to these companies, do not exactly dominate this year’s Inc. 5000 list of fastest growing companies but our industry is certainly well-represented.

The list represents a unique look at the most successful companies within the American economy’s most dynamic segment — its independent small businesses. Companies such as Microsoft, Dell, LinkedIn, Yelp, Zillow, and many other now household names gained their first national exposure as honorees of the Inc. 5000.

Among familiar home care tech names are DeVero (1759), Kinnser (2300), Homecare Homebase (3508), and Quality in Real Time (1452), which has made the list four years in a row. HospiceLink, the Alabama-based HME operations optimization consulting firm is number 160 on the list. [Details about strides achieved  by these companies in this year’s  Inc. 5000 rankings are noted. Extended comments about these companies’ rankings and growth are provided by Steve Randesi, founder and CEO of the highly ranked  DeVero (an EMR vendor). He shares his thoughts on the emerging growth of wide ranging post-acute settings that require service companies like his to provide multiple services across the continuum of patient care. A number of high ranking healthcare at home providers on the 2016 Inc. 5000 list and their rankings are also noted in this article, including Sunny Days In-Home Care, Great Lakes Caring Home Health & Hospice, and Providia. It’s noted that the complete list of 5000 fastest growing companies can be found on the Inc. 5000 web site. ]

BlackTree Healthcare Consulting weighed in at number 942, posting 420% growth over the last three years on 2015 revenue of $7 million.

DeVero led the pack of EMR vendors with three-year sales growth of 212%, and ranked number 20 in the very competitive Silicon Valley (San Jose metro area). DeVero founder and CEO Steve Randesi credits the growth to DeVero’s cloud-based platform that adapts to the needs of the shifting healthcare landscape, as well as a highly-motivated and dedicated team of employees who are laser-focused on providing the best technology and service in the industry.

“We recognize that a major transformation is taking place in healthcare with more and more services now being provided in the home,” said Randesi. As a result, traditional EHR’s, designed to support a single healthcare market segment or service line are becoming obsolete. Such legacy applications are not adaptable to the emerging requirements of healthcare agencies that are broadening their scope to provide multiple services across the continuum of patient care. We’re proud to serve the market with DeVero’s simple yet powerful, adaptable and highly-scalable multi-service line healthcare platform that supports a wide range of pre- and post-acute care services from a single platform and single, consolidated patient record.”

Several Healthcare at Home providers are also on the list. Sunny Days In-Home Care is at number 489 in the U.S., 11 in Pennsylvania and 4th fastest in Pittsburgh.

Great Lakes Caring Home Health & Hospice, based in Jackson, Michigan, makes the list for the ninth time at number 4108. After 22 years in business, the company still managed a 69% growth rate over the last three years and posted nearly $189 million in revenue in 2015.

Providia, in Fort Myers, Florida, is at number 827, after a 3-year growth rate of 480%.

Capitol Home Health in Austin, Texas hit the 2015 list at number 1545, with a 247% growth rate over three years, even though it posted 2015 gross revenue of only $7 million.

A non-medical franchise newcomer in Cincinnati named FirstLight HomeCare is at number 2036 with 2015 revenue of $3.9 million.

Serving Los Angeles, Arizona and Texas, 24Hr HomeCare made number 2295 on $48 million in revenue and a 158% growth rate over the last three years.

The complete list of 5000 fastest growing companies can be found on the Inc. 5000 web site.

“The Inc. 5000 list stands out where it really counts,” says Inc. President and Editor-In-Chief Eric Schurenberg. “It honors real achievement by a founder or a team of them. No one makes the Inc. 5000 without building something great – usually from scratch. That’s one of the hardest things to do in business, as every company founder knows. But without it, free enterprise fails.”

©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

This is the research project we have all been waiting for.

For years, healthcare at home lobbyists and advocacy organizations have been trying to get through to public and private payers the principle that both skilled medical and personal care services provided to people in their homes save more than they cost. The response of CMS and insurance companies has been, “show me.” Anecdotes and heart-wrenching personal stories have not been sufficient to convert the hearts and minds of number crunchers hungry for hard evidence.

Within the next 12 months, this will change
The Journal of the American Geriatric Society will publish an article later today (8/12/16) describing the first phase of Harvard Medical School’s new research into the impact of in-home care on overall healthcare costs. The article will be titled, “Preliminary Data on a Care Coordination Program for Home Care Recipients.”

For a preview of the preliminary data, we interviewed Mr. Geoff Nudd, CEO of ClearCare, a Harvard research partner, in advance of the article’s release. ClearCare is a non-medical home care software vendor based in San Francisco. [Nudd describes the importance of this study to researching the high costs of this industry and explains the rigorous research and study  protocols that have been designed and implemented. These protocols have been   followed by patients in a control group and other patients and their caregivers who are participants using the Right at Home telehealth-assisted home health service delivery system. Early findings are noted, as are next steps of the study.]


“This is a study with foundational, fundamental research for the whole industry,” Nudd told us, “quantifying the impact of home care on overall costs. This is a $20 billion industry but patients with functional disabilities cost the system $200 billion a year. Amazingly, research like this on this massive, high-cost patient population, this huge industry, has never been done before.”

Harvard engaged ClearCare customer Right at Home to participate in the study at 22 of its 310 franchises. “They developed a rigorous study structure,” Nudd added, “to compare patients in a control group to those under carefully designed care protocols.”

Right at Home caregivers using the Harvard protocols complete a brief questionnaire at the end of every shacidift or visit. They respond to questions such as, “Does the client seem different than usual? Has there been a change in mobility, eating or drinking, toileting, skin condition or increase in swelling?” and “Does client show any reduced talking or alertness?”

In the pilot, caregivers reported a change in patient condition after 2 percent of all shifts, representing an average of 1.9 changes per care recipient in a 6-month period. Changes in behavior and skin condition were the most frequently recorded domains.

In those 2 percent of cases, a case manager is alerted via the ClearCare software and a triage sequence begins. The patient may be sent to a doctor visit, to the hospital, or be scheduled for a home RN visit. Sometimes the response is to alert the family.

The test: Medicare claims data
“The evidence is good but anecdotal so far,” Nudd explained, “but during the first six months of next year the Harvard researchers will begin to cross-reference Medicare claims data between clients under the triage protocols and the control group. By the middle of next year, we will have quantified the impact of in-home care on overall healthcare costs.”

He is quick to add that, although this particular trial uses ClearCare software, the Harvard Medical School protocols are not vendor specific. “Any agency can be equipped to execute these protocols,” he said. “Be assured, you do not have to be a ClearCare customer to use these publicly available protocols.”

Behind the Data: People

One of the stories from the early days of the Harvard Medical School study that ClearCare CEO Geoff Nudd found most gratifying was the one he said demonstrated the remarkable effect of catching problems early. A diabetic patient had developed a foot ulcer. Her non-medical caregiver noticed it and reported it electronically to her case manager, who passed it along to the skilled medical home health agency on the patient’s care team, which had a nurse visit on the schedule for the following week. Instead, the HHA sent a nurse immediately. The RN treated the ulcer, it began to heal, and the patient did not have to go to the hospital. “It could have been much more serious,” Nudd opined. “One week later and it might have been too late to successfully treat that ulcer and avoid a trip to the hospital



Governor Pat McCrory, North Carolina Commerce Secretary John E. Skvarla, III, and the Economic Development Partnership of North Carolina (EDPNC) announced recently that Relias Learning LLC will add more than 450 jobs over the coming five years in Wake County. The online learning company had revealed plans to invest $4.5 million at its location in the Town of Cary through the end of 2020.

“North Carolina and Relias Learning share a common commitment to innovation in lifelong learning,” said Governor McCrory. “Our tech-savvy workforce, engaged community colleges and universities, and unmatched quality of life help connect companies like Relias to their long-range business objectives.”

Relias Learning is the leading provider of training, education and professional development for healthcare professionals and organizations.  Founded in 2002, the Cary-based company offers online training to more than 5,000 organizations and 3 million individuals in the United States and has recently expanded to offer its services in the UK and Germany. [Details about the extent of this company’s expansion are provided in this article and about its numerous supporters and beneficiaries.]


“Since moving to Cary in 2012, Relias Learning’s staff has grown twenty-fold and we now have almost 300 Relians here at our company headquarters” explained Jim Triandiflou, CEO of Relias Learning.  “Our people and the culture they have helped build are the leading drivers of our success and this grant will be instrumental to our continued growth and expansion plans.”

Relias Learning’s expansion will contribute approximately $39 million to the triangle’s economy. The new positions will include R&D personnel, sales and marketing professionals, and administrative staff.

“This significant expansion by Relias Learning underscores the value of North Carolina’s strong support for our existing businesses,” said Secretary Skvarla. “In helping companies like Relias address their strategic expansion goals, North Carolina facilitates the job growth that makes our economy one of the best-performing in the nation.”

Relias Learning’s expansion will be facilitated, in part, by a approved by the state’s Economic Investment Committee today. Under the terms of the company’s JDIG, Relias is eligible to receive up to $5.36 million in total reimbursements. Payments will occur in annual installments over 12 years pending verification by NC Commerce and NC Revenue that the company has met incremental job creation and investment targets. JDIGs reimburse new and expanding companies a portion of the newly created tax-base with the goal of increasing the overall tax benefit to the State of North Carolina. The state reimbursement is contingent upon local participation from the Town of Cary and/or Wake County.

By law, JDIG projects must result in a net revenue inflow to the state treasury over the life of the award. For projects in Tier 3 counties such as Wake County, 25 percent of the eligible grant is directed to the state’s Industrial Development Fund – Utility Account to help finance economic infrastructure in less populated counties. The expansion by Relias Learning could provide as much as $1.79 million in new funds for the Utility Account. More information on county tier designations is available here.

“Congratulations to Relias Learning for the remarkable growth that has led to this expansion,” said N.C. Senator Tamara Barringer “I appreciate the company’s decision to undertake its latest expansion in our community.”

“The Town of Cary and the State of North Carolina are enthusiastic partners of Relias Learning as it takes its business and workforce to the next level,” said N.C. Representative Duane Hall.

Since Governor McCrory took office in January of 2013, North Carolina’s economy has created nearly 280,000 net new private sectors jobs.

Several partners joined N.C. Commerce and the EDPNC in supporting Relias Learning’s expansion. They include the Cary Chamber of Commerce, the Town of Cary, Wake County, Wake County Economic Development and Capital Area Workforce Development.


©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.


Overland Park, KS, August 9, 2016Netsmart has announced that Dawn Iddings has joined the company as senior vice president and general manager of Netsmart Homecare™.

Iddings will manage the continued development of Netsmart’s market-leading home care, hospice, palliative care and private duty solution, including integration into the Netsmart CareFabric® suite of clinical and business solutions.

Iddings brings more than 15 years of healthcare and technology experience to Netsmart, including senior-level positions at Siemens Healthcare, Cerner and Garmin International. [Details about The Netsmart Homecare solution to be used to assist home care, hospice/palliative care and private duty healthcare organizations are touched on in this article and more details about Iddings background are also provided. In addition, details about Netssmart’s recently acquiring Allscripts is provided. Its doing so, NetSmart became established as “the largest human services and post-acute technology provider in healthcare,” the article reports.


“Dawn has a proven record of facilitating long-term collaborative relationships with both clients and healthcare industry leaders,” said Netsmart CEO Mike Valentine. “Her diverse experience in the healthcare ecosystem complements our ability to meet the needs of our clients as we grow our quality, innovative home care solutions.”

The Netsmart Homecare solution is designed to fit home care organizations of all sizes nationwide. It provides business, clinical and scheduling functionality for home health, hospice palliative care and private duty, and automates clinical and business processes from care engagement to billing and accounts receivable.

The announcement about Iddings joining Netsmart as Netsmart Homecare executive was made on the opening day of the 2016 Allscripts Client Experience (ACE) user conference, attended by thousands of Allscripts clients and industry leaders. The Allscripts Homecare business unit was acquired by Netsmart as part of a new venture with Allscripts (NASDAQ: MDRX) and GI Partners in April 2016 (see HCTR, 3/30/16, “Allscripts Reinvests in Home Care” and “A Great Marriage“). The relationship established Netsmart as the largest human services and post-acute technology provider in healthcare.

About Netsmart
Netsmart is healthcare’s largest human services and integrated care technology provider. Netsmart technology platforms and expertise are integral to the delivery of outcomes-based services and care to more than 25 million persons nationwide.

Netsmart serves more than 500,000 users in more than 24,000 organizations across all 50 states. Netsmart client communities include behavioral health; addiction treatment; intellectual and developmental disabilities; child and family services; public health; home health, hospice and palliative care, and private duty; and vital records.

Netsmart’s CareFabric®, a framework of innovative clinical and business solutions and services, supports integrated, coordinated delivery of health services across the spectrum of care.

Netsmart’s HIT Value Model™, a vendor-agnostic planning and measurement system, provides a path for human services organizations to evaluate where on the healthcare IT spectrum they should focus their efforts, the value associated with that strategic decision and a comparison with peer organizations nationwide.

Netsmart supports the EveryDayMatters® Foundation, which was established for human services organizations to learn from each other and share their causes and stories.

CareFabric and EveryDayMatters are registered trademarks of Netsmart Technologies, Inc.
HIT Value Model is a trademark of Netsmart Technologies, Inc.

©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.