Staffing Summit Panel: A Discussion with Element5

This article is brought to you by Element5. The article is based on an interview that took place during a virtual panel discussion with Eric Gordon, Co-Founder and CRO, Evelyn Keegan-Wright, Head of Product, and Joe Randesi, Co-Founder and CEO at Element5. The panel took place virtually on March 23, 2022. This is an excerpt from the session, which has been edited for length and clarity.

Hospice News: We’re joined by Joe Randesi, Evelyn Keegan-Wright, and Eric Gordon, from Element5. Joe Randesi brings with him more than 15 years of technology and business experience. Prior to Element5, he led DeVero, a healthcare platform, from startup to acquisition, driving product strategy in overall operational execution.

I’d like to ask, of course, challenges and staffing are predominant in post-acute care. We hear from organizations across service lines on how those troubles are affecting their businesses, including forcing some organizations, unfortunately, to shut down. How do you view this problem and what have you heard from other organizations in the market?

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Joe Randesi: I think I view the problem of staff shortages as really a global problem. Wherever you sit, no matter where you are in the world, no matter what industry, there’s just a common theme of hiring and retaining talent. It just seems like everybody is struggling with this. I think in healthcare, this is amplified for a couple of different reasons. Probably obvious reasons, but one, it’s just a mission-critical business we’re in. Our provider market, they’re taking care of patients. The fact that you have a staffing shortage that directly impacts patients makes it more prominent.

Then I think the pandemic also just rocked our industry in a couple of different ways, shifting more focus to the care at home, so the demand increased. Providers were navigating all the rules and the regulations, which were fast-changing and it was just difficult to manage. I think those are some impacts I’ve seen that have created challenges with staffing. Then just the burden of shifting regulatory and compliance challenges, always staying up to date with them has been difficult. That’s the way I view it.

Everyone I talk to has the same challenges, to be honest with you. I haven’t talked with one company, whether post-acute or outside, that has solved the staffing challenges, so I just think it’s relevant and applicable to everybody.

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Hospice News: Thanks, Joe. Eric, would you like to add your insight?

Eric Gordon: Yes, I would just add on, these problems are not going away. We have been forced to rely increasingly on overtime shifts and agency hires, which is bloating operational costs. We’re putting additional administrative burden on our staff, which is leading to missed revenue. There’s an overall point which is a global imbalance between the supply and demand of available workers, and so what I see is we need to fundamentally shift the way work is getting done inside organizations. That’s what I hope we’re here to talk about.

Hospice News: Excellent. Evelyn, I’d love to hear from you.

Evelyn Keegan-Wright: Thanks, Jim. As you heard earlier, I’ve been in this industry for 30-plus years, most of them on the provider side. In fact, my first job was as a scheduler and trying to get staff ready for shifts. To be honest, I’ve seen these staffing shortages and high turnovers for many, many years. I do, however, think that today’s landscape has made it more difficult than ever. In one way that I see the staffing shortages affecting the business is that it leaves those that are still showing up to work, to carry the burden, ultimately leading to more staff burnout, to unhappy employees, and even higher turnover than before.

Hospice News: Thank you. For the uninitiated, let’s talk a little bit about automation. You mentioned that it’s new and a large group of people aren’t aware that workflows in the post-acute care space can be automated. Can you give our audience a primer on what this technology is and what it could do for them?

Randesi: Absolutely. Automation has been around for a really long time. Everybody knows what that word means. It’s been adopted in tons of industries, even including healthcare, so automation is not a new concept or a new theme. I think our approach to automation though is very different. It’s discretely targeted workflows, and we leverage some incredible technologies with AI and RPA (robotic process automation) and this is really the guts of what we do. It allows us to automate workflows from front to end. RPA allows us to write computer programs that can log in and interact with the software that your team uses day in and day out.

AI is just the umbrella brain on top of that. It allows the automation to be intelligent and really be autonomous, and so when you combine this, you get autonomous processes that are taking over administrative functions so teams can focus on delivering better care or at the top of their license. Really the way we look at this is, if you can pinpoint automation on a workflow by workflow basis and deploy it in that manner, you augment your current staff and your staff really are able to do more by doing less.

Gordon: One of the reasons I wanted to start this company is because in our space it just takes an incredible amount of clicks to do some of the simplest tasks. I believe there’s a huge opportunity to automate those clicks for our back office. When we think about automation, we think about very discrete workflows, and a workflow is literally just a series of tasks connected together to complete a process. We are targeting very discrete pinpoint workflows within your organization. I’ll use authorizations as an example because it’s got a level of complexity behind it.

We’re not selling some monolithic authorization automation project that you have to implement and costs hundreds of thousands of dollars. We’re offering to automate very discrete steps between your EHR and the payer or third-party portal required to process an authorization. We will automate that step from end to end, submit the information, wait for the response, bring that response or authorized number of visits back to your EHR. We price that based on the number of authorizations you process per month. We’re trying to build very discrete authorization or automation workflows that deliver direct ROI and have immediate results for your business.

Hospice News: Excellent. Evelyn?

Keegan-Wright: One of the other benefits of how automation helps the industry is that today we can create integration where integrations today do not exist. You hear the word interoperability thrown around quite often in this industry where we need to connect system to system. That often takes quite a significant amount of time and money. One of the things that we have the ability to do is to work on top of any system that we have, to create those seamless workflows and interoperability operations. Another thing that we have is that we have lots of pre-built workflows.

What that means is that it’s something that you can buy off the shelf that’s pre-built, that works over and over again across specific systems. We can achieve quick implementation. You get a quick return on investment and this causes huge potential for time and cost savings. It’s a big boost for the post-acute organization struggling with shortages today. We also know that the post-acute world is a very compliant and regulatory-driven industry and care teams spend too much time on administrative tasks.

Our automations can be used to really help operations with the administrative checks and balances that they’re required in order to stay compliant, which helps to push the needle towards allowing the staff to be focused on better patient care. That allows the staff to be more highly satisfied and to improve those retention rates. By automation, it also gives you an insight to your data to allow you to make better data-driven decisions that also help to improve operations and allow for peak efficiencies.

Hospice News: Excellent. Thank you. If we can put this into context for home health, hospice, and other post-acute organizations, what would you say are the top workflows that can be automated?

Keegan-Wright: I can start, I’ll give just a small area of some of the ones that we have available quickly. We have automations like clinical chart audits, automations that conduct pre-billing review edits, and then automations. One that I’m particularly excited about is eligibility, being able to read 271 responses, getting documentation from the payer portals and downloading them into EHRs. This certainly enables our teams to be focused on the exceptions and the things that they really need to focus on while we work through those specific repeatable tasks.

Gordon: I’ll tag onto that. I have just this incredible passion around authorizations. Payers have zero incentive to make this any easier for you. They just keep asking for more and more information to authorize the same number of visits, and so authorizations represent a huge opportunity for automation. Authorization workflows we have live and developed right now are United Healthcare, processing authorizations through the United Healthcare portal. MyNEXUS, there’s a number of payers that run through the MyNEXUS third-party clearinghouse if you will, for processing authorizations. CareCentrix is another one.

In each of these scenarios, you have very discrete data that’s requested and automation can aggregate that data from your EHR and submit it on your behalf into these portals and wait for the response. You don’t need a human to free text this information between the systems. It’s a perfect use case for automation. When you do it, you get a lot more benefit from your team. They’re able to focus on the quality of the documentation, making sure that the Is are dotted and Ts are crossed, and let the automation pick up after all of that documentation is accurately correct and ready to go.

Another area that may not seem like there’s huge ROI behind it, but there are a lot of workflows in our industry that are plain and simple file transfers, downloading OASIS, uploading OASIS, downloading claims, uploading claims, downloading NOE files and uploading NOE files. A lot of these things are opportunities for automation as well.

This excerpt has been edited for length and clarity. To watch the full discussion on video, please visit:

Element5 is simplifying the adoption of RPA by offering end to end workflow automation as a SaaS product. Founded by experts with decades of experience in the post-acute space, they’re tackling operational inefficiencies that are bottlenecks to better care and patient outcomes, one workflow at a time. To learn more, visit e5.ai.

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