May 15, 2025 • 23 mins
Dave Marchand reveals how New Day Healthcare's Carelytics platform bridges critical gaps in the traditional home healthcare delivery model by unifying patient data across service lines. Through advanced analytics and proactive interventions, this approach transforms care delivery from reactive, reimbursement-driven episodes to comprehensive patient journeys that identify early decline indicators and prevent catastrophic health events.
• The traditional healthcare model operates reactively, with treatment only beginning after a significant decline
• The Carelytics platform connects data across personal care, home health, and hospice service lines
• Care gap programs focus on specific patient populations and trigger appropriate early interventions
• Unified healthcare data model creates a complete "patient journey" view spanning years, not just visits
• New acquisitions maintain their existing platforms while gaining immediate access to innovation
• AI technology enables the identification of complex patterns and orchestrates appropriate interventions
• Single service providers can develop similar approaches through strategic partnerships
Episode Resources:
- Webinar: Harnessing data intelligence for better outcomes: How data-driven insights are transforming home-based care
- Blog: 3 steps to leverage data science in home care
- Toolkit: Growth in home-based care: How to make the most out of your data
- Video: Elara Caring: Harnessing data for better patient outcomes
If you liked this episode and want to learn more about all things home-based care, you can explore all our episodes at alayacare.com/homehealth360.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Dave Marchand (00:00):
We look at patients in terms of visits and
episodes right, that's it,that's what we get reimbursed
for, that's how we look at themover time.
But when you look at someoneover the years and they go into
and out of service lines, intoand out of systems, having all
of that into a single data modelallows us to do things we were
never able to do before Look forpatterns in that data, look for
(00:23):
other indicators that we wouldhave never seen because we
didn't see all that data in oneplace, and that when we look at
it and we combine what'straditionally in those service
lines, like personal care orhome health or hospice, with the
data that's in these care gapsthat we're going after, we call
that the patient journey.
What are they doing, how arethey doing it?
(00:44):
And can we look at all of thatdata and look for other patterns
, look for those gaps and seewhat we can do to keep them
healthier and at home?
Erin Vallier (01:01):
Welcome to another episode of the Home Health 360
podcast, where we speak tohome-based care professionals
from around the globe.
I'm your host, Erin Vallier,and today I am joined by Dave
Marchand.
With a career spanning almost40 years, dave has successfully
leveraged state-of-the-arttechnology to drive enterprise
(01:22):
innovation transformation.
State-of-the-art technology todrive enterprise innovation,
transformation and processoptimization across several
industries globally, with thelast 25 years focused on all
sectors of healthcare and thelast 15 years specifically
focused on the home healthsector.
Dave is currently the ChiefInformation Officer at New Day
(01:42):
Healthcare and he holds abachelor's in science and
electrical engineering from theUniversity of Notre Dame.
Welcome to the show, dave.
Dave Marchand (01:49):
Well, thank you for having me, and it's a
pleasure to be here.
Erin Vallier (01:53):
I am super excited to have you on the show.
I know you are wanting to talkabout addressing gaps in care
and the home health deliverymodel and with your resume, I'm
sure you have seen the gamut ofhow things can fall through the
cracks.
People can fall through thecracks, so I'm very interested
to hear your perspective.
So I'll start with a questionwhat do you see as the
(02:14):
challenges with the current homehealthcare delivery model?
Dave Marchand (02:18):
And if you look at our delivery model, it's
really driven by payers, whetherthat be Medicare, medicaid,
commercial payers and theirreimbursement models.
What are they willing toreimburse for?
And typically those are dividedinto very discrete service
lines, from personal care, homehealth and hospice.
Erin Vallier (02:38):
Now, is that a bad thing?
Dave Marchand (02:39):
I don't know if it's a bad thing, but
reimbursement models by theirvery nature are reactive.
Erin Vallier (02:46):
after the fact After the fact, and why would
that be an issue?
Dave Marchand (02:51):
If you look at someone's health care or health,
you can see it progress overtime and it starts to decline
and it gets worse over time.
And if you wait till the pointwhere it's bad enough that you
are now going to reimburse forit, you've waited and you've
delayed the interventions we cando, and that increases the
(03:12):
overall cost anxiety on thepatients and everything else.
And so can we get to a moreproactive model.
Erin Vallier (03:21):
It sounds like we should think about it.
But this reactive model thatyou're speaking of, isn't this
the model that the healthcareindustry has pretty much
followed for decades?
Dave Marchand (03:33):
Yes, it has, erin , and that's what we think is
one of the problems.
If you look between thesetraditional service lines, there
are gaps, what we call caregaps, and taking care of the
patient during these care gapsis really what's needed to keep
them healthier and deliver fastintervention and keeping them at
(03:56):
home in a care setting thatthey're more comfortable with.
Erin Vallier (03:59):
Gotcha.
So care gaps, let's dive in alittle bit there.
So I imagine the currentpayer-driven model they're not
going to be proactive aboutpaying for some of this stuff.
I see that as potentially anissue with filling the care gap,
like providing care in thatspace.
Can you talk to me a little bitabout that?
Dave Marchand (04:37):
Yeah, absolutely.
Probably.
The best way, Erin, is to lookat an example.
Imagine we have a patient who'sreceiving personal care
services and our caregivernotices that patient is all of a
sudden having a hard time withbalance or walking or to decline
, and would cause a clinician totalk to that patient and
possibly proactively bring thema physical therapist or an
occupational therapist, with thewhole goal of reducing a fall
or fall risk.
Now when you look at thatpatient population, he realized
(05:02):
they're seniors with multiplechronic conditions.
When they fall it's usually apretty catastrophic event.
They usually break something,they go into the hospital and
the cost and the impact on thepatient is so much greater in
that reactive model than itwould be in a proactive model
where we're looking at earlyindicators and trying to
intervene as quickly as wepossibly can.
Erin Vallier (05:24):
Which seems like the better approach.
Let's prevent the broken hipand all of the hospital bills
and the trauma to this person.
It's potentiallylife-threatening as well, as we
age to break things like that,so it seems like the
reimbursement models need tocatch up.
So I'm curious how are you, atNew Day Healthcare, addressing
(05:46):
these care gaps?
Dave Marchand (05:47):
We focused on building what we call Carelytics
.
It's our advanced technologyplatform that specifically
focuses on these various caregaps that are out there and what
we can do to address those caregaps.
Erin Vallier (06:03):
So how does Carelytics address those care
gaps?
Dave Marchand (06:06):
In two ways.
One is, if you look at it, ourCarelytics platform.
The basis for that is a unifiedhealthcare data model and when
you look across multiple servicelines, across multiple years
and multiple systems, you neverreally get a single view of that
patient.
It's scattered among all thesesystems.
(06:26):
Bringing all that data intothat unified data model gives us
something that we can start towork with.
And then, on top of that right,we have our programs that are
focused on a very specific caregap and what we can do to
address that specific care gap,and we can add multiple programs
to address different care gapsover time.
Erin Vallier (06:47):
Gotcha so many questions.
So you have this layer of IT ontop of all your platforms,
pulling out the structured andunstructured data and pulling it
into one unified record to showthe full spectrum of care being
provided and what couldpotentially be flagged as a
decline.
Dave Marchand (07:07):
Yes, it's the looking for the early indicators
of the decline, but it's alsotrying to keep them healthy,
maybe through education oranything else.
The two parts right.
What can we do to keep themfrom declining?
But then how do we notice whenthey are really first starting
to decline, and can we intervenethen, versus waiting till later
on?
Erin Vallier (07:26):
Can you give me an example of a care gap program?
Dave Marchand (07:29):
Yeah, absolutely.
We talked a little bit beforeabout the full risk, but one of
the best ones is probably ourCDM program.
And if you look at seniors whohave multiple chronic conditions
and their health is starting todecline, it will decline to a
point where they need hospicecare.
But a lot of times what wefirst try to do is establish
goals that we're going toimprove their life, and whether
(07:52):
those are physical goals,spiritual goals or social goals,
can we do things to impact that, that they can do stuff like go
out on a date for the firsttime in six months Maybe that's
through care coordination withall of their physicians or
whatever we can do or bringingthem transportation that they
can get to it.
How do we focus on that?
(08:12):
But at the same time, we knowthat no matter what we do, their
health is going to continue todecline over time.
And if we can notice that pointwhen their health has declined
to a point that they needhospice care, can we deliver
hospice care as quickly aspossible?
Out of all of our service lines, Erin, the one that people
(08:34):
deserve to have as quickly asthey can is hospice care.
At the end of life, we need asmuch care as we can possibly get
.
Erin Vallier (08:42):
Absolutely much care as we can possibly get.
Absolutely what a cool programfinding ways to give somebody
support as they're slowlydeclining.
Where, as you have aptly stated, is a gap in care is where we
typically just dischargesomebody and see them when they
come back after a catastrophicevent.
I'm curious how do you go aboutdefining a care gap program?
(09:04):
What's involved?
Dave Marchand (09:05):
I'll try to simplify it but hopefully not
oversimplify it.
There's really four parts or apattern that we go after, and
the first one is the populationwe want to focus on.
That population could beanything from everyone in a
specific service line in a givenstate with a certain
demographic, Even maybe all themembers that belong to a
(09:29):
specific payer, right?
What's the population we wantto focus on, what's the data
we're interested in?
And whether that data comesfrom our database, whether it
comes from a clinicalobservation, whether it comes
from our customer service teamcalling and talking to the
patient or their caregivers,what's the data that we're
interested in?
And then what are the triggers?
That says, if the data fallsinto one of these states, this
(09:52):
is one of those early indicators.
And then, ultimately, what'sthe action we want to take?
Is it refer them to anotherservice line?
Are we clinically talk to themand see what we need to do?
Or some combination of it?
Bob, they all follow thosepatterns and so, really, what we
want to do is say what are thethings we're really focused on.
Over time and this is theinteresting thing as we built
(10:15):
this, we've expanded what wethink of the care gaps from when
a patient first becomes apatient and someone calls up and
says there's something wrongwith my mom and dad.
I don't know what it is and Idon't know what they need.
And I don't know what they needand how can we guide them among
all the things that they'reeligible for and what's the best
service for them at that time.
(10:35):
And then, after we dischargepeople right, normally they fall
off the radar screen.
Can we keep following up withthem and keep seeing how they're
doing and if their healthstress is declining, can we help
them again more proactivelythan reactively?
Erin Vallier (10:49):
I love that.
Can you tell me a little bitmore about this unified
healthcare data model and therole that that plays
specifically in developing theseprograms?
Dave Marchand (10:59):
The hard part with this is, if you think, in
our traditional model, we lookat patients in terms of visits
and episodes, right, that's it,that's what we get reimbursed
for, that's how we look at themover time.
But when you look at someoneover the years and they go into
and out of service lines, intoand out of systems, having all
of that into a single data modelallows us to do things we were
(11:23):
never able to do before Look forpatterns in that data, look for
other indicators that we wouldhave never seen because we
didn't see all that data in oneplace, and that when we look at
it and we combine what'straditionally in those service
lines, like personal care, homehealth or hospice, with the data
that's in these care gaps thatwe're going after, we call that
(11:45):
the patient journey.
Right, we look at it in termsof years, not visits.
Sometimes you'll hear a call tolaunch an attitudinal health
record, but we like the patientjourney right.
What are they doing?
How are they doing it?
And can we look at all of thatdata and look for other patterns
, look for those gaps and seewhat we can do to keep them
healthier and at home?
Erin Vallier (12:04):
Now, why would you go about building your own
unified healthcare data model?
Why wouldn't you just find atechnology vendor or a partner?
Because you guys acquiredifferent businesses and I
understand you allow them tostay on their platform.
So talk to me a little bitabout that.
This is sort of a differentapproach.
Dave Marchand (12:21):
It is a different approach and, having done this
for years and convertingeveryone to a single platform,
there was a lot of businessdisruption with it and when you
look at multiple service linesand multiple states, there's
really no one vendor that does agreat job with all of that and
has a platform that allows us toput innovation on top of it
(12:42):
really quickly right.
So we needed that flexibility tofocus on these gaps, and it's
kind of unfair to have a vendorwho has an existing client base
and they're trying to go afterthe market in a certain way to
do everything that we want atNew Day right.
So we wanted that layer inbetween that we can build
innovation.
(13:02):
We could take advantage ofwhatever our partners had.
If they had a greathospitalization risk score,
could we take that into effectwhen we're looking at reducing
hospitalizations.
But really, what we wanted toalso do is enable our business
not to go through thatdisruption.
So, as you said, new Daycontinues to acquire other
(13:23):
companies, and one of the thingsthat was so important to me was
that I didn't force ouroperators to have to convert a
new acquisition to a singleplatform.
If I could just map that systeminto our unified data model and
instantly they got all theinnovation we've built on top of
that.
That's a faster way toinnovation and it lowers the
(13:46):
overall cost of innovation,which we think is probably a
better model going forward.
Erin Vallier (13:51):
I think you may have just answered.
My next question was like howspecifically does your
Carelytics platform give you theability to leave those
acquisitions on their platform?
So, essentially, it'sextracting the data that you
need to build that unified datamodel.
Is that correct?
Dave Marchand (14:08):
It does, erin.
It's the how can we map theview of patient inside one
system into this unified model?
And I know it sounds simple.
It's not usually that way.
You know this.
No matter what we do with anysystem, it's how people put the
data in.
So a lot of times we have to dosome translation to do that
mapping, but that is so muchsimpler than converting everyone
(14:31):
over into one, changing howeveryone's used to doing things.
It makes it a lot simpler andeasier to acquire new companies
and bring all this innovation tothem quickly and really it's
really from the perspective ofthe patients.
How can we start serv them, notrequiring you have to be on
(14:51):
this specific platform in orderto make that happen.
We just felt that gave us alittle bit more flexibility as a
company and it was probablybetter for looking at the
patients and what we can do andthe speed to which we can bring
new solutions to them.
Erin Vallier (15:06):
Yeah, time to value there, and my brain wants
to just dive into oh, do youneed open APIs to pull this data
?
All the technology questions.
But I'm not going to bore thelisteners with that.
I do want to talk a little bitmore about the Carelytics
platform.
It sounds way more than just atechnology platform.
There's a lot of moving partsthere.
Dave Marchand (15:26):
It is Anything else and I know it sounds cliche
, but you always hear this it'speople processing technology and
it really is.
The technology platform andthis unified data model gives us
the ability to look at data andlook at patients in a way we
never have.
But our programs are dependenton either our clinicians
(15:48):
interacting with the patients,our customer service reps
calling up and talking to themand interacting with them in
some way, and then the processeswe use to say oh, that was a
trigger.
What do we do in response tothat to address these care gaps
that people process intechnology, where the technology
becomes the enabler to buildall of these other programs on
(16:10):
top of you still need that humantouch to identify really what
the need is when you have peoplecalling in and looking through
the unstructured and structureddata correct.
Gotcha.
Erin Vallier (16:21):
So I know there's a lot of talk and there's a lot
of hype actually about AI.
How does that fit into yourstrategy with Carelytics?
Dave Marchand (16:29):
It's like any new technology, right?
I started doing AI, Erin, inthe 1980s and back then Dating
yourself.
I know I am, I know, but backthen the hype exceeded the
ability, even though a lot ofthe techniques are still the
same.
But what has changed is ourunderlying computing power, just
(16:50):
our hardware platforms andeverything.
So now we're at the point wherethere is still a lot of hype
and there's still a lot ofpeople who say they have an AI
driven system when they don't.
Still a lot of people who saythey have an AI driven system
when they don't.
But we're at the point now withthis technology where it is
truly transformative and can wefundamentally change how we're
(17:11):
doing what we do and, from ahealthcare perspective, how can
we do it to improve how we treatour patients?
And there are really twoaspects to it.
One is generative AI, which isfor the first time.
We can take a software and ifit knows A and B, it can infer C
(17:33):
on its own.
Before we always had to trainit and now they can look at
enough data and train it andensure what's next.
And that is so importantbecause the complexity and the
volume of what they can look atgreatly exceeds the capability
of any individual.
And then, corresponding to that,as you hear, it called
(17:53):
agent-based AI, which is reallyaround complex patterns that we
want to do if we see a trigger,an event.
Complex patterns that we wantto do if we see a trigger, an
event.
We want to process things in avery complex way.
Can these agents take care ofthat for us?
And you see them now, withpersonal shoppers and all this
other stuff, and they perform aset of very complex tasks
(18:14):
orchestrated, and those twotechnologies alone.
Can they be disruptive to ourindustry?
Erin Vallier (18:23):
technologies alone .
Can they be disruptive to ourindustry?
Oh, I think they can.
How do you envision using it inthe platform itself?
I'm sure you have ideas.
Dave Marchand (18:28):
Absolutely, and it goes back to that unified
data model.
When we can bring all of thatdata on a patient, and whether
this is data we pull from othersources like pharmacy data or
anything else, can we bring itall together?
Can the generative AI now startto look for unlocking complex
patterns we could never seebefore and identifying more cure
(18:51):
gap solutions than we couldright?
Can it start to look at stuffalmost exponentially that we're
looking at linearly today?
It's exciting because I wouldlove to be able to tell you I
know everything it was about todo, but I think we're seeing
that this technology is creatingstuff that we even didn't think
it could do, but a lot of it isthe data that we're training it
(19:13):
on, and so, for us, we'refeeding our data into it,
looking for these other patternsthat have the biggest impact on
our patients' lives, and then,once we discover those patterns,
could we use something like theagent-based AI to then process
and do a whole lot of things forus so we can do more for those
(19:33):
patients in a shorter period oftime, address more care gaps,
and this really does move usaway from a reimbursement model
towards a patient-centric caredelivery model.
Erin Vallier (19:47):
Yeah, that's the way it should be and it's super
exciting.
It's sci-fi.
I feel like I'm stuck in thefuture.
Wow, I'm just super impressedwith what you have developed,
and I'm sure that our listenerswould love to know if I don't
have a platform as robust andcomplex as this to layer on top
(20:07):
of even my one single EMR, howcan they think about identifying
where the gaps are in care?
It seems like it might bedifficult, like you might
actually need to have a techstack.
What are your thoughts there?
Dave Marchand (20:21):
That's a great question and, like any other
great question, the answer isusually well, it depends, but I
think what you can do is there'ssome patterns that are simple.
If you've got one service line,you can look at the things
that's going to drive yourpatients into those services and
(20:41):
can you do it more proactively.
So there are more simplepatterns based upon one service
line.
However, if you've got multipleservice lines, you will look at
patterns that span years andall of this other data.
That technology platform is theenabler to do that.
It's what we can build the AIon top of, the enabler to do
(21:03):
that.
It's what we can build the AIon top of.
We can build just otherpatterns and we can build the
ability to look at theseprograms and execute more of
them so we can fill more andmore of these care gaps.
Erin Vallier (21:11):
So what I'm hearing you say is, if you're a
single service line, maybe lookat something as simple as your
quality assurance program andsee where you fall short and get
to a root cause analysis thereand maybe build a program around
where you're not holes in yourcare, maybe people are falling
more frequently.
But if you have multiple linesof care, that becomes way too
(21:32):
complex with a good technologystack.
Dave Marchand (21:36):
It does.
And if you're a single serviceline, maybe one of the solutions
is partnering with somebody whohas another service line.
Because maybe one of thesolutions is partnering with
somebody who has another serviceline because a lot of these
care gaps fall between twoservice lines and they really
help move the patientsproactively from one to the
other.
And if you get a single serviceline, you're trying to figure
out how to move your patientsand give them better care.
(21:58):
So it's moving it into yourservice line.
But it may also look forpatterns that they need other
care and maybe that isaccomplished by partners.
Erin Vallier (22:05):
At that point, yeah, that makes sense.
Well, I really do appreciateyou coming on the show, Dave,
and sharing your wisdom and alsogiving some people who are not
as technologically advanced asNew Day some ideas to identify
their own care gap programs.
Such a pleasure speaking withyou.
Dave Marchand (22:24):
Erin always a pleasure, and you and I have
known each other for a while andthey were really excited about
what we can do to keep improvingpatient care and to really move
it back to a patient-centricdelivery model.
So thank you so much for havingme on today.
Erin Vallier (22:41):
You're so welcome and I can't wait to see what you
guys are going to accomplish in2025 and beyond.
Dave Marchand (22:46):
Excellent.
Erin Vallier (22:48):
Home Help 360 is presented by AlayaCare and
hosted by Erin Vallier.
First, we want to thank ouramazing guests and listeners.
Second, new episodes air everymonth, so be sure to subscribe
today so you don't miss anepisode.
And, last but not least, if youlike this episode and want to
learn more about all thingshome-based care, you can explore
(23:10):
all of our episodes atAlayaCare.
com, slash, homehealth360 orvisit us on your favorite
podcast platform.
We look at patients in terms of visits and
episodes right, that's it,that's what we get reimbursed
for, that's how we look at themover time.
But when you look at someoneover the years and they go into
and out of service lines, intoand out of systems, having all
of that into a single data modelallows us to do things we were
never able to do before Look forpatterns in that data, look for
(00:23):
other indicators that we wouldhave never seen because we
didn't see all that data in oneplace, and that when we look at
it and we combine what'straditionally in those service
lines, like personal care orhome health or hospice, with the
data that's in these care gapsthat we're going after, we call
that the patient journey.
What are they doing, how arethey doing it?
(00:44):
And can we look at all of thatdata and look for other patterns
, look for those gaps and seewhat we can do to keep them
healthier and at home?
Erin Vallier (01:01):
Welcome to another episode of the Home Health 360
podcast, where we speak tohome-based care professionals
from around the globe.
I'm your host, Erin Vallier,and today I am joined by Dave
Marchand.
With a career spanning almost40 years, dave has successfully
leveraged state-of-the-arttechnology to drive enterprise
(01:22):
innovation transformation.
State-of-the-art technology todrive enterprise innovation,
transformation and processoptimization across several
industries globally, with thelast 25 years focused on all
sectors of healthcare and thelast 15 years specifically
focused on the home healthsector.
Dave is currently the ChiefInformation Officer at New Day
(01:42):
Healthcare and he holds abachelor's in science and
electrical engineering from theUniversity of Notre Dame.
Welcome to the show, dave.
Dave Marchand (01:49):
Well, thank you for having me, and it's a
pleasure to be here.
Erin Vallier (01:53):
I am super excited to have you on the show.
I know you are wanting to talkabout addressing gaps in care
and the home health deliverymodel and with your resume, I'm
sure you have seen the gamut ofhow things can fall through the
cracks.
People can fall through thecracks, so I'm very interested
to hear your perspective.
So I'll start with a questionwhat do you see as the
(02:14):
challenges with the current homehealthcare delivery model?
Dave Marchand (02:18):
And if you look at our delivery model, it's
really driven by payers, whetherthat be Medicare, medicaid,
commercial payers and theirreimbursement models.
What are they willing toreimburse for?
And typically those are dividedinto very discrete service
lines, from personal care, homehealth and hospice.
Erin Vallier (02:38):
Now, is that a bad thing?
Dave Marchand (02:39):
I don't know if it's a bad thing, but
reimbursement models by theirvery nature are reactive.
Erin Vallier (02:46):
after the fact After the fact, and why would
that be an issue?
Dave Marchand (02:51):
If you look at someone's health care or health,
you can see it progress overtime and it starts to decline
and it gets worse over time.
And if you wait till the pointwhere it's bad enough that you
are now going to reimburse forit, you've waited and you've
delayed the interventions we cando, and that increases the
(03:12):
overall cost anxiety on thepatients and everything else.
And so can we get to a moreproactive model.
Erin Vallier (03:21):
It sounds like we should think about it.
But this reactive model thatyou're speaking of, isn't this
the model that the healthcareindustry has pretty much
followed for decades?
Dave Marchand (03:33):
Yes, it has, erin , and that's what we think is
one of the problems.
If you look between thesetraditional service lines, there
are gaps, what we call caregaps, and taking care of the
patient during these care gapsis really what's needed to keep
them healthier and deliver fastintervention and keeping them at
(03:56):
home in a care setting thatthey're more comfortable with.
Erin Vallier (03:59):
Gotcha.
So care gaps, let's dive in alittle bit there.
So I imagine the currentpayer-driven model they're not
going to be proactive aboutpaying for some of this stuff.
I see that as potentially anissue with filling the care gap,
like providing care in thatspace.
Can you talk to me a little bitabout that?
Dave Marchand (04:37):
Yeah, absolutely.
Probably.
The best way, Erin, is to lookat an example.
Imagine we have a patient who'sreceiving personal care
services and our caregivernotices that patient is all of a
sudden having a hard time withbalance or walking or to decline
, and would cause a clinician totalk to that patient and
possibly proactively bring thema physical therapist or an
occupational therapist, with thewhole goal of reducing a fall
or fall risk.
Now when you look at thatpatient population, he realized
(05:02):
they're seniors with multiplechronic conditions.
When they fall it's usually apretty catastrophic event.
They usually break something,they go into the hospital and
the cost and the impact on thepatient is so much greater in
that reactive model than itwould be in a proactive model
where we're looking at earlyindicators and trying to
intervene as quickly as wepossibly can.
Erin Vallier (05:24):
Which seems like the better approach.
Let's prevent the broken hipand all of the hospital bills
and the trauma to this person.
It's potentiallylife-threatening as well, as we
age to break things like that,so it seems like the
reimbursement models need tocatch up.
So I'm curious how are you, atNew Day Healthcare, addressing
(05:46):
these care gaps?
Dave Marchand (05:47):
We focused on building what we call Carelytics
.
It's our advanced technologyplatform that specifically
focuses on these various caregaps that are out there and what
we can do to address those caregaps.
Erin Vallier (06:03):
So how does Carelytics address those care
gaps?
Dave Marchand (06:06):
In two ways.
One is, if you look at it, ourCarelytics platform.
The basis for that is a unifiedhealthcare data model and when
you look across multiple servicelines, across multiple years
and multiple systems, you neverreally get a single view of that
patient.
It's scattered among all thesesystems.
(06:26):
Bringing all that data intothat unified data model gives us
something that we can start towork with.
And then, on top of that right,we have our programs that are
focused on a very specific caregap and what we can do to
address that specific care gap,and we can add multiple programs
to address different care gapsover time.
Erin Vallier (06:47):
Gotcha so many questions.
So you have this layer of IT ontop of all your platforms,
pulling out the structured andunstructured data and pulling it
into one unified record to showthe full spectrum of care being
provided and what couldpotentially be flagged as a
decline.
Dave Marchand (07:07):
Yes, it's the looking for the early indicators
of the decline, but it's alsotrying to keep them healthy,
maybe through education oranything else.
The two parts right.
What can we do to keep themfrom declining?
But then how do we notice whenthey are really first starting
to decline, and can we intervenethen, versus waiting till later
on?
Erin Vallier (07:26):
Can you give me an example of a care gap program?
Dave Marchand (07:29):
Yeah, absolutely.
We talked a little bit beforeabout the full risk, but one of
the best ones is probably ourCDM program.
And if you look at seniors whohave multiple chronic conditions
and their health is starting todecline, it will decline to a
point where they need hospicecare.
But a lot of times what wefirst try to do is establish
goals that we're going toimprove their life, and whether
(07:52):
those are physical goals,spiritual goals or social goals,
can we do things to impact that, that they can do stuff like go
out on a date for the firsttime in six months Maybe that's
through care coordination withall of their physicians or
whatever we can do or bringingthem transportation that they
can get to it.
How do we focus on that?
(08:12):
But at the same time, we knowthat no matter what we do, their
health is going to continue todecline over time.
And if we can notice that pointwhen their health has declined
to a point that they needhospice care, can we deliver
hospice care as quickly aspossible?
Out of all of our service lines, Erin, the one that people
(08:34):
deserve to have as quickly asthey can is hospice care.
At the end of life, we need asmuch care as we can possibly get
.
Erin Vallier (08:42):
Absolutely much care as we can possibly get.
Absolutely what a cool programfinding ways to give somebody
support as they're slowlydeclining.
Where, as you have aptly stated, is a gap in care is where we
typically just dischargesomebody and see them when they
come back after a catastrophicevent.
I'm curious how do you go aboutdefining a care gap program?
(09:04):
What's involved?
Dave Marchand (09:05):
I'll try to simplify it but hopefully not
oversimplify it.
There's really four parts or apattern that we go after, and
the first one is the populationwe want to focus on.
That population could beanything from everyone in a
specific service line in a givenstate with a certain
demographic, Even maybe all themembers that belong to a
(09:29):
specific payer, right?
What's the population we wantto focus on, what's the data
we're interested in?
And whether that data comesfrom our database, whether it
comes from a clinicalobservation, whether it comes
from our customer service teamcalling and talking to the
patient or their caregivers,what's the data that we're
interested in?
And then what are the triggers?
That says, if the data fallsinto one of these states, this
(09:52):
is one of those early indicators.
And then, ultimately, what'sthe action we want to take?
Is it refer them to anotherservice line?
Are we clinically talk to themand see what we need to do?
Or some combination of it?
Bob, they all follow thosepatterns and so, really, what we
want to do is say what are thethings we're really focused on.
Over time and this is theinteresting thing as we built
(10:15):
this, we've expanded what wethink of the care gaps from when
a patient first becomes apatient and someone calls up and
says there's something wrongwith my mom and dad.
I don't know what it is and Idon't know what they need.
And I don't know what they needand how can we guide them among
all the things that they'reeligible for and what's the best
service for them at that time.
(10:35):
And then, after we dischargepeople right, normally they fall
off the radar screen.
Can we keep following up withthem and keep seeing how they're
doing and if their healthstress is declining, can we help
them again more proactivelythan reactively?
Erin Vallier (10:49):
I love that.
Can you tell me a little bitmore about this unified
healthcare data model and therole that that plays
specifically in developing theseprograms?
Dave Marchand (10:59):
The hard part with this is, if you think, in
our traditional model, we lookat patients in terms of visits
and episodes, right, that's it,that's what we get reimbursed
for, that's how we look at themover time.
But when you look at someoneover the years and they go into
and out of service lines, intoand out of systems, having all
of that into a single data modelallows us to do things we were
(11:23):
never able to do before Look forpatterns in that data, look for
other indicators that we wouldhave never seen because we
didn't see all that data in oneplace, and that when we look at
it and we combine what'straditionally in those service
lines, like personal care, homehealth or hospice, with the data
that's in these care gaps thatwe're going after, we call that
(11:45):
the patient journey.
Right, we look at it in termsof years, not visits.
Sometimes you'll hear a call tolaunch an attitudinal health
record, but we like the patientjourney right.
What are they doing?
How are they doing it?
And can we look at all of thatdata and look for other patterns
, look for those gaps and seewhat we can do to keep them
healthier and at home?
Erin Vallier (12:04):
Now, why would you go about building your own
unified healthcare data model?
Why wouldn't you just find atechnology vendor or a partner?
Because you guys acquiredifferent businesses and I
understand you allow them tostay on their platform.
So talk to me a little bitabout that.
This is sort of a differentapproach.
Dave Marchand (12:21):
It is a different approach and, having done this
for years and convertingeveryone to a single platform,
there was a lot of businessdisruption with it and when you
look at multiple service linesand multiple states, there's
really no one vendor that does agreat job with all of that and
has a platform that allows us toput innovation on top of it
(12:42):
really quickly right.
So we needed that flexibility tofocus on these gaps, and it's
kind of unfair to have a vendorwho has an existing client base
and they're trying to go afterthe market in a certain way to
do everything that we want atNew Day right.
So we wanted that layer inbetween that we can build
innovation.
(13:02):
We could take advantage ofwhatever our partners had.
If they had a greathospitalization risk score,
could we take that into effectwhen we're looking at reducing
hospitalizations.
But really, what we wanted toalso do is enable our business
not to go through thatdisruption.
So, as you said, new Daycontinues to acquire other
(13:23):
companies, and one of the thingsthat was so important to me was
that I didn't force ouroperators to have to convert a
new acquisition to a singleplatform.
If I could just map that systeminto our unified data model and
instantly they got all theinnovation we've built on top of
that.
That's a faster way toinnovation and it lowers the
(13:46):
overall cost of innovation,which we think is probably a
better model going forward.
Erin Vallier (13:51):
I think you may have just answered.
My next question was like howspecifically does your
Carelytics platform give you theability to leave those
acquisitions on their platform?
So, essentially, it'sextracting the data that you
need to build that unified datamodel.
Is that correct?
Dave Marchand (14:08):
It does, erin.
It's the how can we map theview of patient inside one
system into this unified model?
And I know it sounds simple.
It's not usually that way.
You know this.
No matter what we do with anysystem, it's how people put the
data in.
So a lot of times we have to dosome translation to do that
mapping, but that is so muchsimpler than converting everyone
(14:31):
over into one, changing howeveryone's used to doing things.
It makes it a lot simpler andeasier to acquire new companies
and bring all this innovation tothem quickly and really it's
really from the perspective ofthe patients.
How can we start serv them, notrequiring you have to be on
(14:51):
this specific platform in orderto make that happen.
We just felt that gave us alittle bit more flexibility as a
company and it was probablybetter for looking at the
patients and what we can do andthe speed to which we can bring
new solutions to them.
Erin Vallier (15:06):
Yeah, time to value there, and my brain wants
to just dive into oh, do youneed open APIs to pull this data
?
All the technology questions.
But I'm not going to bore thelisteners with that.
I do want to talk a little bitmore about the Carelytics
platform.
It sounds way more than just atechnology platform.
There's a lot of moving partsthere.
Dave Marchand (15:26):
It is Anything else and I know it sounds cliche
, but you always hear this it'speople processing technology and
it really is.
The technology platform andthis unified data model gives us
the ability to look at data andlook at patients in a way we
never have.
But our programs are dependenton either our clinicians
(15:48):
interacting with the patients,our customer service reps
calling up and talking to themand interacting with them in
some way, and then the processeswe use to say oh, that was a
trigger.
What do we do in response tothat to address these care gaps
that people process intechnology, where the technology
becomes the enabler to buildall of these other programs on
(16:10):
top of you still need that humantouch to identify really what
the need is when you have peoplecalling in and looking through
the unstructured and structureddata correct.
Gotcha.
Erin Vallier (16:21):
So I know there's a lot of talk and there's a lot
of hype actually about AI.
How does that fit into yourstrategy with Carelytics?
Dave Marchand (16:29):
It's like any new technology, right?
I started doing AI, Erin, inthe 1980s and back then Dating
yourself.
I know I am, I know, but backthen the hype exceeded the
ability, even though a lot ofthe techniques are still the
same.
But what has changed is ourunderlying computing power, just
(16:50):
our hardware platforms andeverything.
So now we're at the point wherethere is still a lot of hype
and there's still a lot ofpeople who say they have an AI
driven system when they don't.
Still a lot of people who saythey have an AI driven system
when they don't.
But we're at the point now withthis technology where it is
truly transformative and can wefundamentally change how we're
(17:11):
doing what we do and, from ahealthcare perspective, how can
we do it to improve how we treatour patients?
And there are really twoaspects to it.
One is generative AI, which isfor the first time.
We can take a software and ifit knows A and B, it can infer C
(17:33):
on its own.
Before we always had to trainit and now they can look at
enough data and train it andensure what's next.
And that is so importantbecause the complexity and the
volume of what they can look atgreatly exceeds the capability
of any individual.
And then, corresponding to that,as you hear, it called
(17:53):
agent-based AI, which is reallyaround complex patterns that we
want to do if we see a trigger,an event.
Complex patterns that we wantto do if we see a trigger, an
event.
We want to process things in avery complex way.
Can these agents take care ofthat for us?
And you see them now, withpersonal shoppers and all this
other stuff, and they perform aset of very complex tasks
(18:14):
orchestrated, and those twotechnologies alone.
Can they be disruptive to ourindustry?
Erin Vallier (18:23):
technologies alone .
Can they be disruptive to ourindustry?
Oh, I think they can.
How do you envision using it inthe platform itself?
I'm sure you have ideas.
Dave Marchand (18:28):
Absolutely, and it goes back to that unified
data model.
When we can bring all of thatdata on a patient, and whether
this is data we pull from othersources like pharmacy data or
anything else, can we bring itall together?
Can the generative AI now startto look for unlocking complex
patterns we could never seebefore and identifying more cure
(18:51):
gap solutions than we couldright?
Can it start to look at stuffalmost exponentially that we're
looking at linearly today?
It's exciting because I wouldlove to be able to tell you I
know everything it was about todo, but I think we're seeing
that this technology is creatingstuff that we even didn't think
it could do, but a lot of it isthe data that we're training it
(19:13):
on, and so, for us, we'refeeding our data into it,
looking for these other patternsthat have the biggest impact on
our patients' lives, and then,once we discover those patterns,
could we use something like theagent-based AI to then process
and do a whole lot of things forus so we can do more for those
(19:33):
patients in a shorter period oftime, address more care gaps,
and this really does move usaway from a reimbursement model
towards a patient-centric caredelivery model.
Erin Vallier (19:47):
Yeah, that's the way it should be and it's super
exciting.
It's sci-fi.
I feel like I'm stuck in thefuture.
Wow, I'm just super impressedwith what you have developed,
and I'm sure that our listenerswould love to know if I don't
have a platform as robust andcomplex as this to layer on top
(20:07):
of even my one single EMR, howcan they think about identifying
where the gaps are in care?
It seems like it might bedifficult, like you might
actually need to have a techstack.
What are your thoughts there?
Dave Marchand (20:21):
That's a great question and, like any other
great question, the answer isusually well, it depends, but I
think what you can do is there'ssome patterns that are simple.
If you've got one service line,you can look at the things
that's going to drive yourpatients into those services and
(20:41):
can you do it more proactively.
So there are more simplepatterns based upon one service
line.
However, if you've got multipleservice lines, you will look at
patterns that span years andall of this other data.
That technology platform is theenabler to do that.
It's what we can build the AIon top of, the enabler to do
(21:03):
that.
It's what we can build the AIon top of.
We can build just otherpatterns and we can build the
ability to look at theseprograms and execute more of
them so we can fill more andmore of these care gaps.
Erin Vallier (21:11):
So what I'm hearing you say is, if you're a
single service line, maybe lookat something as simple as your
quality assurance program andsee where you fall short and get
to a root cause analysis thereand maybe build a program around
where you're not holes in yourcare, maybe people are falling
more frequently.
But if you have multiple linesof care, that becomes way too
(21:32):
complex with a good technologystack.
Dave Marchand (21:36):
It does.
And if you're a single serviceline, maybe one of the solutions
is partnering with somebody whohas another service line.
Because maybe one of thesolutions is partnering with
somebody who has another serviceline because a lot of these
care gaps fall between twoservice lines and they really
help move the patientsproactively from one to the
other.
And if you get a single serviceline, you're trying to figure
out how to move your patientsand give them better care.
(21:58):
So it's moving it into yourservice line.
But it may also look forpatterns that they need other
care and maybe that isaccomplished by partners.
Erin Vallier (22:05):
At that point, yeah, that makes sense.
Well, I really do appreciateyou coming on the show, Dave,
and sharing your wisdom and alsogiving some people who are not
as technologically advanced asNew Day some ideas to identify
their own care gap programs.
Such a pleasure speaking withyou.
Dave Marchand (22:24):
Erin always a pleasure, and you and I have
known each other for a while andthey were really excited about
what we can do to keep improvingpatient care and to really move
it back to a patient-centricdelivery model.
So thank you so much for havingme on today.
Erin Vallier (22:41):
You're so welcome and I can't wait to see what you
guys are going to accomplish in2025 and beyond.
Dave Marchand (22:46):
Excellent.
Erin Vallier (22:48):
Home Help 360 is presented by AlayaCare and
hosted by Erin Vallier.
First, we want to thank ouramazing guests and listeners.
Second, new episodes air everymonth, so be sure to subscribe
today so you don't miss anepisode.
And, last but not least, if youlike this episode and want to
learn more about all thingshome-based care, you can explore
(23:10):
all of our episodes atAlayaCare.
com, slash, homehealth360 orvisit us on your favorite
podcast platform.
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