The Homecare Intelligence (HCI) Solution - Providers

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© Homecare Intelligence Canada Inc. 2016 - All rights reserved© Homecare Intelligence Canada Inc. 2016 - All rights reserved

© Homecare Intelligence Canada Inc. 2016 - All rights reserved

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0 Table of Contents

1. Executive Summary

2. Homecare Intelligence Canada

3. Context

4. The Challenge

5. The HCI Logistics Solution

6. The Benefits

7. Competitive Advantage

8. Additional Offerings

9. Conclusion

10. Contact Us


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Demand for home care is rising, and the increase in demand is putting pressure

on the ability of agencies to deliver required care within their current financial

and health human resources

Provision of home care can be viewed as a ‘logistics challenge’ to provide the

right care, at the right time, in the right place by the right provider – the current

solutions used to address this challenge leave significant room for improvement

◦ As an example, home care providers in the US travel an estimated 5 billion

miles/year

◦ In contrast, sophisticated routing solutions allow FedEx to travel only 2.5 billion

miles/year globally – without these solutions, logistics companies like FedEx would

not be able to survive

1 Executive Summary



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Our team has developed a unique solution that addresses the logistics of home

health care delivery to enable a home care agency to deliver on its care

commitments in the most cost effective way while meeting quality of care

considerations

◦ By using algorithms to identify the set of visit assignments and sequencing of those

visits, clinical, operational and other factors can be easily incorporated into each and

every assignment decision

◦ By assigning patients that are closer to one another to the same clinician, our

solution minimizing clinician travel time and costs

◦ By automating scheduling, visits sequencing and notification/reminder tasks for

scheduler and clinicians, reducing operational overhead

Together, these solutions can help home care agencies:

◦ Improve patient care & outcomes

◦ Improve clinician & patient satisfaction

◦ Reducing ongoing operational costs

◦ Enhance operational performance

1 Executive Summary (cont’d)



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Homecare Intelligence Canada Inc. (HCIC) is a dedicated group of health and

business experts focused on delivering innovative health solutions to address

health system capacity, spending and quality of care challenges

◦ We have an intimate understanding of the Canadian and Ontario home care policy

and operations, along with expertise in developing automated business solutions

HCIC has partnered with Homecare Intelligence Inc. (HCI) to provide an

innovative set of data-driven solutions specifically designed to solve healthcare

service delivery challenges

2 Homecare Intelligence Canada



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To date, the complex logistics of scheduling care in the community has not been

adequately addressed, resulting in:

◦ Use of manual processes that rely on the knowledge of scheduling staff, making

scheduling more art than science

◦ Increased care staff turnover and decreased work satisfaction from:

◦ Staff needing to work longer days/hours to bill a regular days’ work

◦ Travelling long distances to reach patients, including from rural staff travelling to

serve patients in urban areas or in opposite directions to other care providers

instead of being grouped to served closer to where all their other patients are

◦ Reduced continuity of care as schedulers focus simply on ‘just getting care’

scheduled

The sub-optimal scheduling has significant impacts for clinical staff, as they:

◦ Have to travel long distances between their home and their appointments

◦ Have large gaps between appointment times for which they are either not or only

partially compensated

◦ Encounter patients not at home upon arrival

◦ Have conflicting demands of their time (e.g. scheduling, providing care vs. charting)

3 Context



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Home health care logistics is unique and challenging

◦ Unlike for other industries where delivery can be done by any personnel, provision

of care in the home requires precision – the right care at the right time in the right

place by the right resource with the right skill sets

In other words, home care service delivery is among the most complex of the

transportation class of problems, being:

◦ Multi-depot (care providers typically start work from their homes)

◦ Capacitated (care providers have limited availability)

◦ Time window constraints (visits can have specific service times)

Identifying the optimal set of territories within a geography is also extremely

challenging due to the infinite number of solutions that are possible

The Challenge4


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Our solution is a patient-centred heuristics-based solution to clinician assignment

and routing of home care staff across a region.

5 The HCI Logistics Solution

Home of Nurse

for Agency 1

Home of Nurse

for Agency 2

Home care Patients

Current StateFuture State with

the HCI Solution:



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The home care scheduling problem is in a class of computing problems called a

vehicle routing problem (VRP) and is considered an NP-Hard problem (i.e.

effectively unsolvable)

The multi-depot, time-windowed, vehicle routing (MD-TW-VRP) problem is one

of the hardest within this category

◦ A 100 point problem could take a super-computer 3 weeks to solve, if it is even

possible

Therefore, we use an heuristics-based approach to obtain a high-quality solution

in minutes – not weeks

5 How Do We Do This?



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Simplifies scheduling of home care visits to a single automated function that

simultaneously considers:

◦ Clinical requirements (e.g. time constraints, frequency, resource skill types)

◦ Patient preferences and requirements (e.g. clinician gender, languages)

◦ Resource preferences and requirements (e.g. travel preferences, working hours and

conditions)

◦ Agency goals and preferences (e.g. minimizing travel across all resources,

preferences for using RNs vs. RPNs, salaried vs. variable pay staff, etc.)

Allows new visits to be quickly and easily fit into an existing schedule, honouring

previously assigned visits

Provides care providers with a mobile application that allows them to effectively

manage their assigned visits in real-time, through the ability to set visit times,

see the best routes to patients homes, and accept/decline last-minute

appointment requests

Includes an optional auto-dial feature to automatically notify patients ahead of

their visits or contact clinicians about changes to their schedules

5 Key Features of the HCI Solution



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5 Logistics Product Features

We have identified 5 optimization levels that can be applied to routing in home

care. The levels of optimization increase in complexity, and are based on analytical

factors and your organization’s strategic goals.

0: Mapping Taking an address and calculating its place on a map. The basis for all

geographic calculations in the system

1: Ordered Routing Calculates the driving distance and time for a set of stops in a given

order. Does NOT put the stops in the optimized sequence

2: Optimized Routing Given a set of stops, optimizes the sequence of the stops, then calculates

the driving distance and time. Optionally, can take into account event

windows (e.g. patient needs to be seen in the morning

3: Event

Recommendation

Returns a recommendation list for a particular event. Takes into

consideration the existing clinician schedule, patient location, skills and

time windows.

4: Daily

Recommendation

Takes a list of events for a given day, plus all available resources, and

calculates to best distribution of events among the resources

5: Clinician

Recommendation

Also known as “Primary Assignment”, this optimization analyzes all the

events for a given patient and returns a list of recommended clinicians to

best serve as each patient’s main clinician for the full episode of care



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Levels 0 and 1 are basic logistics calculations that serve as the foundation for

everything HCI does

◦ Correctly placing an address on the map (Level 0) is so critical to all the subsequent

levels, we use multiple redundant geocoding services to ensure accuracy

Optimized Routing (Level 2) is the first level where we make a recommendation

– by providing the fastest order to complete a set of visits for a day

◦ Included in our solution is the ability to incorporate time constraints (e.g. due to

patient availability or clinical requirement) in determining the best route for the day

5 Levels 0-2: Maps & Routing


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Event recommendation (or Best Fit Analysis) can help you adjust quickly to urgent

service requests, or if a clinician calls in sick at the last minute.

5 Level 3: Event Recommendation

Using the event recommendation

tool, you will be presented with a list

of recommended resources to choose

from, along with their score.

The score is determined by:

Distance from the Patient

Resource Type & Capacity

Patient/Resource Preferences

The lower the score, the better the

fit!


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Event recommendation comes with additional tools to help schedulers evaluate

each recommendation before selecting the final resource assignment.

5 Level 3: Event Recommendation (cont’d)

Map

Provides a quick overview of the selected

resource’s driving route for that day

Current Schedule

Shows the resource’s current schedule

including the proposed visit to be added

Driving Detail

Easily see the driving schedule for the day

before assigning the visit


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Through an automated process, the scheduling algorithm compares the services

required to the location and types of staff available to come up with the best

overall solution for the organization for that day.

5 Level 4: Daily Recommendation


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Patient Recommendation can help identify a clinician who can provide the

maximum number of visits within the required episode of care, while travelling as

little as possible.

5 Level 5: Clinician Recommendation



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Reduce scheduling effort, travel time and associated costs

Improve working conditions and retention without increasing compensation

rates

◦ Reduce unpaid time between visits & provide greater predictability in staff

schedules

◦ Reduce paid travel time

◦ More time for staff to complete required documentation in a timely manner –

improving compliance and reducing issues upon billing

◦ Greater client satisfaction with “local” care providers within their own communities

◦ Reduce coordination staff which in turn produces annual savings without reducing

effectiveness

Potential to optimize on other factors (e.g. pay type, skill, or to balance

schedules among staff)

Easy integration with existing clinical operations and billing systems, even for

those few that have automated scheduling within their silo organization

6 Operational Benefits of the HCI Solution

The HCI Logistics solution provides many operational benefits to service providers

organizations:



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PSW harmonization (scheduled to begin in 2017) will make clinician travel costs

visible to the funder

◦ Given that funders will be responsible for travel costs, they are incented to provide

volume to those agencies that can demonstrate lower associated travel costs

◦ This provides an opportunity for SPOs to distinguish themselves from their

competitors if they proactively address the issue of accurate and enhanced travel

cost management

Additionally, the HCI solution will help your agency demonstrate other

advantages over your competitors

◦ The ability to complete more visits with fewer resources enhances efficiency and

creates capacity for growth

◦ Flexible heuristics-based assignment enables the organization to ensure every

patient assignment decision works towards improving your desired quality and

operational performance indicators

◦ Real-time metrics enables ongoing proactive operational management of your

clinical staff

◦ Access to a robust business intelligence solution allows the agency to uncover new

opportunities to improve patient outcomes

6 Strategic Benefits of the HCI Solution

In a competitive environment, the operational benefits of the HCI solution can help

strategically position your agency for growth.



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Many other companies claim that their solutions will also save mileage costs.

In general, these claims are based simply on the impact of:

◦ Using simple GPS/geofencing for visit verification

◦ Calculating the distance between each sequential visit (e.g. using Google Maps or

similar), based on an order determined by the clinician with no system guidance,

and using that as the billable mileage

◦ Reduction in mileage due to the “monitoring effect” on clinician mileage behaviour

– i.e. a “fraud check” to eliminate rounding effects and clinician bias

These features alone are wholly inadequate for optimizing and managing the

complex logistics challenges that home care agencies face today.

7 Competitive Advantage



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As far as we have been able to determine, no other solution other than HCI

includes any ability to help your organization make better decisions about:

◦ Which visits to assign to which clinicians to best enable continuity of care, and to

minimize the distance between a clinician’s patients (“clustering”)

◦ How a clinician should order the visits within their day to complete them in the

most efficient manner

The HCI application and mobile application together can provide all of these

benefits and more in a single integrated solution, including:

◦ Geofencing and visit verification

◦ Visit completion and documentation

◦ Automated visit billing and mileage calculation

◦ Optimization of visit sequencing by clinicians

◦ Automated notification to patients (auto-call)

◦ Heuristics-based optimization of visit assignment over entire episodes of care

◦ Operational management dashboards

◦ And much more…

7 Competitive Advantage (cont’d)



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8 Additional Offerings

In addition to the Logistics Solution, HCI also offers a Territory Generation solution

and healthcare-focused Data Analytics Services.



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8 The HCI Territory Solution

The HCI Territory Solution supports three potential ways to divide a geographic

area into territories, each with its own set of benefits and drawbacks.

Postal codes provide a pre-defined and relatable set of boundaries, and as such

are a common method used to define territories. However, postal codes were

not designed to represent geographic areas, and many have strange shapes or

are non-contiguous

Free-form generation usually yields better territories

than postal codes but is extremely time-consuming

Algorithms can automatically generate a set of territories

that are designed to optimized for designated

variable(s), and can dynamically flex to adjust to

changing demands

Once the territories are generated, the HCI Territory solution includes an intake tool

that identifies the appropriate territory for any given address.



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8 The HCI Territory Solution (cont’d)

HCI’s territory generation solution can combine the “art” of free-from adjustments

with the “science” of the algorithms to easily yield a set of territories that are fair

and operationally efficient.



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As experts in collecting and managing Big Data analytical systems, we have

experience building data warehouse solutions for service providers, EHR vendors

and tele-monitoring companies

Our experience with the nuances of home care enabled us to create advanced,

multi-dimensional business intelligence solutions.

◦ The architectures were based on traditional DW strategies involving periodic ETL

processes and pre-processing the multi-dimensional cubes.

While traditional data warehouse architectures are well established, tried and

true methods, we feel the future of big data is not based on these architectures,

rather using new Big Data architectures.

8 Data Analytics Solutions



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9 Conclusion

HCI’s solutions can enhance existing home care assignment, scheduling and routing

processes for a home care agency, functioning as:

An Analyzer – assessing the myriad of

scheduling and routing combinations

to provide the best daily, weekly

schedule for care providers

An Optimizer - determining the best

clinician to perform visits in the best

order and on the best days to ensure

patient care needs are met ensuring

continuity of care

An Efficiency Expert – by improving

mileage efficiency, the same amount of

work can be done with fewer staff,

without the perception of staffing

shortages

A Watch Dog – to help benchmark

and measure productivity and financial

progress

A Tree Hugger – reducing home care’s

carbon footprint through reduced

travel

An HR Manager – analyzing for HHR

staffing efficiencies to create the

capacity needed to meet growing

demands

A Strategy – to improve home care

system effectiveness, reducing costs

while improving quality of care


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10 Contact Us


Or Contact Us At:

E-mail: [email protected]: (561) 506-4613USA: 1 (800) 763-1957UK: (+44) 7464-720798

For more info, find us at:http://homecareintel.ca


http://homecareintel.ca

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The Homecare Intelligence (HCI) Solution - Providers