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Post-acute care, AI and the future of independent living

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Health Tech World speaks to MatrixCare general manager Bharat Monteiro about the ever-increasing role of AI in senior care.

As the ageing population continues to grow, senior care faces a unique set of challenges, from staffing shortages to financial strains.

Although often overlooked in the senior care sector, AI is set to be at the heart of solving these issues.

We hear from MatrixCare General Manager Bharat Monteiro who talks about the future of healthcare in senior care facilities, and how this future will be shaped by AI.

Tell us about yourself, your background and what led you to do what you’re doing now.

I’ve spent about 20 years in the healthcare industry in a variety of different roles.

I started off by bringing efficiency tools and methodologies like Lean and Six Sigma into the acute care space. I worked with hospitals to improve workflows.

I applied that in Europe and the Middle East and some parts of northern Africa, and then moved to Southeast Asia, India, Singapore, Thailand and the ASEAN countries to really bring innovative medical technologies to that market.

I recently moved to MatrixCare to focus on the out-of-hospital space.

My remit today is creating technologies and providing products and services, comprehensive solutions for the senior living, independent living, assisted living and skilled nursing communities.

We offer everything from electronic health records as a core foundation, to dietary nutrition solutions, revenue cycle management, software and services, and artificial intelligence and robotic process automation-based technologies to improve what we call the post-acute hospital space.

What are some of the unique challenges that you have to overcome in post-acute space versus other healthcare spaces?

Right off the bat, it’s two things.

There are significant staffing challenges.

While there are staffing shortages across the healthcare industry, it takes a very different DNA for an individual who wants to care for the elderly.

The elderly require significantly more help with their activities of daily living. They need more help with rehabilitation than a healthy adult would need, so it takes a greater toll.

Number two, I think the industry as a whole is really challenged with reimbursements.

I know there are certain states in the [US] where over the last 10 years, the reimbursement hasn’t changed from the CMS [Centres for Medicare & Medicaid].

They have to make do so the margins are extremely thin, which in turn means that the ability for a senior living facility or a skilled nursing facility to invest in technology is even further reduced.

Bharat Monteiro

From what we know, in the hospital world, they spend as much as 10 per cent of their annual budget on technology and technology-related investments.

Translated to our industry, that’s probably around 2 per cent.

Can you talk about the MatrixCare offering? 

MatrixCare has been around for over 30 years. The company came together through a variety of different acquisitions and mergers.

Today, we are a comprehensive suite of products and services that are enabled by technology.

At its core, we are an electronic health record (EHR) product.

But then as we’ve expanded over the years, we now have enterprise financials that allow operators to run their business, we have dietary and nutrition products, we have patient engagement tools and we have services that we offer, including revenue cycle management services.

Today, we are […] supporting everybody from the resident, the family member, the clinician or the caregiver, as well as the ecosystem of partners that can come together to make it work.

Underpinning a lot of this technology is AI, which is obviously a massive talking point everywhere at the moment. Could you explain how it’s being used by matrix care and how it’s helping to improve efficiency and security?

Before I jump into that, I’d like to level set on AI. As you said, everybody’s talking about AI and the introduction of ChatGPT has really brought that to the forefront.

At its very core AI is the ability to combine computer science and data analytics and an aspect of self-learning so that you can begin to identify patterns in the data and begin to make predictions.

And as those predictions get corrected it gets more and more accurate. Let’s keep that on one side and let’s pivot over and talk about the challenges in the post-acute space today.

One of the challenges for most of our seniors is falls. The acuity of that fall can vary on the spectrum.

I’ve had personal friends and colleagues whose parents have fallen in a facility and have passed, and the cause of death has been identified as blunt force trauma to the head.

Falls are a really big issue from a care perspective. It obviously impacts that person’s life, it impacts the lives of their families, but it also puts undue pressure on the operator.

So, one of the first problems we sought to solve was the ability to predict falls.

There are a lot of technologies in the market that identify when a fall has taken place to ensure that a response to the fall happens without any delay.

That’s very useful but we said, ‘Okay, how about we look at preventing the fall from occurring in the first place?’.

We developed a tool called Clinical Advanced Insights.

Under this broader family, the first tool that we brought to market is the ability to identify a change in the condition of a resident.

We’re looking at over 150+ different data points from the EHR and we’re able to identify a change in condition of a resident that would result in a higher risk of fall.

Recent analysis showed that across our cohort of 220 customers, collectively, there’s been an 8 per cent reduction in falls for that group, which is tremendous.

The journey has just begun but I think falls is a great place to have started.

Not only can we identify the change in condition, we’re now creating what we call a Smart Care Plan where we’re recommending, based on that individual’s conditions, what we think the right care plan should be, again.

This is by no means to try to replace a clinician. it’s just to make it a little easier for them and say, ‘Hey, we’re looking at 170 data points, we’re looking at the change in condition and we believe that this pathway of care may help.’

We keep track of those changes and the system gets smarter and smarter.

And because we’re looking at so many data points, we’re now able to predict changing moods that could lead to depression.

If you’re able to identify change in condition that leads to factors that influence depression, we can flag them in advance and we can intervene in advance.

How receptive have care facilities been to these technologies? Are there any particular challenges that you face in getting them to use new tech or understanding how it all works?

When we first created this capability, we talked about it as a fall risk prediction tool and of course, there’s a fee associated with that.

So a subset of our customers said, ‘Hang on, I care for residents that have just come out of surgery, they have come for rehab, they have a hip replacement. They are most definitely at high risk of fall, so what is the additional value that your tool is giving us?’.

That was the first barrier we faced.

When we went back, we said, ‘What we’re actually looking at is a change in condition across all these different parameters and it’s happening in real-time.’

All of a sudden, it clicked and it made so much more sense [to customers].

The ability to pay for some of this continues to be a challenge. It’s chicken or egg, right?

On our side, we have evidence that you can reduce falls, which will result in savings. Now that we have clinical cases and testimonials, there seems to be a lot [more] interest.

Are there any gaps that are still yet to be filled when it comes to senior care?

I think we’ve not even scratched the surface.

I think everybody is looking at – not even the low-hanging fruit – the fruit on the ground if you will.

The staffing shortage, the fall reduction, the speech-to-text. I think those are the fundamentals.

As these things come into the industry, the experts, the caregivers and the operators are going to say, ‘Hey, what about this, what about that’.

That’s going to really begin to fuel more applications.

That’s why for us, partnering with our customers at every level, at the executive level, departmental level and at the user level is so critical. We have them in the loop as we are creating.

There is nothing like the combination of a caregiver and a technologist coming together and saying ‘what if’.

What have you got in the pipeline for the rest of 2023 and 2024?

We’re now in the process of piloting a smart care plan that supports falls.

We’re looking also at a pilot for identifying changes in mood that could potentially lead to depression. And we’re looking at a change in staff engagement that could lead to attrition.

MatrixCare is part of ResMed Corporation, the world’s largest leader in sleep and respiratory care.

We know that a significantly high percentage of seniors or people over the age of 65 suffer from respiratory conditions, whether it’s asthma or COPD.

We’re now looking at changes in condition and vitals that could potentially impact the respiration and sleep patterns of a senior citizen, which then has a downstream impact.

If a senior is not sleeping well, if they’re not breathing well, it can lead to other things like an increased risk of diabetes or heart conditions, which then sends them out of their residence to the hospital.

Our whole ambition is to keep patients out of the hospital. Keep them in their place of living and in their place of care.

I would say the world is our oyster.

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