December 16, 2024 • 20 mins
In this episode, Barbara Andazola, VP of Clinical Practice, Strategy, and Programs at Amedisys, discusses the groundbreaking role of molecular testing in home health care. As an RN with over 27 years of nursing experience, Barbara shares how Amedisys is leveraging PCR (Polymerase Chain Reaction) testing to diagnose infections like UTIs, respiratory conditions, and even COVID-19 faster and more accurately at home. By identifying pathogens within hours, this technology not only improves patient outcomes but also helps prevent hospitalizations and antibiotic resistance. Barbara explores the challenges and rewards of integrating this advanced technology into home care, its impact on reducing healthcare costs, and the future possibilities for further innovation in diagnostics. Listen to this episode to learn how molecular testing is not only improving care but also driving efficiency, reducing healthcare costs, and shaping the future of home-based care—proving that innovation in home health care can lead to faster, smarter, and more precise treatment at home.
Related resources:
- Prevent hospitalizations and adverse events with AlayaCare's Client Intelligence Suite
- AlayaCare Cloud platform for Home Health providers
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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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Barbara Andazola (00:00):
We're always looking for how we can
incorporate technology, how wecan be innovative to meet the
changing needs of our patients.
You know, I think we're seeingpatients with more complex care
needs at home and we need tofind ways to incorporate
advancements such as moleculartesting into our care.
(00:20):
I believe, as all of us in homehealth believe and the patients
we serve, that receiving carein the home is the patient's top
choice for where they want tobe and where they want to heal.
So this cross-collaboration andhealthcare advancements will
really help to ensure that homehealth care will be available
(00:42):
for the foreseeable future.
Erin Vailler (00:59):
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 Valliere,and today I'm joined by Barbara
Andazola, home Health VP ofClinical Practice Strategy and
Programs at Amedisys.
Barbara oversees the creationand execution of clinical
practice standards, programs andprocesses.
Her work is pretty pivotal inoptimizing strategic initiatives
(01:21):
to enhance clinical care andpatient outcomes.
With a rich career spanning 27years as a registered nurse,
barbara has dedicated 22 ofthose years to home health and a
variety of leadership roles,and has been a member of a
Medisys for the last four years.
Welcome to the show, barbara.
Thank you Glad to be here.
(01:42):
I am so excited to talk to youtoday.
You have this reallyinteresting program that you've
recently launched at Amedisys.
That caught our eye and I feellike we need to talk all about
it, because it seems like itmight revolutionize some things
in home care, including delivery, diagnosis and treatment to
keep people safe in the home,and it's molecular testing.
(02:05):
Can you tell me a little bitabout that?
What is molecular testing?
Barbara Andazola (02:09):
We're pretty excited here at Emeticis as well
about molecular testing.
Molecular testing, it's alsoknown as real-time PCR or
polymerase chain reactiontesting.
The test works by applyingpolymerase, which is an enzyme,
to a sample of blood, urine,saliva, mucus, etc.
(02:31):
After the enzyme is applied tothe specimen, it is inserted
into a machine, and if thesample contains
infection-causing pathogens, theenzyme will cause the DNA of
that pathogen to replicate, andso in a short amount of time, or
an hour or so I'm not the labexpert, but as I understand it,
(02:55):
an hour or so millions oractually billions of copies are
made and the specific pathogenresponsible for the infection is
identified.
Erin Vailler (03:04):
Well, that's pretty cool.
So, if folks are familiar withCOVID, if you remember that
there was a PCR test that youhad to go and take before you
got on a plane, this is whatyou're doing to diagnose
different things in the home.
Is that correct?
Exactly, very cool.
So what inspired Amedisys toinvest in providing this testing
to clients?
(03:25):
I'm sure there's a good originstory here.
Barbara Andazola (03:29):
Absolutely.
I started talking with a coupleof folks over at Patient Choice
Laboratories.
I didn't know at the time whenwe were doing COVID testing that
this same technology was usedto help identify other
infections UTIs, urinary tractinfections, other respiratory
infections could also help usidentify infections and wounds,
(03:53):
and when you look at our elderlypopulation, there is a pretty
significant number of urinarytract infections and UTIs are
actually one of the leadingcauses of hospitalizations with
our patients, and so that's whatreally piqued my interest and
we started talking with them andwe felt that through use of
(04:15):
molecular testing, we couldreally make an impact by
identifying the infections earlyand help prevent
hospitalizations.
Erin Vailler (04:23):
Wow, I also didn't know that a PCR was good for
other things than COVID.
It's really very cool thatyou're using it for UTIs.
It can cause death.
Yes, absolutely, and a lot ofcases.
I have a personal experiencewith my own grandmother, who
didn't catch that UTI quite intime.
Barbara Andazola (04:43):
I'm sorry to hear that we have that in common
, unfortunately.
Erin Vailler (04:47):
I can tell that this is probably why you're a
little passionate about thisproject, because we can
implement this technology andprevent some of those things
from happening, which is amazing.
How does molecular testingimprove the speed and accuracy
of infection diagnosis in homehealth care?
Barbara Andazola (05:03):
Yes, great question.
As I just said, we can.
Through molecular testing.
The specific pathogen can beidentified within an hour or so.
Traditional methods of testing.
Let's take UTIs.
Usually we contact the provider, the physician provider, and
that provider usually orders aurinalysis with a culture and
(05:26):
sensitivity if indicated.
So the first part of that testis that urinalysis and really
what that urinalysis shows is ifthere are any red blood cells,
white blood cells or bacteria inthe urine.
That is the first result thatwe get and that takes a day to
get those results.
What does the physician do?
(05:48):
Of course, if that test showsthat there might be potential
infection, the physician makes adecision and that decision is
usually to prescribe a broadspectrum antibiotic.
So it's an antibiotic that maycover more than one type of
bacteria, right?
That may cover more than onetype of bacteria, right?
Not until we get the culture dowe know that specific type of
(06:09):
bacteria or virus, right?
That's causing infection, thatpathogen.
So when we get the informationabout the specific pathogen,
unfortunately and often thephysician provider needs to
prescribe a different antibiotic, one that is specific to
treating the pathogen.
So you can see the time delayagain 24 hours for your analysis
(06:30):
.
I think I failed to mentionthat a culture and sensitivity
piece of the test can takeanywhere from two to five days
or more.
That culture process there aresolutions applied to the
specimen sample.
Then that sample gets put intoan incubator and, depending on
the specific pathogen causingthe infection, it can take two
(06:52):
to five days or longer, as someof these pathogens have
different incubation periods.
Erin Vailler (06:57):
Wow, that's too long.
Yeah, we don't recognize thesymptoms in the elderly until
they're pretty far advanced,especially if a client has
dementia, because they don'tnecessarily understand pain
anymore.
Some of that's numbed out and,wow, you really do need a much
faster way to diagnose things.
(07:19):
And this is exciting, whatyou're telling me now about
molecular testing.
Barbara Andazola (07:23):
Yeah, we're super excited.
Erin Vailler (07:25):
Thank you.
What impact has theintroduction of molecular
testing had on patient outcomesso far?
Barbara Andazola (07:34):
We're still rather early into the adoption
of molecular testing.
I can share and really happy toreport that overall in our care
centers that are higherutilizers of molecular testing
we are seeing an overalldecrease in hospitalizations.
One of the other things thatmolecular testing does, like you
say, it's rapid identificationof the pathogen.
(07:56):
But also with those resultsthat we receive from the
laboratory there's alsorecommendations specific to that
patient for how the bacteriashould be treated.
So this helps us get thepatient on the right antibiotic
the first time and help to keepthem out of the hospital.
Erin Vailler (08:15):
I love that.
It's going to make a real hugeimpact the more and more you
guys continue to use thissolution.
How have you been able toensure the integration of
advanced molecular testing intoyour centers nationwide?
Barbara Andazola (08:30):
Yeah, great question and also just to
clarify and this is really alicensing issue we have and we
can do molecular testingnationwide.
We work with patient choicelaboratories and they are able
to do the molecular testing forall of our care centers with the
exception of those in New York.
However, if our care centers orproviders work with a lab in
(08:54):
New York City or New York State,we can do the testing in New
York as well.
So as far as how we integrateadvanced molecular testing into
our care centers, what we havedone is we have updated our
clinical pathways in our EMRsystem and this really helps to
guide the patient as to whenthey should use molecular
(09:15):
testing.
We also have establishedprotocols and we work really
hard to get physician approvalto incorporate these protocols
into our plan of care uponadmission of the patient to
services so that at first signsand symptoms of an infection,
whether it be a respiratorywound or urinary, we can get a
(09:38):
specimen collected, get it sentto the lab and get that patient
on the right treatment.
Erin Vailler (09:43):
It does sound like a really nice integration of
technology and collaborationwith the doctor.
Is what's happening here?
You've mentioned your partner acouple of times Patient Choice
Laboratories.
Barbara Andazola (10:00):
Can you explain the significance of that
partnership?
Yeah, absolutely.
At Amatis we recognize thatstrategic partnerships such as
the one we have with PatientChoice Laboratories play a
pivotal role in reinforcing ourcommitment to quality home-based
care, and our collaborationwith Patient Choice Laboratories
really exemplifies thiscommitment by leveraging the
(10:20):
latest in diagnostic technology.
It also reflects our commitmentto evidence-based practices
which empower us to reallytailor treatment plans to the
specific needs of our patients.
Erin Vailler (10:32):
Yeah, sounds like you found yourself a really good
partner, and that's amazing.
We've talked a little bit aboutUTIs and we've talked about
COVID, but I'm curious ifthere's other types of
infections that you can usemolecular testing to identify
and inform treatment decisions.
Barbara Andazola (10:51):
Yeah, absolutely.
We also use this to help usidentify if we have an infection
in a wound that may be slow toheal or just not responding to
treatment.
It can also be used to identifygastrointestinal infections of
various sorts as well and, as wementioned, covid, influenza A,
(11:12):
b, other respiratory infections.
Erin Vailler (11:15):
Wow GI infections even that's fascinating.
Yeah, it's a very robusttesting mechanism.
I'm thoroughly impressed.
What challenges have you facedimplementing this testing and
how did you guys manage toovercome those?
Barbara Andazola (11:33):
Yeah, as you can imagine, with anything new
or different, there is going tobe some hesitancy, and we found
this to be true with providersand even our clinicians.
However, once we were able toeducate on the benefits, which
of course, are precise andtimely identification of
pathogens, and then also when weshared with those who are maybe
(11:57):
hesitant that this is the sametesting that we used with COVID
right, with rapid COVID testingthen they were more open to
learning and adopting moleculartesting into their care.
And I'll say, for our clinicians, we all are operating during
staffing shortages.
As a clinician in myself, Ithink, oh goodness, is this more
(12:20):
?
Is this going to add more to myday Is just how different is
this?
But once they found thatcollecting the specimen was no
different and in fact sometimeseasier than a traditional
specimen, and then the fact thatthey can collect a specimen,
drop it in, of course, packageit up, seal it up, package it
(12:40):
nicely into a FedEx envelope orUPS envelope and drop it at the
nearest drop-off, versus havingto drive out of their way to go
to a lab or rearrange how theyvisit their patients that day
just to make sure that they'reclose by to a lab, this was also
a benefit that our clinicianssaw.
It made it much easier tocollect the specimen and get it
(13:01):
to the right place so we couldget that processed.
Erin Vailler (13:03):
That's great.
It sounds like it was just alittle bit of a change
management situation for youguys, having to educate the
clients just to make sure theywere comfortable with this new
and scary thing and make surethat it was really convenient
for your clinicians to do,because, lord knows, their job
is hard enough as it is.
We don't need to add any extralayers of administrative burden
(13:27):
or time on the road right,exactly, exactly.
In what ways, I'm curious, doesmolecular testing contribute to
antibiotic stewardship and theprevention of antibiotic
resistance?
I read a little bit about that.
Barbara Andazola (13:44):
I think we hear more and more about and
what some will say are superbugs right these infections or
bacteria that are resistant tomultiple drugs.
So by using PCR testing ormolecular testing, because of
that rapid detection of thespecific pathogen, physician
(14:07):
providers are able to prescribethe precise antibiotic to treat
that pathogen much more quicklythan by using traditional
methods and this really helps tominimize or reduce the increase
of these drug-resistantbacterias.
Erin Vailler (14:26):
That's important.
That's very important, as thebugs seem to be morphing I don't
know if that's the rightscientific word A little bit
faster these days.
Barbara Andazola (14:36):
Yeah, and not so much scientific word, but
right, I think they're becomingresistant to the antibiotics
prescribed.
They're becoming powerful,right, yeah.
Erin Vailler (14:45):
Do you have a success story that you can share
with us where you use moleculartesting and it significantly
impacted the patient's care?
Barbara Andazola (14:54):
I've heard from not maybe not one specific,
if you will, but just overalland, like I said, with our care
centers that are using moleculartesting more so than others
just a lot of good feedback fromthe nurses and the providers on
, just again, the ease of useand how just getting the patient
(15:14):
on the antibiotic, the rightantibiotic the first time, how
they're able to see that patientovercome the infection so that
they can engage in their plan ofcare and help to achieve the
outcomes a lot quicker thanversus having to send the
patient to an ER or urgent careon the weekend because we're
(15:34):
still pending culture resultsand the current antibiotic isn't
working, but so we have beenable to keep patients out of the
ERs and hospitals.
Erin Vailler (15:42):
That's wonderful, not just because it's more
convenient for the client andthey get the care they need a
lot faster, but it also helpsreduce health care costs
Absolutely.
So this is great.
You've mentioned your EMR andyou've mentioned a couple other
technology pieces, so I'mcurious if you could expand on
that a little bit and tell mewhat role does technology play
(16:06):
in your strategy to enhancethose outcomes?
Barbara Andazola (16:10):
Yeah, absolutely.
We're always looking for how wecan incorporate technology, how
we can be innovative to meetthe changing needs of our
patients.
You know, I think we're seeingpatients with more complex care
needs at home and we need tofind ways to incorporate
advancements such as moleculartesting into our care.
(16:32):
I believe, as all of us in homehealth believe and the patients
we serve, that receiving carein the home is the patient's top
choice for where they want tobe and where they want to heal
top choice for where they wantto be and where they want to
heal.
So this cross-collaboration andhealthcare advancements will
really help to ensure that homehealth care will be available
(16:54):
for the foreseeable future.
Erin Vailler (16:56):
That's awesome.
You mentioned some innovationand I want to know if you have
any future plans.
How are you going to furtherinnovate in the field of home
health care diagnostics?
Do you have any projects oranything you're exploring?
Barbara Andazola (17:10):
You know in general and how we care for our
patients.
I think a medicine like manyother providers, you know, we're
looking at ways that maybe wecan use technology to improve
patient engagement.
We're also looking at how wecan optimize our support teams.
We're all in a staffingshortage, so how best can we
(17:33):
support our clinicians?
With tools that includetechnology education, emr, but
definitely focus on the patientand always open to hearing new
ideas or new technologies andwhat that can do to the care
delivery.
Erin Vailler (17:50):
Are you dabbling with AI at all?
Barbara Andazola (17:53):
Yeah, some.
We are trying to see where thatfits in.
Is it in the back office, inthe front end?
But yeah, just vetting throughsome options there.
Erin Vailler (18:01):
Yeah, I've seen some exciting solutions with AI
to help predict adverse eventsand also enhance the back office
, so I'll keep my eye on youguys and see how you continue to
develop in that area.
Yeah, I have one final questionfor you as we approach our time
here, and this one is in honorof Jeff Howell.
He was one of the creators ofthis podcast and he was the one
(18:24):
who teed this conversation upfor us today, so I feel like
it's only fitting that I stealhis question that he always asks
his guest.
So, barbara, can you give us areason to be excited about the
care provided in the place thatour patients call home?
Barbara Andazola (18:40):
I think home is where we all want to be, but
a reason to be excited about it.
I work among so many dedicatedcaregivers.
In a medicine, everyone is acaregiver.
You don't have to be aclinician, you don't have to be
a nurse, a speech therapist,occupational therapist we are
all caregivers and we trulybelieve in what we do, and that
(19:08):
is providing the best care inthe home for our patients, and
so that excites me every day.
It motivates me to get up anddo my best, and so, for everyone
out there, you have a team ofcaregivers at Ametasys that are
really challenging each otherevery day to provide the best
(19:31):
quality care out there.
Erin Vailler (19:33):
Sounds like a great place to be if you're
working and it sounds like agreat place to partner with if
you need the care and the placethat we call home.
I appreciate your time, barbara.
It's been a lovely conversationand I've learned a lot about
molecular testing, and I'm surethat you have piqued the
interest of our listeners aswell.
So thank you.
Yeah thank you, Erin.
(19:53):
Homehelp 360 is presented byAlayaCare and hosted by Erin
Vailler.
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
(20:15):
all of our episodes atalayacare.
com / homehealth360 or visit uson your favorite podcast
platform.
We're always looking for how we can
incorporate technology, how wecan be innovative to meet the
changing needs of our patients.
You know, I think we're seeingpatients with more complex care
needs at home and we need tofind ways to incorporate
advancements such as moleculartesting into our care.
(00:20):
I believe, as all of us in homehealth believe and the patients
we serve, that receiving carein the home is the patient's top
choice for where they want tobe and where they want to heal.
So this cross-collaboration andhealthcare advancements will
really help to ensure that homehealth care will be available
(00:42):
for the foreseeable future.
Erin Vailler (00:59):
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 Valliere,and today I'm joined by Barbara
Andazola, home Health VP ofClinical Practice Strategy and
Programs at Amedisys.
Barbara oversees the creationand execution of clinical
practice standards, programs andprocesses.
Her work is pretty pivotal inoptimizing strategic initiatives
(01:21):
to enhance clinical care andpatient outcomes.
With a rich career spanning 27years as a registered nurse,
barbara has dedicated 22 ofthose years to home health and a
variety of leadership roles,and has been a member of a
Medisys for the last four years.
Welcome to the show, barbara.
Thank you Glad to be here.
(01:42):
I am so excited to talk to youtoday.
You have this reallyinteresting program that you've
recently launched at Amedisys.
That caught our eye and I feellike we need to talk all about
it, because it seems like itmight revolutionize some things
in home care, including delivery, diagnosis and treatment to
keep people safe in the home,and it's molecular testing.
(02:05):
Can you tell me a little bitabout that?
What is molecular testing?
Barbara Andazola (02:09):
We're pretty excited here at Emeticis as well
about molecular testing.
Molecular testing, it's alsoknown as real-time PCR or
polymerase chain reactiontesting.
The test works by applyingpolymerase, which is an enzyme,
to a sample of blood, urine,saliva, mucus, etc.
(02:31):
After the enzyme is applied tothe specimen, it is inserted
into a machine, and if thesample contains
infection-causing pathogens, theenzyme will cause the DNA of
that pathogen to replicate, andso in a short amount of time, or
an hour or so I'm not the labexpert, but as I understand it,
(02:55):
an hour or so millions oractually billions of copies are
made and the specific pathogenresponsible for the infection is
identified.
Erin Vailler (03:04):
Well, that's pretty cool.
So, if folks are familiar withCOVID, if you remember that
there was a PCR test that youhad to go and take before you
got on a plane, this is whatyou're doing to diagnose
different things in the home.
Is that correct?
Exactly, very cool.
So what inspired Amedisys toinvest in providing this testing
to clients?
(03:25):
I'm sure there's a good originstory here.
Barbara Andazola (03:29):
Absolutely.
I started talking with a coupleof folks over at Patient Choice
Laboratories.
I didn't know at the time whenwe were doing COVID testing that
this same technology was usedto help identify other
infections UTIs, urinary tractinfections, other respiratory
infections could also help usidentify infections and wounds,
(03:53):
and when you look at our elderlypopulation, there is a pretty
significant number of urinarytract infections and UTIs are
actually one of the leadingcauses of hospitalizations with
our patients, and so that's whatreally piqued my interest and
we started talking with them andwe felt that through use of
(04:15):
molecular testing, we couldreally make an impact by
identifying the infections earlyand help prevent
hospitalizations.
Erin Vailler (04:23):
Wow, I also didn't know that a PCR was good for
other things than COVID.
It's really very cool thatyou're using it for UTIs.
It can cause death.
Yes, absolutely, and a lot ofcases.
I have a personal experiencewith my own grandmother, who
didn't catch that UTI quite intime.
Barbara Andazola (04:43):
I'm sorry to hear that we have that in common
, unfortunately.
Erin Vailler (04:47):
I can tell that this is probably why you're a
little passionate about thisproject, because we can
implement this technology andprevent some of those things
from happening, which is amazing.
How does molecular testingimprove the speed and accuracy
of infection diagnosis in homehealth care?
Barbara Andazola (05:03):
Yes, great question.
As I just said, we can.
Through molecular testing.
The specific pathogen can beidentified within an hour or so.
Traditional methods of testing.
Let's take UTIs.
Usually we contact the provider, the physician provider, and
that provider usually orders aurinalysis with a culture and
(05:26):
sensitivity if indicated.
So the first part of that testis that urinalysis and really
what that urinalysis shows is ifthere are any red blood cells,
white blood cells or bacteria inthe urine.
That is the first result thatwe get and that takes a day to
get those results.
What does the physician do?
(05:48):
Of course, if that test showsthat there might be potential
infection, the physician makes adecision and that decision is
usually to prescribe a broadspectrum antibiotic.
So it's an antibiotic that maycover more than one type of
bacteria, right?
That may cover more than onetype of bacteria, right?
Not until we get the culture dowe know that specific type of
(06:09):
bacteria or virus, right?
That's causing infection, thatpathogen.
So when we get the informationabout the specific pathogen,
unfortunately and often thephysician provider needs to
prescribe a different antibiotic, one that is specific to
treating the pathogen.
So you can see the time delayagain 24 hours for your analysis
(06:30):
.
I think I failed to mentionthat a culture and sensitivity
piece of the test can takeanywhere from two to five days
or more.
That culture process there aresolutions applied to the
specimen sample.
Then that sample gets put intoan incubator and, depending on
the specific pathogen causingthe infection, it can take two
(06:52):
to five days or longer, as someof these pathogens have
different incubation periods.
Erin Vailler (06:57):
Wow, that's too long.
Yeah, we don't recognize thesymptoms in the elderly until
they're pretty far advanced,especially if a client has
dementia, because they don'tnecessarily understand pain
anymore.
Some of that's numbed out and,wow, you really do need a much
faster way to diagnose things.
(07:19):
And this is exciting, whatyou're telling me now about
molecular testing.
Barbara Andazola (07:23):
Yeah, we're super excited.
Erin Vailler (07:25):
Thank you.
What impact has theintroduction of molecular
testing had on patient outcomesso far?
Barbara Andazola (07:34):
We're still rather early into the adoption
of molecular testing.
I can share and really happy toreport that overall in our care
centers that are higherutilizers of molecular testing
we are seeing an overalldecrease in hospitalizations.
One of the other things thatmolecular testing does, like you
say, it's rapid identificationof the pathogen.
(07:56):
But also with those resultsthat we receive from the
laboratory there's alsorecommendations specific to that
patient for how the bacteriashould be treated.
So this helps us get thepatient on the right antibiotic
the first time and help to keepthem out of the hospital.
Erin Vailler (08:15):
I love that.
It's going to make a real hugeimpact the more and more you
guys continue to use thissolution.
How have you been able toensure the integration of
advanced molecular testing intoyour centers nationwide?
Barbara Andazola (08:30):
Yeah, great question and also just to
clarify and this is really alicensing issue we have and we
can do molecular testingnationwide.
We work with patient choicelaboratories and they are able
to do the molecular testing forall of our care centers with the
exception of those in New York.
However, if our care centers orproviders work with a lab in
(08:54):
New York City or New York State,we can do the testing in New
York as well.
So as far as how we integrateadvanced molecular testing into
our care centers, what we havedone is we have updated our
clinical pathways in our EMRsystem and this really helps to
guide the patient as to whenthey should use molecular
(09:15):
testing.
We also have establishedprotocols and we work really
hard to get physician approvalto incorporate these protocols
into our plan of care uponadmission of the patient to
services so that at first signsand symptoms of an infection,
whether it be a respiratorywound or urinary, we can get a
(09:38):
specimen collected, get it sentto the lab and get that patient
on the right treatment.
Erin Vailler (09:43):
It does sound like a really nice integration of
technology and collaborationwith the doctor.
Is what's happening here?
You've mentioned your partner acouple of times Patient Choice
Laboratories.
Barbara Andazola (10:00):
Can you explain the significance of that
partnership?
Yeah, absolutely.
At Amatis we recognize thatstrategic partnerships such as
the one we have with PatientChoice Laboratories play a
pivotal role in reinforcing ourcommitment to quality home-based
care, and our collaborationwith Patient Choice Laboratories
really exemplifies thiscommitment by leveraging the
(10:20):
latest in diagnostic technology.
It also reflects our commitmentto evidence-based practices
which empower us to reallytailor treatment plans to the
specific needs of our patients.
Erin Vailler (10:32):
Yeah, sounds like you found yourself a really good
partner, and that's amazing.
We've talked a little bit aboutUTIs and we've talked about
COVID, but I'm curious ifthere's other types of
infections that you can usemolecular testing to identify
and inform treatment decisions.
Barbara Andazola (10:51):
Yeah, absolutely.
We also use this to help usidentify if we have an infection
in a wound that may be slow toheal or just not responding to
treatment.
It can also be used to identifygastrointestinal infections of
various sorts as well and, as wementioned, covid, influenza A,
(11:12):
b, other respiratory infections.
Erin Vailler (11:15):
Wow GI infections even that's fascinating.
Yeah, it's a very robusttesting mechanism.
I'm thoroughly impressed.
What challenges have you facedimplementing this testing and
how did you guys manage toovercome those?
Barbara Andazola (11:33):
Yeah, as you can imagine, with anything new
or different, there is going tobe some hesitancy, and we found
this to be true with providersand even our clinicians.
However, once we were able toeducate on the benefits, which
of course, are precise andtimely identification of
pathogens, and then also when weshared with those who are maybe
(11:57):
hesitant that this is the sametesting that we used with COVID
right, with rapid COVID testingthen they were more open to
learning and adopting moleculartesting into their care.
And I'll say, for our clinicians, we all are operating during
staffing shortages.
As a clinician in myself, Ithink, oh goodness, is this more
(12:20):
?
Is this going to add more to myday Is just how different is
this?
But once they found thatcollecting the specimen was no
different and in fact sometimeseasier than a traditional
specimen, and then the fact thatthey can collect a specimen,
drop it in, of course, packageit up, seal it up, package it
(12:40):
nicely into a FedEx envelope orUPS envelope and drop it at the
nearest drop-off, versus havingto drive out of their way to go
to a lab or rearrange how theyvisit their patients that day
just to make sure that they'reclose by to a lab, this was also
a benefit that our clinicianssaw.
It made it much easier tocollect the specimen and get it
(13:01):
to the right place so we couldget that processed.
Erin Vailler (13:03):
That's great.
It sounds like it was just alittle bit of a change
management situation for youguys, having to educate the
clients just to make sure theywere comfortable with this new
and scary thing and make surethat it was really convenient
for your clinicians to do,because, lord knows, their job
is hard enough as it is.
We don't need to add any extralayers of administrative burden
(13:27):
or time on the road right,exactly, exactly.
In what ways, I'm curious, doesmolecular testing contribute to
antibiotic stewardship and theprevention of antibiotic
resistance?
I read a little bit about that.
Barbara Andazola (13:44):
I think we hear more and more about and
what some will say are superbugs right these infections or
bacteria that are resistant tomultiple drugs.
So by using PCR testing ormolecular testing, because of
that rapid detection of thespecific pathogen, physician
(14:07):
providers are able to prescribethe precise antibiotic to treat
that pathogen much more quicklythan by using traditional
methods and this really helps tominimize or reduce the increase
of these drug-resistantbacterias.
Erin Vailler (14:26):
That's important.
That's very important, as thebugs seem to be morphing I don't
know if that's the rightscientific word A little bit
faster these days.
Barbara Andazola (14:36):
Yeah, and not so much scientific word, but
right, I think they're becomingresistant to the antibiotics
prescribed.
They're becoming powerful,right, yeah.
Erin Vailler (14:45):
Do you have a success story that you can share
with us where you use moleculartesting and it significantly
impacted the patient's care?
Barbara Andazola (14:54):
I've heard from not maybe not one specific,
if you will, but just overalland, like I said, with our care
centers that are using moleculartesting more so than others
just a lot of good feedback fromthe nurses and the providers on
, just again, the ease of useand how just getting the patient
(15:14):
on the antibiotic, the rightantibiotic the first time, how
they're able to see that patientovercome the infection so that
they can engage in their plan ofcare and help to achieve the
outcomes a lot quicker thanversus having to send the
patient to an ER or urgent careon the weekend because we're
(15:34):
still pending culture resultsand the current antibiotic isn't
working, but so we have beenable to keep patients out of the
ERs and hospitals.
Erin Vailler (15:42):
That's wonderful, not just because it's more
convenient for the client andthey get the care they need a
lot faster, but it also helpsreduce health care costs
Absolutely.
So this is great.
You've mentioned your EMR andyou've mentioned a couple other
technology pieces, so I'mcurious if you could expand on
that a little bit and tell mewhat role does technology play
(16:06):
in your strategy to enhancethose outcomes?
Barbara Andazola (16:10):
Yeah, absolutely.
We're always looking for how wecan incorporate technology, how
we can be innovative to meetthe changing needs of our
patients.
You know, I think we're seeingpatients with more complex care
needs at home and we need tofind ways to incorporate
advancements such as moleculartesting into our care.
(16:32):
I believe, as all of us in homehealth believe and the patients
we serve, that receiving carein the home is the patient's top
choice for where they want tobe and where they want to heal
top choice for where they wantto be and where they want to
heal.
So this cross-collaboration andhealthcare advancements will
really help to ensure that homehealth care will be available
(16:54):
for the foreseeable future.
Erin Vailler (16:56):
That's awesome.
You mentioned some innovationand I want to know if you have
any future plans.
How are you going to furtherinnovate in the field of home
health care diagnostics?
Do you have any projects oranything you're exploring?
Barbara Andazola (17:10):
You know in general and how we care for our
patients.
I think a medicine like manyother providers, you know, we're
looking at ways that maybe wecan use technology to improve
patient engagement.
We're also looking at how wecan optimize our support teams.
We're all in a staffingshortage, so how best can we
(17:33):
support our clinicians?
With tools that includetechnology education, emr, but
definitely focus on the patientand always open to hearing new
ideas or new technologies andwhat that can do to the care
delivery.
Erin Vailler (17:50):
Are you dabbling with AI at all?
Barbara Andazola (17:53):
Yeah, some.
We are trying to see where thatfits in.
Is it in the back office, inthe front end?
But yeah, just vetting throughsome options there.
Erin Vailler (18:01):
Yeah, I've seen some exciting solutions with AI
to help predict adverse eventsand also enhance the back office
, so I'll keep my eye on youguys and see how you continue to
develop in that area.
Yeah, I have one final questionfor you as we approach our time
here, and this one is in honorof Jeff Howell.
He was one of the creators ofthis podcast and he was the one
(18:24):
who teed this conversation upfor us today, so I feel like
it's only fitting that I stealhis question that he always asks
his guest.
So, barbara, can you give us areason to be excited about the
care provided in the place thatour patients call home?
Barbara Andazola (18:40):
I think home is where we all want to be, but
a reason to be excited about it.
I work among so many dedicatedcaregivers.
In a medicine, everyone is acaregiver.
You don't have to be aclinician, you don't have to be
a nurse, a speech therapist,occupational therapist we are
all caregivers and we trulybelieve in what we do, and that
(19:08):
is providing the best care inthe home for our patients, and
so that excites me every day.
It motivates me to get up anddo my best, and so, for everyone
out there, you have a team ofcaregivers at Ametasys that are
really challenging each otherevery day to provide the best
(19:31):
quality care out there.
Erin Vailler (19:33):
Sounds like a great place to be if you're
working and it sounds like agreat place to partner with if
you need the care and the placethat we call home.
I appreciate your time, barbara.
It's been a lovely conversationand I've learned a lot about
molecular testing, and I'm surethat you have piqued the
interest of our listeners aswell.
So thank you.
Yeah thank you, Erin.
(19:53):
Homehelp 360 is presented byAlayaCare and hosted by Erin
Vailler.
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
(20:15):
all of our episodes atalayacare.
com / homehealth360 or visit uson your favorite podcast
platform.
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