Part IV: Enabling Home Care Services with Technology

The President of The HomeCare Advocacy Network discusses how technology plays a role in empowering seniors to age in their homes.

Matthew D Edwards
September 29, 2020

Enabling Better Health Care & Senior Care Outcomes with Technology

This series focuses on how the health care and senior care industries are enabling more autonomous living opportunities for all ages while improving and expanding care in face of the exponential growth of the senior population. These industries face labor shortages and a strain on existing systems that must evolve and scale while meeting information security and privacy requirements.

Show Highlights

In the fourth episode of this series, Matthew D Edwards and Mark Goetz, President of The HomeCare Advocacy Network, discuss how technology plays a role in empowering seniors to age in their homes.

Key Takeaways

  • For successful outcomes overall, companies must include training and education for everyone involved – from the caregivers and families to the seniors themselves.
  • The next big disruption or evolution is to establish more interconnections and connections to the actual care through a “virtual private network” for the family – from fall risk technology to a comprehensive communication suite.
  • In recent years, home care technology has developed due to a competitive marketplace, and COVID-19 has sped up new purchasing by senior living providers missing communication links.
  • Collecting data enables more opportunity and also increases responsibility, accountability, and liability 100 percent, so companies must have more in-depth organizational plans for data management and data privacy when adopting technology.
  • Address the diminishing returns on the data collected and ensure only necessary data is collected and stored to serve the clients and improve decision-making.
  • Letting the client and caregiver connection drive your mission forward when it comes to technology and how it can improve that connection.

About Our Guest

Mark Goetz, President of The HomeCare Advocacy Network, a premier provider of home care related benefits and services, ensures the organization delivers what people need to live their best life and enables local franchise owners to leverage the HCAN brand.

Read the Transcript

00:00 Matthew D. Edwards: Welcome to another episode of The Long Way Around The Barn. My guest today is Mark Goetz, the president of Home Care Advocacy Network, whose mission is to enhance the lives of aging adults and their families. This episode, continues my conversation on how technology can improve the lives of our aging population through the use of remote monitoring solutions using Internet of Things or connected things technologies, while also ensuring purposeful comprehensive privacy and information security practices along the way. Mark, good afternoon.

00:34 Mark Goetz: Hey good afternoon Matthew.

00:39 Matthew D. Edwards: Mark, the name of your organization is HomeCare Advocacy Network, and people can obviously go learn more about your org by visiting your website, What do you offer folks today? Where do you wanna go? What do you wanna be. Teach us.

01:03 Mark Goetz: Alright, well, thanks Matthew, it's an honor to be here today. The HomeCare Advocacy Network was created… We really started the creation of it in 2018 with a vision of becoming the world's leading source of home care connections for seniors and their families. The way we see the home care world today is that generally speaking, you have 45- to 64-year-olds who are trying to set up services for mom, and that's usually when the care processes start, our company gets involved in helping them find ways that they can age in place. We decided on a decidedly franchising route for our business model, so we do sell territories to do business as the Home Care Advocacy network. We sell those to individuals and entrepreneurs who generally speaking, are mission-oriented people, they wanna own their own business and they wanna do good in the process.

02:05 Mark Goetz: The other side of our business, which is very closely related to the entrepreneur side, is the white label franchise model, and so through my experience with other large franchised organizations that do in-home care, and as well as working with senior living, we realized that senior living needed an option to be able to provide consistent, successful and competitive in-home services, to be able to expand their marketplace. The place for senior living in the in-home services world is, I would say a fractured one, at best about 46% of the revenue coming into home care companies today comes from the senior living referral that is most of the time made because there is a vacuum where the senior living company just doesn't provide or maybe doesn't quite know how to provide successful competitive in-home services in a local market. So we provide both options, you can own your own business doing business as Home Care Advocacy Network, or a senior living provider can own their own in-home services business under their own name, supported by the Home Care Advocacy Network.

03:20 Matthew D. Edwards: Nice. That's a nice approach. That's interesting. Ultimately, your goal is to enable age in place or people to stay home basically for as long as possible. Overall, that's what you're trying to enable is people to stay home and maintain their integrity, their autonomy, their independence as long as possible. That's really interesting.

03:46 Mark Goetz: The way we see it, in the past, the continuous care retirement community was defined as Independent Living, then when you lose your ADLs as a senior, you move to assisted living, and then finally you move to skilled and then hospice, so that's pretty much been the standard continuum. We believe there's a step missing, and that's the in-home services to independent or that gray area between in-home services and independent living. We have over 93% of consumers right now who want to, if they could, age in place in their homes. So we believe there's a big opportunity to empower senior living to capture more of this market and have a much better, more succinct client nurturing program for themselves in the process.

04:41 Matthew D. Edwards: Okay, interesting. That's all good stuff. So given where you'd like to head, what you're doing, taking in other considerations such as needing to have staff, medical care staff, experienced people to do these types of things, complicating it with pandemic-type considerations whereby human touch and contact is challenged or complicated. I'm curious then, how do you see the use of technology changing the way you provide home care services or how workers do their jobs in the future, or have you already started making changes. Teach us about that a little bit.

05:27 Mark Goetz: Sure, so between eight and 10 years ago, there were a number of disruptions in the home care market, many home care companies up to that point had created their own proprietary scheduling software, and there were a number of people from Silicon Valley that saw that as an opportunity where you had companies that had their own home-grown services, technology services, and they created some of the world's finest software to manage in-home services, but it required a different level of connectivity with caregivers for the first time in the marketplace. So this technology really caught on, and I would say today to do in-home services well, it really takes a digitally connected caregiver with a client that's attached to a care plan.

06:28 Mark Goetz: And in the marketplace over the last seven, eight years, that technology has really caught on. Very few providers today are old school, just running their business on a spreadsheet and having caregivers call in and not having it all connected into one tight little box. So technology has really been probably one of the biggest change agents, and the ability to get that technology for a relatively low price has been one of the biggest innovations in the home care world. How we see that in the future, as we see the next evolution, is for families to be more interconnected and connected to the actual care.

07:16 Mark Goetz: So you've seen other disruptors now or disruptive companies come into the marketplace that have taken the standard Home Care software and they've said, "Hey, there's something missing in this", "Hey, we're missing falls technology", "We're missing a greater family virtual private network in the technology." And so I think you're gonna see some of the larger scheduling, all-in-one billing companies look to probably either purchase or create their own virtual private network family-connected technology, so families can stay more in touch with what's happening with their loved ones care.

08:04 Matthew D. Edwards: So does that then suggest the virtual private network, which I get is basically for those that are unfamiliar, it's a dedicated private secured tunnel from one point to another, as opposed to just data traveling across the Internet wild and open for anybody to look at. So virtual private network. But Mark, in that illustration that you're talking about, are you talking about just providing communication links between family members, or are you also talking about sharing health status or living status through other types of monitoring and measurement solutions as well?

08:42 Mark Goetz: It's a little of both. So I think when we look at it through the home care lens, we see some people that really need a fall risk technology, and there's some really good services out there and good companies out there, but that particular technology may not be all inclusive of a full communication suite, and I think there have been some really strong players enter the market. In that, a particular service company that comes to mind is LifeLoop. What's interesting is it isn't necessarily directly connected to the home care technology that we see.

09:23 Mark Goetz: So home care has created its own all-in-one service, most, all of these companies that serve the home care market. So what is happening within the homecare space right now is that it's oftentimes missing out on that complete picture. The complete holistic picture, but it's still far better than much of the technology, I would say that a senior living community actually runs on. So, outside of a senior living community technology system, home care technology has developed, I would say, quite a bit faster over the last seven, eight years, because they've been pushed by a more competitive marketplace.

10:08 Matthew D. Edwards: So you're thinking that based on what you're communicating, technology has helped facilitate a change in the industry, and that's a positive thing. And so some of the things that you're observing or talking about things like communication pipes, the virtual private networks, how existing software providers might augment their existing solutions to include some of these ideas. You've mentioned fall detection. I'm wondering, as you see technology evolve, do you see a difference or is it the same, a difference between new technologies enabling a change in the way home care providers provide their care, and does that look different than the technologies that are changing the quality of life, quality of home care experience for our elders? Is it one and the same or do you see two different things going on at the same time?

11:07 Mark Goetz: You know what? We're seeing it go on, like multiple things happen at the same time. And the reason being certain companies, so for instance, we've seen a massive, over the past seven, eight months with COVID, you've seen massive new purchasing of technology by senior living providers, many of those senior living providers were missing that communication link. So before, maybe COVID, it was a really good idea, it was maybe on their overall tech road map to get in, COVID helped speed that up and it helped speed up that integration and even the adaptation to it.

11:49 Mark Goetz: What has happened though, is that home care still in large part exists outside of senior living, and so home care technology was already pretty much there, but new providers without a home care perspective have crept into the senior living marketplace, so now we do see two siloed very good products, generally speaking, at play, whether or not a client has… They could be at a senior living provider, and this is kind of a misnomer, you think well when we move mom into a community, then we can be done with having her own caregiver from an agency. Oftentimes, when mom has a caregiver before she moves into a community or senior living provider, she will generally speaking keep that caregiver when she moves.

12:44 Matthew D. Edwards: Okay.

12:46 Mark Goetz: So now the community's trying to solve for its own communication challenges, but the client exists between the family and the home care service provider. So, we have created two different communication channels when that situation exists.

13:04 Matthew D. Edwards: So as an industry, as an industry overall and/or specific to home care, would you consider the industry that you're in, the segment that you're in are companies like yours generally ultra conservative in adopting new technology. Are there some companies that are ultra aggressive, like bleeding edge, like somebody had an idea and they've already tried to implement it? And as an industry, do you find that technology exists and then there's variable speeds of adoption? Is there a general profile, how would you even profile your perspective on things. What makes sense, what's safe?

13:47 Mark Goetz: Very good question. So we see there's generally speaking, two different mindsets. So our industry in general, in home services, primarily, we monetize ourselves by being really good at recruiting caregivers and applying their availability against need, against the hours that a client or a client's family wants. And so I would say there are certain companies in our space where they see technology as a threat to that business model, and so there is, I would say, on one side of the camp, it's highly cautionary, many of the leaders in our industry. And there's another side that really understands the future is technology plus caregiving, so we believe that it's not just caregiving that's going to solve the problems that face us with aging, but it's caregiving plus technology, and I would say that's where our company is standing pretty firm on, we realize that there are many quality players in this market. So right now I would say there's a lot of right answers, and I think that is one of the things that's happening in the marketplace when there is a lot of right answers, it can lead to inertia.

15:23 Mark Goetz: So you kind of wade through it with leaders to say, is this a fear that you have generally of technology, or could it be that you're being bombarded with so many good options, you don't know what the… You don't wanna take the wrong step because there's a lot of really good options there. I would say where we're at, what we wanna do is find a real quality technology provider that could deliver on our service model, and then we're on the lookout for quality providers that can help augment that and create another dimension of our business that helps the caregiving services just be that much more effective for families.

16:05 Matthew D. Edwards: That's fair. So that segues then to another question I have based on what we've been discussing, which is, you know in many industries through the years, we would see chief information officers, chief technology officers, and then CIOs, EOs, FOs and so on. But over the last number of years, in many industries, we've seen them start to bring on chief information security officers or chief privacy officers, are you seeing the same types of things or perspectives or movement in this industry, or what is the general outlook on that idea?

16:46 Mark Goetz: Yeah, absolutely. I think if you're naive to it, you find out relatively quickly and you usually learn the hard way, if you err on the side that a Chief Information Security Officer isn't as much of a need, because the systems are just so well-developed, I think you can't underestimate your organization's need for that type of leadership, and I think we're playing a catch-up game to the HR… On the HR side, to actually be able to find those qualified individuals who can help data architect your system, so not just through…

17:31 Mark Goetz: And not just from HIPAA violations or some of the things that we have going on in the States, it's nefarious individuals who are out for information and sometimes just looking to take down a company because it's part of what they do, it's creating chaos, which creates more business opportunities for the nefarious individuals they work for, so I don't think you can underestimate the need for Chief Information Security Officers, chief information officers that have those folks very tightly tied to the very… The highest echelons of any organization.

18:09 Matthew D. Edwards: That makes sense. So when I talk about readiness to adopt new methods of monitoring and data collection, like you've mentioned fall detection a couple of times, there are companies out there that actually have some really cool and innovative next gen ideas, and they have the working hardware to show it but one device in a room, it collects data about you and your movements all day, every day, all of the time in order to establish and understand patterns. Then after it understands patterns, it's able to start doing predictive analytics to say, "Hey, this seems to be an out of ordinary walking behavior as compared to other data we have, this has the probability or at least possibility of leading to a fall." Having that type of technology potentially is magnificent and wonderful and amazing in understanding behavior and habit and results and state and all of the things, however, it's also lots and lots and lots of data that we would now be collecting 7 by 24, so not just when a healthcare worker comes in to collect it, but all of the time.

19:19 Matthew D. Edwards: And we already do that with today's medical devices, but now it becomes multi-dimensional, if you will. Do you think that… Is that… Are you seeing the adoption of these types of ideas, and tell me too, if you think I'm talking crazy, but like the idea of geo-fencing to understand where people are in relation to where they shouldn't be, or understanding when healthcare workers did arrive or when they left, or those types of things. Do you think the organizations are entertaining these things, actively reviewing, adopting, have already implemented, and I'm behind the curve here?

20:00 Mark Goetz: So it's a great question, and it's a fantastic discussion, so I'd say the first thing, that was probably the biggest innovation when it came to homecare was the adoption of geo-fencing, to whether or not a caregiver was actually at the client's home or not. Prior to geo-fencing technologies or telephony, that could be tied to even a phone number, so caregivers at a client's home, they call a number, they check in, but then also on the back end, you can geo-fence where that phone is, so you can ensure that the caregiver is actually at the client's home, so I think that's step one, and that is highly active within the home care world. And I think other technologies like Kronos and whatnot is widely used within senior living. The challenge with Kronos is that it doesn't attach to multiple payers, it's built for a single payer system, but they have also advanced their technology, so at least they're on mobile and they have geofencing ability. So I think, on the HR side, absolutely at work, and getting better day by day.

21:15 Mark Goetz: On the client side, I think the challenge is, in what I've seen in the industry over the last 10 years as these technologies have developed, is I've seen attorneys mesh with executives inside of organizations to say, if we get a certain amount of data, who is going to respond to it, and how are we gonna respond? And in what period of time? And setting the criteria to responding to data anomalies and an algorithm, that's the real challenge, I think. And some of these technologies have done a really nice job of kind of self-regulating that and becoming a system to itself, but I still think organizations wrestle with their overall liability when it comes to taking in too much data. So if I don't get the data, then then they're less liable for their organization to say, "Well, you have the data, you had the alert and you didn't respond," and so the back side of that is that most of these organizations haven't done a great job of separating sales from operations, and that's a challenge because you generally speaking, are driven by whether you say you're in a 513c3 and you're completely a mission-oriented, you're still driven by a board who wants results.

22:44 Mark Goetz: And so you still have operational leaders who are maybe running skinny on staff, and you have people and then one day you have somebody call out and you have to reapportion staff to fix an emergency, and then all of a sudden they can't sit in front of the monitoring technology and respond to an alert. It comes down to prioritization in organizations and risk management, and some are more ready for that than others, but I think COVID has shown that organizations have to prioritize this, they need to prioritize this, and they can solve some of that peace of mind that's inside of a decision maker's head, in terms of the quality of care that their loved one's being provided.

23:32 Matthew D. Edwards: That's fair. You're right, you haven't set all these things, and we'll add a couple of things to what you've mentioned, but I think that… You're right, I agree with you in that a lot of the technology adoption considerations, really, it comes down to who's going to be responsible for deciding what you're going to do, what problem are you solving, what are the solutions that are available to help you solve the problem? And then if you're going to implement it, how do you operationalize that? And more and more, a lot of the new Internet of Things, connected things technologies, remote monitoring, geo-fencing, fall detection, all of these types of things are designed to be collecting data all of the time, which requires its own on-purpose plan.

24:18 Matthew D. Edwards: How much data are you getting, where are you putting it, how do you secure it? Who gets to use it? All of those things, those are organizational problems to solve. But you have additional challenges, which is how many people do I need on my team to do this stuff, like if I'm primarily a healthcare provider, my job is to love people with the mission for independence, autonomy, dignity, and in the medical care space, that may not mean then that I'm also technology savvy, which means I have to bring on more technical staff, I have to have a more in-depth organizational plan for data management, data privacy. This looks like adopting the technology could be a double-edged sword, which is enabling more opportunity, but also increasing responsibility, accountability and liability.

25:14 Mark Goetz: Yeah, 100%. And I think just from a basic leadership encouragement for organizations, what I would say is an area to focus on would be to help your employees overcome the, "I'm just a" kind of syndrome. Well, I'm just a nurse, I'm just an LPN or I'm just a director. Oftentimes, when people say that it's a cry for help, that you're asking them to get into something that they don't fully understand, and so helping them along saying, "We're gonna walk through this with you, we're gonna learn this together," and then relying on your partners who are providing the technology for service is critical, and I think…

25:56 Mark Goetz: I don't know of anybody in the space of technology or the provision of technology services that is succeeding and thriving without having an extremely strong support team. People they can questions, people that offer 24/7 support and with a smile. The industry is really getting better at this, but employees still need a lot of encouragement because it still is relatively new, and you are looking for oftentimes that person who's wanting to step forward and raise their hand and say, "I'll take that on."

26:31 Matthew D. Edwards: So Mark, that brings me to a different question, given that you mentioned earlier that this is a franchised-based model, which understandably, everybody understands that in order to have a business, anybody can start a business, but in order to keep a business, you have to take into consideration a lot of things, which is, if we want to continue to exist, I have to continue to make money. And the amount of money I make has to be greater than the money I'm spending, so profitability, everybody gets that.

27:00 Matthew D. Edwards: But there are additional things as well, especially in a franchise model, which is how much responsibility, accountability, autonomy is provided to the franchises. In other words, do they get to make all of their own decisions on tools and privacy and security, or is there some level of things that's passed down from the enterprise that says, "Hey, this is yours, but you have to follow these 10 privacy and confidentiality expectations, or we have a problem." How do you balance that? Or how do you see that happening?

27:39 Mark Goetz: Sure, so I can speak from my own experience, and then a few places that I've worked before, so we created our model at HomeCare Advocacy Network based on a lot of what we saw was missing between the two worlds, both the home care world, and the senior living world, so the start start with a couple of broad statements. In general home care is fairly poor at document management, so we saw this as a real challenge when I was working with franchise owners and in the past with other organizations. One of the worst things that can happen to a franchise owner was when you let him know that the standards team was coming out, even though the standards team was well-meaning, they were coming out to check on their records, to look into things, and there was always a mad scramble to make sure we had documents all in line because they wanted to do well for the franchisor, they wanna present well.

28:37 Mark Goetz: And they wanted to have the best processes. So we created a system that's required, we didn't create it, we purchased it, and so we require an HR management system that we provide at an extremely low cost, it's called Ease, and that's a required system. The other required system in our ecosystem is ClearCare Online, and this is just me speaking to the systems that we're utilizing. What we liked about that is that when it came to decision-making, we were able to see from headquarters perspective what our franchisees were billing, and then we knew that the system we chose at every opportunity for our franchisees to abide by the local laws that governed their individual business. So I think that's some of the challenge that's in our marketplace is where you have a system like ClearCare Online that's clearly built for home care with the proper rules and settings in place. And home care is a decidedly territorial, unique business, so the laws in Philadelphia can be extremely different than the laws governing that business in California.

29:58 Mark Goetz: So you have to have a system that is able to operate within the territories that you as a franchisor want and need to operate. And so we had to pick systems that, one, could help get our franchisees in elite class of document management, and we believe that the system we chose with Ease. And two, ClearCare Online was the largest provider of in home services technology and billing, payroll, caregiver and care plan support in the industry. So we have those two as requirements within our ecosystem.

30:34 Mark Goetz: And I think where we go with franchisees, if there's something outside of those two systems that a franchisee seizes an opportunity to augment their system or add their own technology or add a new provider into the way they're approaching the marketplace, we like to have, first of all, conversations and relationships with our franchisees to understand if that's something that is going to detract from the mission or it's something that's going to augment the mission, and so we like to start there and if it's something that we're missing, we're open to it, we're open to hearing or seeing their perspective on things, but we definitely wanted to control the two core systems that our franchisees operated under.

31:27 Matthew D. Edwards: Okay, that makes sense. So I imagine that as that… Basically, what you just said was, you do have a baseline, a baseline expectation, but the franchise may have additional different or augmented ideas, if you will, that… And you're willing to hear those and evolve with those. Technology changes all of the time anyway, and so the thing that made sense now may not continue to make sense six or 18 months from now anyway, so it's good that you're constantly evaluating and listening.

32:00 Mark Goetz: I'll tell you just a quick story. About five years ago, I was working for an organization and we surveyed… We had 180 caregivers locally, and we surveyed 100 of them, and we asked them what their number one technology challenge was that they encountered in their work day with clients. And you would think it would be something like something kind of grandiose, but in large part, what our caregivers came back and said that it was the remote control. [chuckle]

32:33 Mark Goetz: Before we get too far down the road and get two grandiose in talking through technology and making sure where end users are really at. So it's five years down the road, and our caregivers still may be struggling with, how do I change the channel after one caregiver leaves? What's that button? What's that input button again, and how do I navigate just the basic daily activities of technology? And so it's important to keep good relationships with both families and caregivers, just to make sure they're getting everything they need right now, before we start adding and layering further things that could complicate their jobs or their daily lives.

33:16 Matthew D. Edwards: And that is a really good call out. I did not think of that, Mark. That's just generally operating the household in which they're supposed to be helping, there are fundamental things that… Now, that's a good call out. So like a long time ago, people used to complain about programing the VCR. Now people are saying, "Hey, there's 75 different types of remotes, and I can't even turn on the TV." That's a good call.

33:43 Mark Goetz: If you could program a VCR back in the day, if you could get it figured out, you were a genius and you were probably calling your neighbor who was good at it to come over and program yours, and so… You're absolutely right. So the basics of daily caregiving are challenged with some basic technologies. So it is as well just from an Aging in Place perspective, if you're a senior in the home. So smart technologies, I think will, of course, continue to be an important factor in aging in place services.

34:16 Matthew D. Edwards: It's a good call though. We've done some work in past lives with care centers, customer care centers across the US and internationally, and one of the problems that they ended up having to solve was, we can have all of the software and we can have all of the technology solutions and the ability to receive the calls and help the client, but all knowledge is not common, and so there would have to be intranet sites or frequently asked questions sites where anybody who's on the phone could go look up anything, not just what was being sold, but all the unexpected crazy things as well.

34:53 Matthew D. Edwards: That's a really good amplification there. So when you're working with different technology organizations, you're looking at software, you're looking at hardware, you're looking at communications solutions, your organization's focus is loving people, and that may mean that not all of the people in your house are actually technology savvy or even desire it and that's understandable. So when you do have a technology company, when you're looking for technologies, what are you looking for in the companies? What would be an ideal scenario? Forget, you find a device, you find this device, the device looks amazing, but you meet the people in the company and you actually don't wanna work with them at all.

35:35 Matthew D. Edwards: So a device or some solution that they sell is one thing, but what types of things in a technology company would you actually find valuable and what influences you to make a decision?

35:48 Mark Goetz: What we look for are tech companies that understand how a franchise owner would position their particular technology if they're asking us to include it in our service model. Oftentimes, they just want corporate to buy it. Well, in a franchise world where there's a gross margin that you're managing with each service hour, every incremental step up in cost, either raises the cost of care, or if you get technology to get cheaper over time, you can drive it down. So we look for technology companies that are empathetic and that understand and that are really trying to understand the business model, that these are primarily it's 98 to 99% of our clients are private paid clients, and everybody's trying to figure out how to deliver more and better care for less.

36:47 Mark Goetz: So if they come at us with, "Hey, let's go ahead and we would like to sell this to you for $30,000 a year," and they really haven't put much thought into it on a per franchise basis, that they almost kind of self-select out of the process for us to consider their technology. Or if they approach you to say, "Well, Mark, maybe your franchisees could add an extra $10 per day to their care," like they clearly don't understand that generally speaking, it's not billed on a per-day basis, clients get 20 to 27 hours a week, so there's a lot of self-selecting out when we're looking at what companies have really tried to understand the model and which ones haven't.

37:34 Mark Goetz: Now, there's certain technologies where we're working on the other side, really trying to figure out also how could we get this technology to make sense for our business model? Our question is now, how does that change the pricing scenario with a local family until either that technology is paid for in a similar way to remote patient monitoring has kicked in for certain technologies, but that's based on Medicare and it isn't based on generally a private pay model.

38:08 Mark Goetz: So that's kind of the first thing we look at. The second thing that we're really looking at is, is it applicable, is it something that we're seeing consumer demand for, or is it just a really great idea that might be either… Might be too soon to the marketplace? And there are a number of those companies that have just arrived maybe a little too soon for consumers or for home care businesses, or even senior living providers or whatnot, and so there's just a balance there, and we try to balance our consciousness with optimism at all times.

38:48 Matthew D. Edwards: So technology providers that approach you from your perspective, and we tend to agree as well, on our side is really what you're asserting is, if you don't understand my business model, it's gonna be pretty hard for you to actually say words that resonate with me, because I understand my business model, I need you to also. So that was first and foremost, what I took was, you need to understand how I operate as opposed to just trying to sell me a new widget.

39:24 Matthew D. Edwards: Then the next thing that I heard you say as well, if I could restate and tell me if I get it right. For all practical purposes, it's important for you guys to know what problem you want to solve, or else you just have to look at this as, "Hey, is this really cool or is it actually going to change how we do business?" But you can't answer that question unless you already know what problem you wanna solve, and that's one of the things that we see a lot. Which is, it's interesting to look at new things, but if you don't know what problem you wanna solve, or if you don't know what it's good for, then you're just spending money.

40:14 Mark Goetz: That's right. Yeah. And we have some very important colleagues that we work with. We also have created a 501c3 professional caregiver support fund. And someone who we've worked with quite a bit here in the state of Nebraska, Dr. Joy Doll, she works for the Nebraska Health Information Initiative, the health care collaborative here, and she's written white papers for us. She has a great TED Talk out there, but she challenges me often to think differently about the changing world we live in. And one of the things I've really learned from her is there's a point where you're collecting too much data as well in your… There is diminishing returns on the data that you're bringing in.

41:03 Mark Goetz: Do you need to bring in all the data that is available to you for decision-making? And so I've had her join me on some calls with tech providers, and those are some of the questions that she comes back with, whether or not they're really a savvy person who understands a healthcare space, or if they're more purely on the tech side, they're a newbie to the market, and they have a really cool idea, but they haven't figured out where those boundaries are. And to real practitioners within the healthcare space, as you get further outside of home care into healthcare, they're looking for some of those boundaries. They're not looking for every single piece of data necessarily, because they know there's a challenge to then managing that data.

41:48 Mark Goetz: The fact that you have that data now becomes something that your organization may have to manage and act on. So I try to arm myself with people like her in my life that can sharpen me in areas and keep me on my toes when I'm… As I'm thinking about technology as well.

42:06 Matthew D. Edwards: That makes a lot of sense and you're right, if you don't know what you wanna do with the data, then it's just noise. And if you're collecting it, now you have to store it and pay for the storage and pay for the management, even though you still have no idea what you're gonna do with it. So it just goes back to know what you wanna solve, and then go looking. Do you believe the home care industry right now, do you see any risks in the future? In other words, do you see cause for concern or risks or things that really make you uncomfortable in the future as it relates to melding new technologies with home care teams and our elders? Do you see things that make you say, "That could be cool, but I'm gonna wait a little bit and see how this pans out"?

42:56 Mark Goetz: Yeah, absolutely. So I think as we're looking down the road, the natural biggest risk is actually what our business model is. So if you ask people, generally speaking, in the home care world, what they need as a franchise owner or somebody who operates a homecare business, they would say, "Well, I need more caregivers. I just need more." They're always talking about needing more caregivers, and so I do think the biggest risk, I would say in our industry is overall, as it comes to technology, making sure that caregiver workforce is educated, is in touch, is able to adapt to new technologies so our industry doesn't get out paced.

43:48 Mark Goetz: So what you have happening right now is you have oftentimes home care agencies where demand is high, just running forward trying to meet demand without being able to step back or not taking the time to step back and actually work on their business. And that would be coaching, developing, training caregivers on the importance of technology, bringing them in, focusing on training with their caregivers so that they can have the opportunity to adapt to new technologies and feel taken care of. So that's one of the larger risks, I would say, that's out there in the industry.

44:26 Mark Goetz: I would say there's generally speaking, more opportunities than there are risks, because when you're selling a service where 93% of the people that you are working with, they don't want to move somewhere and you're offering them the opportunity to age in place. It's something they want just whether or not your service and their needs match up somewhere in the middle. So generally speaking, a more optimistic and less risk-heavy in this, but managing, not just getting caregivers, but then managing them, training them, staying connected with them as it goes with the technology, is gonna be key for the future of home care.

45:13 Matthew D. Edwards: That's a really good call out, that's pretty insightful. It would be a normal thing for a technology company to arrive at some type of software or hardware or combination service, product and service and try and sell that thing and to add it to the existing operation, to be used to take care of our elders, that would be a focus of a sale many times. But to your point, I think, is value is defined by not only providing seven-star service on a five-star scale to your customers, your clients, our elders, it could be my mom, but it's also making sure that the franchise owners, the home care providers, the healthcare services folks aren't left behind along the way, or the business itself could just implode.

46:04 Matthew D. Edwards: Which is, you're doing spectacular, amazing, cool things for the people at home, but the healthcare providers are having to bear the weight of being left behind and becoming less and less relevant or aware of how to do a good job, so it's gotta be holistic. This comes back to your business plan. Know my business plan… You didn't say this, but more or less, know my business plan or stop talking. Similarly, if you're gonna bring me a solution, make it a holistic solution, take care of my customers, take care of my staff. It's the same conversation, not two different conversations.

46:45 Mark Goetz: Yeah. And I would also say, that to add to that, it's not just home care companies and senior living providers, but it's… When I worked for an organization based out of Maryland, I worked a lot, pretty heavily with the Department of Aging in the State of Maryland, who was looking for a strong technology platform that could help keep their seniors in their homes, interconnected with high-touch, high-value services, from a command center. Because they knew that a lot of times people's general reaction is when something goes wrong to call the doctor or call 911, so you see emergency room visits, you see readmissions go up when people aren't connected socially. So I think maybe not one of the risks but a competitor almost in our business is going to be other people like state governments and what not actually pursuing innovation harder than our own industry is, as well. So there's maybe a little bit of caution there because everyone is trying to figure out how to keep a senior population that's aging fast, better connected, feeling better about their decision-making when it comes to healthcare, and even state-level organizations like the Department of Aging for Maryland is…

48:12 Mark Goetz: They're trying to find opportunities. They actually came up with a grant program, we worked within called Community For Life. And it was that they were challenging local organizations to try to figure out how to… And giving them a territory, it was very similar to franchising. Giving them a territory and a grant in helping them figure out and paying for them to figure out how to keep seniors better connected in the community, and they wanted to see the best creativity rise to the top.

48:40 Mark Goetz: Well, that in part really inspired the HomeCare Advocacy Network because I was a part of the development of that, of many of those discussions in the state of Maryland at the time as they were launching that program. And so what we saw broadly in the marketplace was you had this private market that's growing, but then also you have the public sector that's trying to figure out very similar issues, and they may be lacking awareness about home care and how flexible and creative we've already been and how flexible and creative in some of the vast technology enhancements we've already made. And so I think at some point in the future, we have to meld those worlds, but I like to stay on our toes, 'cause everybody's going after very similar solutions.

49:36 Matthew D. Edwards: Any parting thoughts for us as it relates to today's internet of things, connected things, technologies or risks and liabilities or data, or senior leadership, anything else you'd like to teach us or share with us?

49:52 Mark Goetz: I think there's one thing, and I learned this a long time ago, that home care and caring for a senior is as simple as a caregiver and a client. So never underestimating the power first and foremost of human contact, human touch and the value of having another human say, "You're important, I value you. I'm taking the time out of my day to let you know that I value you, and I'm here with you." You can't understate the value that that brings to the human condition. So I'd say, first and foremost, I would encourage leaders to just… If you're gonna boil down, what you can do is figuring out how to make that caregiver, client, caregiver, receiver of services connection happen, and let that passion drive your mission forward when it comes to technology. How to augment, make that connection even better between a caregiver and a client and a family member, that's what life is all about, is helping make the experience here on earth just a little bit more hopeful, a little bit more empathetic, and we're all happier at the end of the day when that happens. So that's my closing words.

51:12 Matthew D. Edwards: That's outstanding. Mark, thank you for taking the time to get together with us today to teach us and give us insight into what you see and experience, and we look forward to learning from you and watching your company's growth and evolution into the future. Thank you very much.

51:30 Mark Goetz: Mr. Edwards, thank you.

51:35 Speaker 3: The Long Way Around The Barn is brought to you by Trility Consulting where Matthew serves as the CEO and president. If you need to find a more simple, reliable path to achieve your desired outcomes visit

51:51 Matthew D. Edwards: To my listeners, thank you for staying with us. I hope you were able to take what you heard today and apply it in your context, so that you're able to realize the predictable repeatable outcomes you desire for you, your teams, company and clients. Thank you.