This article is sponsored by KanTime. This article is based on a Palliative Care News discussion with Deanna Heath, senior vice president of customer experience at KanTime, Jared King, vice president of business development and sales at Hospice Dynamix and Sundar Kannan, CEO of KanTime. The discussion took place on February 29, 2024 during PCN Conference in Tampa. The article below has been edited for length and clarity.
Hospice News: How would you describe the current state of palliative care in today’s world?
Deanna Heath: At one point palliative care was hospital-based, now it’s so much more home-focused. It doesn’t just focus on the physical, it also focuses on the emotional and the spiritual with the use of social workers and spiritual counselors.
Can palliative care function without numerous systems?
Jared King: With technology in multiple systems, for years, palliative care has been the Wild West of technology because most of the home health platforms or the hospice platforms and the palliative care platforms didn’t match up. That’s not the case anymore. If anybody talks to me for more than five seconds about palliative care, I talk about the importance of consistent data flow and a more comprehensive and controlled amount of data coming into the technology side because it then allows organizations to have further insight into what’s going on with those patients and move those patients to the appropriate level of care at the appropriate time.
How is technology changing the world of palliative care right now?
King: With our industry as a whole, we’ve been slow to adopt technology. It’s finally getting to a point where there is with platforms like KanTime and you have the documentation that you need for the ancillary products that are out there to work and give data insights. From that, create efficiencies. Any time you’re going to bring a technology platform into your organization, it has to serve a purpose with the end goal being improved patient care. How do you get there? It has to be something that will create efficiency within the organization and not just more work.
I think that the technologies that are out there that do just that assist an organization in creating efficient ways of handling either the back office side of the work or the scheduling aspect or the pharmacy aspect, it will help in the end, create and give the resources allocated to better take care of the patients.
Sundar Kannan: In palliative care, from a tech angle, there’s nothing structured. For that matter, if you really look at the whole healthcare system, the data collection, it’s a Wild West. Certainly, you must collect a certain amount of data and somebody else collects different ones and things like that. If you take home health and things like that, at least you have a structured data set which you are going to collect and then you are going to go from there. Palliative care doesn’t have any structure. If you were to get into the current scenario of what kind of patients we are managing at home in the palliative, it’s multiple chronic diseases, and different types of things. Technology plays a very important role in terms of trying to pipe in that information correctly based on the patient requirements and all those different things.
Heath: I would only add that I think technology, too, has helped palliative care in that you have remote patient monitoring, you have telehealth, you have the ability to communicate better when you have a good EMR. You can do the IDTs and everyone can be there. If you have a patient who’s been on home health or even if they were on private duty or something like that, if you have an EMR that has a longitudinal medical record, then you see that patient all the way through their scope of care.
What are some of the most important types of systems that palliative care providers are exploring right now?
Heath: EMRs, a lot of palliative programs are still on paper., I also think the good use of telehealth, data analytics like Jared and their company does, I think that’s important to look at that entire length of stay and to look at those patients and say, “Okay, here’s where we are, maybe we should start talking to them about hospice.” Because if you can get them on to hospice earlier, then, it’s a win-win for everybody. Those are the kinds of things. Then, of course, a longitudinal medical record I think is very important. If you can see that patient through their whole scope of care, I think that’s important, because you can grasp different things from different areas.
King: All of the technologies are very important, probably none more so than the EMR as far as getting that central data flow going. Palliative care organizations, hospice care organizations, they’re understanding now that you don’t have to have just whatever is out there. They’re exploring the different technologies because technology, as we all know, we’re in this great growth and boom of artificial intelligence. It’s aggravating in the industry that you can walk around with an app for everything in the world on your telephone, but the options that were available to you to do your job were so limited, and that’s no longer the case.
I think that companies are much more adept now at asking for things that work together, ask for things that deliver the need that they want and that they have, and proceed from there. Every palliative care organization doesn’t have to do the same thing. They can build out a platform that works the way they want it to.
Can you talk through some of the potential benefits that could come from investing in some of the systems you’re describing?
Kannan: One benefit is that you’re able to look at that patient in a holistic manner. Second is that particular patient’s disease-specific care. If you’re able to inherit some of the dos and don’ts or the interventions and goals and those plans and those protocols, I think that is the most beneficial for the patient. This industry was not born yesterday. We have a lot of best practices. We have a lot of things. We need to capture the knowledge we currently have and go from there.
King: The need at the end of the day would be to improve patient care or at the very least, help the organization to allot its resources in such a way to do that. The most important facet of having any technology is to create those efficiencies wherever they can so you don’t want to add more to clinicians. They’ve got plenty. You want to do everything that you can to create a more efficient and optimized performance across the board.
How does the implementation of these tech platforms affect the patient?
Heath: It’s better care. If I need to meet with my team about my patient, and everybody’s stuff that they put in can go into the meeting, much better than just us randomly talking about the patient if I have communication inside the EMR. Again, it helps the patient whenever I do have telehealth because I can see that patient quicker and more timely. It also helps with remote patient monitoring because you can keep up with the patient a lot.
Kannan: The care coordination is a very important piece of the puzzle, how you manage it by the complete care team, and how you’re able to bring everything together and communicate in the same platform becomes extremely important.
King: The proper use of technology allows you to have so much more insight into every patient that you have on service. Be it a predictive length of stay or an understanding of a medication profile or a plan of care needed for an extended period of time, if you’re able to plot out everything that that patient needs and you, through the use of technology, as a tool for that clinician. Because none of the technologies are ever going to take the place of a clinician. What they can do is be a tool that gives them greater insight into what they need to do to give a better level of care.
What are some of the biggest challenges of adopting AI technologies?
King: With our platform, the ability to understand the length of stay for the patient. If the predicted length of stay is X, does that mean that this patient is not palliative care appropriate or not hospice appropriate? Where does it belong? It’s more of working with that organization to understand that the information generated by artificial intelligence is being pulled directly from that EMR. It is more indicative of how that patient’s being charted on than anything. The challenge with AI, from our standpoint, is working with organizations to understand that it is a tool and that it is one that is incredibly powerful. We don’t want to take away humanity from an industry that, when done well, is such an incredible gift.
Kannan: When it comes to AI, we can put it to use in different ways, for predicting the length of life so that you can provide the appropriate care at the appropriate time. The transitions can be done at the right times from one setting to the other setting. I always go back to what the primary focus when we got into this business is to take care of these patients. Accordingly, with the time frame which we have, and we are able to see those symptoms and those things to manage and be able to transition it, I would say that is a good way of using the AI.
How do providers ensure that they’re entering good data? How do they discern what they need to put into these systems?
Heath: You have to have a good QA-type program. I came from an agency before I started working with Sundar that we QA’d every note. Now, that’s a little extreme, but I do think you have to continue to monitor for the quality of the note as well as you have to continue that education to make sure that you’re getting that updated education to make sure that you take care of that patient well.
King: AI is an enhancement of what you initially program it in there. Having clinical experts work in helping to develop what this machine initially starts looking for and a surplus of data for the unstructured machine learning to learn against as well ensures that you’re going to have the machine looking for the right thing. We were former hospice owners and operators, so we knew we had people within the industry that we could call on to say, “Hey, help us tell this machine what to look for initially,” and then let the AI do the magic that it does. The most important part is not losing focus and keeping well-versed people that are experts in the field constantly having input on what drives that machine.
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