Mobility Solutions to Support the Booming Home Health Services Market

The market for home health care services is growing rapidly and is not likely to slow any time soon. The expanding need is due in large part to the aging of the baby boomers, those born between 1946 and ‘64.  The boomers were once the nation’s largest living generation, defined by a notable increase in births in the United States following World War II. As this generation ages, it is creating a boom of sorts in the home health services industry.

Roughly 10,000 baby boomers turn 65 every day, and increasingly these seniors wish to continue living in their own homes rather than being moved to nursing homes or assisted living facilities.   According to AARP, nearly 90 percent of seniors want to stay in their own homes as they age, referred to as “aging in place.” Most seniors (up to 82 percent) would prefer to stay in their homes even as they need daily assistance or ongoing health care.  Few seniors say they would prefer to move to a care facility, and even fewer identify living with extended family as a desirable option.

The rate of home ownership among boomers is higher than with the rest of the population today, which is one of the primary reasons for increased demands for home care services.  Reports reflect that 81% of seniors today own their own homes, compared to 68% for the rest of the population. The majority of these seniors live alone or with a spouse – we’ve already established that living with extended family isn’t a frequent choice, possibly due at least in part to reduced home ownership rates. There are also suggestions that the reduced economic status of later generations has similarly reduced the capacity for extended families providing the long-term care for their seniors.

Projected to double by the year 2050, the number of Americans requiring daily help with living at home is expected to grow from the current 12 million to 27 million.  Older adults will make up almost 20 percent of the population, if not more.

These and other factors are driving rapid growth and expansion in the home health care field. Projected job growth for home health providers and personal care aids is expected to reach a whopping 70 percent by 2020. Larger than any other occupation grouping in the country, direct care workforce is projected to exceed teachers from kindergarten through high school (3.9 million), all law enforce and public safety workers (3.7 million), and registered nurses (3.4 million). Between 2010 and 2020, the fastest growing occupations in the country are projected to be Personal Care Aides and Home Health Aides.

Home health care businesses providing in-home senior care, hospital after-care, veteran care and numerous other specialized and general services are supported by a number of specialized software solutions designed to meet the specific needs of this segment of the healthcare industry.  The software used to support the business generally includes specific functionality for managing client and patient records, caregiver and provider information, scheduling and dispatch, payroll and HR, billing, and other back office and accounting processes.

Many of the industry-specific solutions available on the market address different or unique aspects of operating the home health care business, integrating data from their system with separate accounting and finance applications (such as QuickBooks desktop editions) for the rest of the functionality needed.  This allows the developer of the line of business application to focus on the valuable features and capabilities that will make the practice more efficient, compliant and profitable, leaving general accounting processes (payroll, accounts payable, general ledger and reporting) to the accounting software.

With greater frequency, the applications servicing the home health care industry are SaaS solutions, crafted with online access and mobility in mind.  This industry in particular has a specific need for remote and mobile access to information, as it is a “field service” operation at its core with healthcare rolled in.  The requirements to manage not just scheduling and services, but to deal with compliance, privacy and other factors involved with healthcare information complicates matters, placing an additional focus on the security and mode of access to the software and information.

Businesses using solutions such as Kinnser ADL, Shoshana Rosemark, Kaleida eRSP and Generations Homecare System rely on the software to streamline their operations.  Not only designed to support a remote and mobile workforce, these application services also provide business owners and managers with the ability to access essential business data at any time.  At issue is the rest of the software and systems which support the business operation and its processes.  Word and Excel or other productivity tools are almost certainly used at some level, and QuickBooks is in use, too.  These applications and their data typically reside on the desktop computer or local network.  As desktop applications, these solutions deliver the best power and performance for the business in terms of features and usability.  While some users may consider moving to web-based versions of these products, those who favor performance and functionality over framework often return to the feature-rich desktop applications that do the full job required.

In order to give business owners and remote workers the access they need to desktop applications and data, secure remote access solutions are required.  When the software and systems reside in the locked office of the business, the people operating outside aren’t usually able to access them in a way that is useful – or useful for more than one person at a time.  Remote control solutions that broker access to a PC cannot provide the multi-user support, application security or overall performance that most businesses require.  Attempts to implement simple RDS solutions or use similar products to create access often expose the business to unnecessary risk and limited capability while introducing heavy technical and licensing expenses.

With an offsite option, where the applications and data reside with the commercial hosting provider, business owners and line managers benefit from being allowed to focus on operations and not on managing the underlying software and systems. The business outsources the provisioning, management and protection of primary IT resources to support users, software and data, but the business should retain the capability to administer their own cloud as personnel changes impacting information access can occur at any time.

Whether their software and data are hosted on-site with existing equipment or offsite with managed hosting, home health care businesses need to have an easy-to-use solution for administration of user accounts, application access and secure filespaces.  For the home health care business, this is critical functionality that can mean the difference between spending too much time in the office handling general business and software matters versus meeting with clients and managing caregivers and revenue-generating activities.  In a fast moving, fast growing and highly mobile business, getting to information at anytime from anywhere using any device means being able to meet booming business demand.

Make Sense?

J

https://www.census.gov/newsroom/press-releases/2014/cb14-84.html https://www.ioaging.org/aging-in-america http://www.pewresearch.org/fact-tank/2016/04/25/millennials-overtake-baby-boomers/ http://www.iyhusa.com/AginginPlaceFacts-Data.htm http://economistsoutlook.blogs.realtor.org/2012/01/13/homeowners-by-age/

Compliance in the Cloud – Their System; Your Responsibility

Can you outsource compliance to the cloud?

Outsourcing IT to a cloud service provider can be tremendously beneficial for a business.  The model allows an organization to offload not just IT infrastructure costs, but also the costs associated with developing and maintaining all of the practices and processes involved in managing and maintaining the infrastructure and systems.   There is tremendous responsibility in handling everything from platforms and infrastructure to creating best practices for maintenance, management of scalability and growth, forecasting bandwidth requirements, implementing and monitoring security compliance, creating effective and comprehensive disaster recovery plans, and more.

The question which begs to be asked is whether or not HIPAA, PCI/DSS or any other compliance requirements, and the complexities, risk and legalities that come along with them, can also be outsourced to the CSP. For that matter, can any real level of responsibility be fully outsourced, where the liability for non-performance or noncompliance is also fully shifted?

Ummm. No. It is still your problem.

What too many companies really don’t understand is that they aren’t eliminating risk by moving to the cloud, and the requirement to meet various compliance requirements really can’t be outsourced. Particularly in this area, businesses need to recognize that outsourcing certain functions doesn’t reduce or eliminate responsibility or liability.  Just the converse, it could make things a bit more difficult if you don’t keep close tabs on how the provider implements and is involved with your solution. Even beyond that, what is the impact to the business operation when requirements are not met?  Cost recovery from the provider may be one option, but how does that help the business remain operating in the meantime?

Gramm-Leach-Bliley (GLB) Act  Requires financial organizations to enter into contracts with third parties that they share their customer information with (including cloud vendors) to ensure that the third-party handles that information securely. Executives of those financial organizations can be held personally liable for failure to do so.

Sarbanes-Oxley Act (SOX)  Defines specific security mandates and requirements for financial reporting to protect shareholders and the public from accounting errors and fraudulent practices. SOX dictates which records are to be stored and for how long and requires the data owner to know the location of the data in the cloud and to maintain control of it. Failure to comply can result in fines and/or imprisonment.”

source: CIO.com

This discussion Isn’t limited just to compliance with regulations (at least it shouldn’t be)

In this conversation we need to also address what a business should do in terms of protecting and preserving its information assets (data!) even beyond what the CSP offers. Keeping confidential and private information secure and protecting the data of the business (and clients or patients or other entities) is essential, even when the CSP fails in its obligations or abilities.  This aspect of disaster recovery and continuity planning is not often considered by the CSP yet remains critical to the business customer. The sales pitch, however, never really delves into this area, because it represents an aspect of service coverage that the provider simply can’t provide.

Illustrating this particularly difficult aspect of outsourcing to the cloud is the hard lesson learned by customers of a QuickBooks hosting provider who experienced a severe outage due to a ransomware attack. The hosting service provider promised customers it backed up their data and it did, but the backup archives were also compromised.  In order to restore service, customers were expected to have their own backups of the cloud-hosted data.

While there may have been items in the service agreement which address these issues, I can say – based on a great deal of experience in just this area – the service providers rarely make this point very clear to customers, and more frequently tell customers backing up their data is no longer something they need to really worry about. It’s like that really tiny type at the bottom of a contract that nobody notices until it is too late.

“..restoration proved more difficult in Texas. Lezama explained that for the Texas clients, the backups had been compromised as well, because their backup data had synchronized with corrupt files. But Cloudnine clients are obligated backup their own data as well, as a sort of third-level security measure..”

source: AccountingToday

With compliance in the cloud, it’s their system, but your responsibility.

Outsourcing IT to a cloud service provider in no way eliminates or reduces the obligations of the business to manage certain aspects of information systems and data.  What outsourcing can do is deliver a greater operational capacity and agility more affordably.

The responsibilities to establish information and systems management practices and processes remain firmly with the business, and actually represent a strategic component of the business that is unwise to outsource anyway. Resilience in a business and its ability to conform to regulatory and other requirements are the foundations of sustainability. Remember that cloud providers and services can be leveraged to improve certain cost and system performance metrics, but it remains solely with the business customer to find ways to reduce risk and create a greater assurance of continued operational capability.

Make Sense?

J