Leveraging Tech in Care ft. Diane Gotebiowski
Diane Gotebiowski, VP of Client Services at VivaLynx and EverHome Care Advisors, joins us to discuss how care managers can best leverage monitoring devices to reduce caregiver burden, managing costs, and improving patients' quality of life.
Top 3 Takeaways for Care Managers
Implement a structured onboarding process with continuous support and re-evaluation. Typically, clients take about a month to adapt to new technology. Regular check-ins every two weeks and formal annual evaluations are essential. This helps in addressing any issues promptly and adjusting the care plan as clients' needs evolve. Bi-monthly Zoom meetings with clients and caregivers can facilitate ongoing education and support.
Evaluations should consider clients' needs, safety, resources, and ability to engage with new technology. It's crucial to assess both the abilities and desires of clients, as well as their comfort with technology. This ensures the technology adopted aligns well with their preferences and lifestyle. Example: A tech-savvy client became anxious with additional technology, highlighting the need for personalized assessments.
Use technology to collect valuable data, identify patterns, and preemptively address potential health issues. This can save healthcare costs and improve care efficiency. For instance, sensors can monitor nocturnal activity, allowing care managers to deploy resources more effectively. The integration of telemedicine services can provide immediate medical consultations, further enhancing care delivery and potentially reducing emergency visits.
Episode Link: Spotify
Transcript
[00:00:04] Ariadne: Welcome to today's episode of CareCraft. I have Diane Gotebiowski with me today. She's a seasoned physical therapist with a rich career. She completed her doctorate in physical therapy in 2006. And then opened her own practice, led care teams in several regional skilled nursing facilities, worked in chronic disease management, and in 2023 joined EverCare, EverHome Care Advisors and VivaLynx as the Vice President of Client Services.
So super excited to have you on today, Diane. How are you doing?
[00:00:40] Diane: I'm doing great. And the only thing I'll edit about my intro is that I did my doctor in the middle of my career. So I opened my private practice long before I did that. So just said, I don't want people to think I'm too young
[00:00:56] Ariadne: for that clarification.
I had the pleasure of getting to meet you at the ALCA National Conference just a little while ago, but for our listeners that aren't familiar, could you give a little bit of an introduction about the work that you're doing at VivaLynx and how it relates with Ever Home Care Advisors?
[00:01:16] Diane: Absolutely. And thanks for inviting me, by the way.
We have sister companies, Ever Home Care Advisors, I'll mention first, because people will be mostly familiar with this, because we're a care coordination care management company. So we employ geriatric care managers, we call them life care coordinators, a combination of social workers, nurses, and therapists, both occupational and physical therapists and we do care coordination.
Viva Lynx, our sister company, was the brainchild of our founder, who was like so many of us struggling to find care and manage care for his parents. And he is an attorney. He was introduced to a geriatric care manager and he has been an incredible advocate for geriatric care management since that point, because he said it changed the trajectory of his life and his mother's life. So he founded VivaLynx, as a sister company and just a way to provide some technological assists for especially remote caregivers.
So I always like to say that, you know, we don't transfer people. We don't toilet people. We're not hands on care, but we know that 24/7 care. It's really not 24/7 hands on care. A lot of it's eyes on care, ears on care, and just supervision. So he developed with a team that he put together an app called VivaLynx.
And VivaLynx is an open integration app that helps to connect the caregiver to their, what we call the care recipient, their loved one at home. Whether they're five miles away, 40 miles away, or 400 miles away, they have a connection.
Potentially a view into the home, eyes into the home and connection to, in our case, a device in the home, which can help coordinate that care and bridge some of those gaps for everyone who's involved in the care, including the geriatric care manager.
[00:03:31] Ariadne: That's super interesting that you guys are set up as sister companies, because that provides a lot of feedback both ways, for the continued development of VivaLynx and then also for the care managers.
Would love to understand more of what you've learned about how the care managers are really evaluating if VivaLynx is appropriate for their client and vice versa.
[00:03:55] Diane: Sure. And I can add actually another layer to that as well.
When I was hired here and joined the team at VivaLynx and Ever Home Care because I work for both companies I was a caregiver. I still am a caregiver. So my mom was actively involved in care. I was her primary caregiver. And so my perspective is both from an administrator of the company and the services and a recipient, because certainly we've used all of our technology in my parents home.
So I have like three levels of of viewpoint, if you will. We do have some people that come directly into VivaLynx and just want the technology. They don't need any care coordination. And we do an assessment.
We look at all aspects of needs, safety resources, what's going to be feasible, what's not going to be feasible. What do they want to happen? What do they want to accomplish? And that might be, I want to stay right here in my house. My, I'm going to quote my boss because he our founder, because he tells his story very eloquently, but he always likes to say that his mom said the only way she was leaving her home was feet first.
And, you know, My mom, I vowed that I vowed, you know, as we as children often do, we say, this is what I will do for you. And sometimes it becomes impossible. But I was very fortunate that my mom stayed in her home as well. So is that what they want? We look at what technology would be helpful.
The VivaLynx device in the home. We think of that as the communication hub. Right now, we're using a 17 inch touchscreen tablet, and the person can check in, they can manage their schedule, manage their medications.
[00:05:54] Diane: And when I say they can manage, it depends on how independent they are. It might be their remote caregiver who is managing that, and how are they doing that? Through the app from wherever they are.
That assessment is ongoing. Who is the responsible family member? How much Information do they need? What do they need to do? Our services go as high as wrap around security or wellness services wellness devices, which people who have alarm systems in their home might be familiar with door sensors, you know, window sensors motion sensors, cameras, et cetera.
We're not necessarily monitoring the home, we're monitoring the individual bed sensors, chair sensors, motion sensors that can detect fall
Is there room for the equipment and devices? Some, in some homes, for those of us that have done home care, finding a space to put a 17 inch tablet might be a challenge. If there's care coordination involved, it could be part of the care plan is to help that person and their family organize the area and make it more safe.
So assessment goes from soup to nuts.
[00:07:05] Ariadne: So to summarize you were describing the framework that you use to evaluate for that particular client, if it might be an appropriate situation to use an assistive technology, and that fundamentally comes down to the client's needs the resources available, right?
On the other side, you were mentioning a little bit about kind of the levels of assistance that you might get through technology. How do you think about those?
[00:07:32] Diane: Sure. We know that not everyone embraces technology. So I was thinking of a particular example where we were doing an assessment on an individual who was very tech savvy in that electronic equipment in the home. He had a computer and he had a, you know, a digital theater and he, he liked gizmo.
So we thought, perfect. And the assessment seemed to indicate, because we looked at his adoption of technology, a step further and we kind of maybe missed is adding one more thing. And this type of technology was not what he was comfortable with.
And after a very short period of time, before we even really got him there, anxiety started to set in with this is too much for me to manage. So that's part of the assessment as well. It's not just the abilities, but the desires and health and maybe mental health issues that go with it.
We also have an integration in our system with a concierge medicine company, a telemedicine company. So clients that get our services also get 24/7 telemedicine, and they can access that through the system and get a provider on the phone, usually within 10 minutes.
So, if there's a transportation issue, if there's a minor health issue that someone's not sure if they need to go to an emergency room or act promptly on that, they can get a consultation with a medical provider.
And then there are the, the highest level, which are the sensors in the home. And, and again, there's a whole menu of sensors that are available. And through the assessment what's needed. We might want motion sensors in an area that if we don't want motion at a certain hour of the day so we can program those and set up alerts again based on what the person's needs are.
But it all in my mind circles back to what does the individual really want? What are their goals? What are they trying to avoid? What are they trying to accomplish? What's in the way? How do we take it out of the way? Will our technology do that?
[00:10:01] Ariadne: Certainly there's a very thorough evaluation period to determine, you know, what the needs are for the individual, what might be appropriate technology that could be introduced. If that evaluation has been done and it's deemed this is a good fit and we want to try this.
What do you recommend as kind of like the onboarding timeline? You know, what have you seen as far as like, how long it takes an individual to to really learn a new technology or get used to it being incorporated into their care routine?
[00:10:35] Diane: Sure, that's not a simple answer. We've seen people adopt very quickly, but we typically demo first, let them touch it a little bit, and again, depending on the supports install it, but we tell them, we don't expect them to be experts at it.
So, you know, I'd say, looking at the clients that we have, it's a good month. It's a good month before they even know everything that it can do. And then family members have more questions. We hold a Zoom meeting every other month for all of our clients and their caregivers. And we hold that Zoom meeting for them to just come to the table with us and say, What have you been using?
What, what don't you know? What would you like more help on? And I think that we started that about three months ago. And I think that's been pretty helpful, and it's been really interesting to see the people participating and being able to talk to other people that are using it. So that's been good. But I will also tell you that you have to be ready for the slow roll as well.
And we have a client that has been involved in our program with the app and they have a tablet in the home, but no other devices. But over the course of a year, as they got more and more comfortable with everything, the care coordination piece of it, the technology piece of it, they're communicating with relatives out of state, which the relatives love.
They've participated in our call. As that has rolled, it's been almost a year later. They're now asking for more. They're now asking to go to the next step. So we never shut the door on anything.
[00:12:29] Ariadne: Yeah, you bring up a great point, which is really that individuals needs change over time. Right? And maybe they're looking for more support. Maybe they just get comfortable over time and are willing to try something additional. What have you really seen in that aspect, is it usually something that the individual is bringing up?
Is there kind of a cadence to which care managers or the care team should be thinking about reevaluating the effectiveness?
[00:12:54] Diane: Yes, we are currently re evaluating, having kind of a formal re evaluation annually, but we check in every other week. And it's kind of interesting that people are now expecting it and liking it.
They, some of them have questions ready, but that every other week check in seems to be really very. Very useful. It can bring up issues that the person wasn't sure they wanted to talk about or not. It can bring up, you know, you ask some directed questions. Is everything working? Okay. Yeah. Well, my camera hasn't been working, but you know.
So the formal evaluation is, is about is, is an annual, but certainly like any clinical situation, it's as, as needed. It depends on who's involved as well. 50 percent is driven by the client and 50 percent is driven by their caregiver. You know, their caregiver may call us and say, I'm concerned about this, or I, I want to look at this, or I think they need more, or in some cases, I think they need less.
And sometimes the client will do that themselves.
[00:14:03] Ariadne: A consideration for everything in life is, of course the cost associated with it. And you know, different systems will have different costs. So how can you consider the actual value that it brings in a situation.
Like, what are the benefits that the care team or individual should really be looking for to see if it is working for them?
[00:14:25] Diane: Yeah, that's a really great question. There is a cost associated and there's a lot of technology, different technologies out there that are not covered by insurance. So how can this save money when you have to spend money? And again, it depends on what level of care you get.
Here's one benefit that I see.
We are collecting information, right? If the person has sensors or they're communicating with us, we know how often those communications happen, what the cadence is.
If, if you will, this is a person that we hear from three times a day, or this is the person that video chats with their loved one. every day or hasn't done it in six weeks. So you start to see patterns and you start to assess those patterns. Let's use the case of an in and out of bed. We can Go back and interrogate, if you will, the system and say, how many times does this person get out of bed during the night? Typically twice. And I'm going to look over the last few weeks.
Oh, it's changing. It's four times a night. It's five times a night. That's valuable information. That could be the indicator of a problem or something that's, that's brewing. You can intervene there. Something like that can save the healthcare system, not to mention the The quality of the health and the safety of the individual, but could save the health care system dollars in that if you can catch something before it's a problem.
Then there's the case of we need to get staff and we all know there's a staffing shortage. We need to get somebody in to help care for them. And let's say they have insurance. And let's say the insurance has granted them eight hours a day of care, but no agency has bodies to provide eight hours of daycare.
They can only provide two or three hours of care a day. So now you have to make the decision. I'm going to accept that obviously, because it's better than nothing. But if you have some information that looks at patterns of movement, that looks at behavioral patterns, that looks at when are people most likely to call, when do others call? When is the most activity? You might be able to use those two to three hours at a time that they need them the most. So you're going to deploy the resources that you have at the best time, based on some of this information, or you know where the gaps are might be.
So those are ways that we can use resources use resources better.
[00:17:03] Ariadne: That's a really great call out. And where do you hope to see the space in the next 5 to 10 years?
[00:17:09] Diane: Oh, everywhere. I think we're just getting better and better. And, and honestly, I don't just mean VivaLynx.
We worry about our privacy, but I see that some kind of tech augmented care we're all using it now. And the more we fine tune it, we protect people's information. We protect their privacy, but we respect what they need. And we can, we can bridge those gaps.
I know, personally speaking, to be able to communicate with my parents to be able to look in on them, and I'll tell you up front, my dad was not nuts about the idea of having this in his house. And when you start to see the utility of, of these, these things, and I don't want to ever minimize the importance of the social connection as well while monitoring behavior.
I worry that there's, there's not one size that fits all, and, and I don't think anybody should be selling one size fits all. It has to be individualized and it has to meet those individuals needs. But I think we're getting more and more nimble at being able to do that. So I think you're going to hear more about it, not less about it, for sure.
[00:18:32] Ariadne: That's super exciting. I can't wait to hear more about it. Thank you so much for joining us today, Diane. It was wonderful to hear about the work that you are doing. And I look forward to continuing to see how VivaLynx grows in the future.
[00:18:46] Diane: Thanks, Ariadne. I appreciate you.
And it's nice to see you again. Thanks for asking me.