Welcome to the Healthcare CEO podcast. Join us as Daniel Fernandez, healthcare leader and patient experience advocate, leads dynamic one-on-one discussions with healthcare executives, consultants, and other industry experts. Listen in as they share actionable insights and unique perspectives in the day in the life of a healthcare CEO.
*The following has been adapted from our full-length interview, which can be found here.
Meet Patrick Daly
Patrick is the CEO of Sonas Home Health Care. His extensive experience in management, sales, marketing, and operations — combined with 15 years in the home healthcare industry — have helped him grow the organization to a brand singularly focused on defining how home health care should be done in the technology age.
About Sonas Home Health Care
Their mission is to bring love, light, and laughter to the homes and communities they serve. They do this with the long-term vision of how they define a community. They’re also vastly different because they find people who embrace their local communities, become active in supporting their diversity, and build a platform as a corporation that reduces the burden of some of the day-to-day operations so that they can focus on delivering high levels of patient satisfaction as well as caregiver satisfaction, retention, and delivering quality care to those lives in which they can make a difference.
Measuring the Success of an Organization
Daniel Fernandez (DF): A lot of people say they’re amazing at all of these things, but how do you know this to be true? Are there any measurements you’ve used? How have you gone about measuring your success in this space?
Patrick Daly (PD): That’s a great question. I think everybody shows up to work every day, and we all think we’re doing a great job, but sometimes it’s hard to validate that. As an organization who has gone through exceptional growth in a short period of time, we wanted to make sure that we were living up to our mission and providing exceptional care in the communities we serve. The best way to find that out is really to ask your constituents.
So towards the end of last year, we hired a third-party agency to conduct interviews with our referral sources — the hospitals we work with, the physicians, the case managers, the health plans, the discharge planners, etc. It was an opportunity to say, you know, we think we’re doing great based on the number of new patients we’re taking on and the number of new caregivers we’re hiring, but is that really true?
Fortunately, the feedback we gathered validated that sense that we are doing a good job. I think our overall net promoter score was 85 or so, which is great in our industry. You don’t know what the outcome is going to be when you initiate something like this, so it felt good to receive those kinds of results.
We also did the same thing for our caregivers. That was another point of potential concern. When you are growing this fast, are you delivering consistent enough services to the employee base? The variation between the net promoter score of our employee base and the other competition was over 60 points, so overall not just our referral sources were happy, but our employee base as well.
It was reassuring to know that who we are saying we are on the outside is represented within the walls, too.
Using Technology to Grow Your Healthcare Practice
DF: What are some of the ways you’ve leveraged technology to help with Sonas’ growth?
PD: We’ve gone through multiple iterations of technology investments in the three years since I’ve been here. Prior to my arrival, people were working in a remote desktop environment where they were logging into a server somewhere out in Colorado. There were bandwidth issues, we had multiple phone vendors, and so forth. Granted, when we created Sonas we rolled multiple legacy companies into one, so we had different databases we were utilizing and different electronic health record systems. So, when we set forth the vision of the company three years ago and said we wanted to be the leader of how home healthcare was going to be delivered in a technological world, we realized we needed to make a significant investment in our infrastructure.
Step 1: Going from a remote desktop environment to the cloud
The first step was: how do we get from a remote desktop environment to the cloud. While that seems to be a simple step, the application of that is certainly a challenge — especially when you have a dozen locations across the state of Florida and over 100 administrative users who were used to working one way.
Step 2: Finding an EHR system that is up to the task
We knew we needed an electronic health record that was going to take what was historically documented on a piece of paper at the caregiver level and transition it to a digital model. In the pen-and-paper model, there’s a lot of variation in terms of the scalability and success rate when you may not know what’s happening in people’s homes on a day-to-day basis. So over the last 18 months, we implemented a cloud-based software in which each individual can document what they’re doing, where they’re doing it, and the conditions of each patient in real-time. It’s an application on their phone they can clock in and out with. It’s utilized in everything from our payroll record all the way through to ensuring that nurses know where they’re supposed to be and when they’re supposed to be there. It also has geofencing capabilities so we know if a caregiver is really showing up to support that client and if they are doing what the doctor has ordered in their care plan. It’s a seamless way to support all of our operations.
As far as the hiring process goes, we’ve been able to digitize the entire application and onboarding process, which is especially helpful for individuals who are not currently close to one of our brick-and-mortar locations. Essentially, they can sign up and come work for us from their living room — and that includes background screenings, competency tests, and matchmaking for particular skill sets we might need.
So, in a short amount of time we’ve made a lot of headway in terms of taking what was historically a business run 25 years on a piece of paper with a lot of people doing a lot of different things in a lot of different ways, to a tightly controlled system so that we can maintain a certain level of quality and consistency throughout our organization. We talk a lot about how diverse each one of the communities we serve are, so it’s important to find the right people in those local markets. Utilizing new technologies allows us to really focus on the caregiver-client relationship and take a lot of the back-end, administrative burdens off of them so that they can focus on providing high-quality care.
Staffing in Times of a Pandemic
DF: On the topic of caregivers, many large companies are furloughing team members, and unemployment rates are rising — how has your organization been doing from a staffing perspective?
PD: From a staffing perspective, we still don’t have enough. We are hiring probably 30 to 40 nurses every month at this point, and we’ve also hired more administrative staff over the last six months.
In the wake of Covid-19, there are new challenges for administrative staff, but for the most part, we’ve been able to sustain our operations and attract more talent for the organization. The onboarding experience is entirely different right now than before Covid, however. Previously, they would travel to our corporate office, and we had a routine orientation process where they would learn not only about our company’s mission and culture but also experience the people they were going to be working with on a regular basis. So now that’s gone, and we are certainly still learning as we go from a business standpoint, but it’s certainly nice to lead from a position where we’re still offering opportunities to people who are going to be a good fit for this organization for the future.
Utilizing Telemedicine to Improve Patient Experience
DF: Many healthcare organizations who had never considered telehealth or telemedicine technologies are being forced to adopt new technologies to keep up with the shifting practices in the industry around the world. Has being an early adopter of these technologies helped you weather the storm?
PD: Absolutely. We’re fortunate to be ahead of the curve at this point. To think about going through a cloud migration so that people could work at home at this point would be disastrous. If you look at the accelerant the pandemic has created on a relatively archaic system, I think in a lot of ways it’s going to have a positive outcome, ultimately, for the consumer. It’s not like this technology didn’t exist. Several practices that were using older models (e.g. pen-and-paper patient intake forms) undoubtedly had the opportunity to switch to an electronic health record at some point over the last decade, but for whatever reason chose not to. Now they’re probably forced to figure out a pivot and how to implement telehealth themselves in a time when people aren’t going to want to go to the doctor for a regular, routine checkup out of fear for their own safety. I would not want to be that practice that’s having to implement something new right now while also just trying to provide leadership through a time of such uncertainty.
DF: Have there been any changes in the expectations from either caregivers or patients during this global pandemic?
PD: The sensitivity around the home environment and personal safety has risen to a level in which you have a responsibility to each one of the families we serve — and whether we see that client for just a day or two a week, or when we’re within their home environment for 24 hours a day, 7 days a week, the responsibility doesn’t change. And the work we’ve done proactively to secure protective equipment for the caregivers and the rapid response we had in a short period of time — I couldn’t have been more proud by leading a company with some caring and compassionate and empathetic people who just want to do the right thing to promote safety during this time.
The testimonials and stories I’ve received during this time and the responses have really been remarkable. The families we serve are scared, too, so if one of their regular nurses is unable to fulfill a shift, they may ask us not to send somebody else out, and we have to respect that because we don’t know where somebody may have been and such — it’s just such a dynamic and fluid environment. You just want to do the right thing for the other person that you’re taking care of right now, and most of the time we get it right, but obviously we aren’t perfect.
What does the future of home health care look like?
DF: If you were to pull out a crystal ball and predict what the future of home health care will be like, what do you see, and how is it evolving?
Forecast #1: A Rising Demand for Home Care
PD: In such a short period of time, we’ve seen the immediate impact of technologies like telemedicine — which for the last decade were held up in bureaucratic nonsense — but I think in the future the focus is going to be how do we take care of the consumer in an environment where they feel safe? And, given the pandemic, I don’t know if anybody really wants to be in a hospital or senior living facility right now. Families are rethinking where they want their loved ones to be when they need care. So the first thing I foresee is an increasing demand for home health care.
Forecast #2: A Need to Incentivize Organizations Who Can Deliver This Kind of Care
PD: Now that we understand where people want to be to receive care, how do we help incentivize organizations to be able to deliver this care, and when will the funding align with where people want to be? As with telemedicine, most of the red tape was really around funding — who’s going to pay for it and how are people going to continue to ensure that they have a sustainable practice?
Looking at the extraordinary costs and the burden that are on the healthcare system as a whole, you look at one of the most cost-effective ways to deliver it and keep people safe for a variety of needs. So the question becomes: how can we as an industry advocate for fair reimbursement so that we can help prevent an acute health event and get ahead of the curve on these issues? If we put more money into healthy living and well-being, would there be such a systemic financial impact on health care?
In an ideal world, I would like to think that an industry like ours could help demonstrate that value in the long-term picture.
Learn More About What Patrick and Other Healthcare Leaders are Doing to Adapt and Stay Successful in Today’s Ever-Changing Environment
Listen to the full interview to hear more of Daniel and Patrick’s conversation about the future of healthcare and how to thrive in the present. Be sure to subscribe to our podcast to hear more about what he and others are doing to leverage technology and provide high-quality care in these uncertain times.