Part III: The Future of Technology in Home Care Services

CEO of Home Instead Senior Care shares how the traditional business model must adapt and evolve in the face of three megatrends in the senior care industry.

Matthew D Edwards
September 22, 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 third episode of this series, Matthew D Edwards and Jeff Huber, CEO of Home Instead Senior Care, discuss how the traditional business model must adapt and evolve in the face of three megatrends: 

  • The fastest-growing age segment is 85+ and its effect on every developed system. 
  • Healthcare delivery is moving from a fee-for-service and volume-based model to outcomes.
  • Digitalization of everything and this industry’s ability to adapt and succeed.

Key Takeaways

  • Leading a cultural change of a large distributed network that needs autonomy and a certain amount of uniform systems and processes to unlock a digital future that meets business and security requirements.
  • The foundational work required for a future where big data and artificial intelligence analytics truly play a very predictive and prescriptive role.
  • Getting an organization and its people to leverage digital-enabled tools and think differently about how care is provided – while ensuring regulatory compliance.

About Our Guests

As Chief Executive Officer of Home Instead, the leading global provider of home care services for older adults, Jeff Huber leads the company and its franchises in their commitment to addressing the challenges of the aging global population by promoting consumer choice in care. In his four years as CEO, he has also increased the organization’s commitment to leadership development and training to empower professional and family caregivers and to advance the mission of Home Instead Senior Care: To enhance the lives of aging adults and their families.

Read the Transcript

00:05 Matthew D Edwards: Welcome to the long way around the barn, where we discuss many of today's technology adoption and transformation challenges and explore varied ways to get to your desired outcomes. There's usually more than one way to achieve your goals, sometimes the path is simple, sometimes the path is long, expensive, complicated and or painful. In this podcast, we explore options and recommended courses of action to get you to where you're going, now.

00:58 Matthew D Edwards: Welcome to another episode of The Long Way Around The Barn. My guest today is Jeff Huber, the CEO of Home Instead, whose mission is to enhance the lives of aging adults and their families. Jeff, good morning.

01:09 Jeff Huber: Good morning. It's great to be with you, thank you.

01:11 Matthew D Edwards: 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. So Jeff, the name of your organization is Home Instead Senior Care, and people can learn more about your organization by visiting Teach us a little bit about your organization. What are your organization's aspirations? What do you offer folks today? Teach us.

01:52 Jeff Huber: Yeah, great. First, I'm really pleased to be with you, so thank you for having me. Home Instead Senior Care is the world's leading provider of in-home care for seniors. We were founded right here in Omaha in 1994 by Lori and Paul Hogan out of a very personal need they were experiencing. Paul's grandmother, Eleanor Manhart, was the matriarch of a very, very large family. She had 12 children, 50 to 60 grandchildren, and as many great-grandchildren. She was widowed, living alone in her apartment in downtown Omaha, and was in her late 80s and was in failing health. She couldn't even get out of a chair. She was becoming very frail. And so the family surmised that Grandma Manhart, she only has a few more months and so let's make those the best they can. They made a couple of decisions, the first one is there's not gonna be any nursing home. The second was they were gonna move her into the home that Paul Hogan grew up in, down at 38th and Cass, his mother's home. And third, they were going to surround her with a schedule, they're gonna take all these cousins, aunts and uncles and put together a schedule and figure out how they could be with Grandma Manhart, to get her engaged in things that really gave her meaning and purpose, like getting to daily mass or those kinds of things.

03:26 Jeff Huber: And what they found, instead of having just a couple of months to live, Grandma Manhart did a remarkable U-turn when she got really plugged back into and having a support system around her, and she actually went on to live 11 very fruitful years. And that caused Lori and Paul to just wonder, first, what do other families do that don't have 50 first cousins in town and all these resources? But also they saw the power of socialization, interaction, things like making sure she had three square meals a day, and how that had a transformative effect on Grandma Manhart's life. And so, Paul had always wanted to have his own company, he's an entrepreneur heart, he was working for Merry Maids, which was an Omaha-based franchise home cleaning company, where he learned franchising and he learned home services. And so he put together a business concept and struck out on their own with three young kids and one on the way and being the sole bread winner, classic American entrepreneurial story.

04:40 Jeff Huber: That was 1994, so fast forward to today, we're the world's leading provider of home care services. We have about 1200 franchises operating in 14 countries around the world, we'll provide more than 90 million hours of care to our clients. Today we'll be in probably 85,000 or 90,000 homes around the world. We'll employ more than 100,000 caregivers this week through our network of independently-owned franchises. We have a particularly heavy emphasis and expertise in caring for people with Alzheimer's or other forms of dementia and multiple chronic conditions. So that's a little bit about Home Instead and our 26-year history.

05:25 Matthew D Edwards: Yeah, that's outstanding. And all of those things being focused on in-home care or aging in place.

05:33 Jeff Huber: Exactly. So the name implies, it's home instead of a nursing home or something. The truth is, we can provide care to clients wherever they call home. Most of our clients, it's the traditional home that you would think of, but we provide an awful lot of care to clients who live in a facility of one sort or another.

06:00 Matthew D Edwards: Very good. So you very well know how times have changed through the years, and the needs of people, and the logistics and complications of home and staff and training and verification of quality of service, and all of those things have impacted your business and likely a lot of other people's business, to just say, "Hey, what we did yesterday still works well, but now we need to consider these additional things or different things as well along the way." And even this recent pandemic, if you will, has probably, I would guess, impacted in some way, shape or form some of the decisions that you and your teams have to make in order to take care of people and just love them in place.

06:46 Matthew D Edwards: This podcast that we're working through is really talking about of the technology that continues to be created and adopted and evolved and available in the home care space and the senior living space, just to people in general. We spend a lot of time just talking about, "What is available? What do you do with it? How does it work? What are the risk exposures? And then what are the decisions that leaders need to make in order to provide the best quality of service using the newest sensible technology while also having the right protections in place along the way?" Specifically around privacy and information security, because they're more difficult than just a Saturday afternoon jaunt and they're getting more complex. In the world that you live in, the work that you do, the folks that you work with on your teams, your leadership teams, your operational teams, as well as the clients that you serve, do you see technology changing the way home care service providers and workers do their jobs today different than yesterday, or do you see it changing even more drastically in the future?

07:57 Jeff Huber: Well, there's a lot to unpack there. First I would say, the way we look at the world is at the intersection of three global mega trends. The first is what you talked about, which is aging. We're about to undergo the most massive demographic shift in the history of the planet. For the first time there are more old people, in developed countries at least, more old people than young. That'll be true within 10 or 15 years across the board. 85 plus population is the fastest growing segment of the population. So we're really at the very front edge of a 30-year surge in the oldest of the old, and that's having ripple effects on every system that's been developed. I like to talk about the inversion of the aging pyramid, right? So if you think of the traditional age pyramid where the oldest is at the top and the smallest segment of the population and the youngest is at the bottom, that's literally going through a period of inversion. And so every system that we have today has been built for the traditional pyramid, whether it's transportation or retirement systems and savings, vehicles or education, it's all been built for… So that's creating all kinds of pressures on those systems, and the world needs to rethink, every system needs to re-think. So, that leads me to the second major global trend, which is the transformation of the healthcare delivery system, that's where it's gonna be felt most acutely.

09:40 Jeff Huber: So not only do we have this massive population, but they're living longer. The life expectancy is up more than 25 years since the end of the Second World War. With that brings a huge influx in multiple chronic conditions. And so there's this big movement in healthcare delivery moving from a fee-for-service or a volume-based model to outcomes. And what we know about our types of services is that when we're part of the care equation, our clients' usage of that healthcare system go down dramatically, particularly with someone who has Alzheimer's or other dementia, and we can care for them at home more cost-effectively, better outcomes and higher quality of life. So I like to say the future of the hospital looks a lot like your living room, because the home is really gonna be the only scalable place where we're gonna be able to care for this massive influx of seniors. And then the third, getting into your world, the third global mega trend, is really the digitalization of everything. Now that the Internet's three decades old and we're seeing the transformation that's happening on every business model, radical new business models disrupting old, and those companies who can lean into those changes and adapt are the ones that are gonna have success in the future.

11:16 Jeff Huber: So that's sort of the context in which we're looking at the world and this whole big question that you've posed, and I think it's just… With all of that, technology absolutely will play a role in helping to solve that. So we talk about we need to expand the capacity of the world to care for seniors. Technology should do just, it should enable us to expand capacity. So the big challenge for us is taking… We're a very high-touch organization, a very high-touch approach, we're in our client's home, in the US at least, on average about 25-26 hours per week. And we like to say we're barely not analogue, we're so high-touch. So the challenge for us is to take that footprint that we've spent 25, 26 years developing and retrofit it with some digital-enabled tools, giving our caregivers and our franchise owners some new tools and capabilities to deliver more care and more effective care, do more with less, more predictive and prescriptive types of care. So is technology gonna play a role? Absolutely. What that looks like precisely is yet to be told, but we can get more into our experience and learning so far.

12:44 Matthew D Edwards: That makes sense. So you're expecting out of those three ideas that you brought up, the three things that you're paying attention to, you're expecting that the technology is not only going to impact the operation from the perspective of your company, but it's also going to impact how the elders are able to take care of themselves through the years, as well as how they engage with your organization. You didn't say all of those things, but that's an extrapolation that I'm reading, it sounded like you're asserting technology is one of the three legs that are going to create change ripples, and you'd like to be at the head of it.

13:22 Jeff Huber: Yeah. At the intersection of those three, we looked at that and said, "Okay, our traditional business model, given those three global mega trends, we need to evolve our model." And what remains true for us is the delivery of highly personalized care at home. How we do that going from a purely caregiver, physical presence in the home at all times, needs to evolve and we need to give our caregivers and their families who provide most of the care some new tools and capabilities and the ability to use data and to provide insights in how we can do all of that better.

14:06 Matthew D Edwards: From your perspective, do you think the home care industry itself, the senior industry itself and/or your organization from a risk appetite perspective, do you think in general that the adoption of new ideas like new tech, is the industry ultra conservative? Is it somewhat moderated? Is a leading edge? How do you see it today versus the future?

14:32 Jeff Huber: Well, I think the aging space itself is garnering a lot of attention in innovation and technology and how we care and keep people safe and secure at home, or care for them in different ways. I don't know that I can speak for the entire home care industry. Our experience has been in leading a large multinational franchise company that has an awesome group of franchise owners, but they're also very entrepreneurial. I'm confident we're gonna be able to solve the technical challenges ahead. The big issue that you're really asking about is leading a cultural change of a large distributed network that we have some controls over, but it's franchising. And so, there's a large underlying cultural shift that needs to happen and a mentality that needs to be open to doing things differently in new ways around technology. That's a journey we've been on. I think this Covid situation has really opened the minds of our network and softened maybe some of the defenses against those things, and has actually helped us with the adoption of some of the digital tools we've been rolling out.

15:56 Matthew D Edwards: Sure. So Jeff, based on the things you're talking about then, entrepreneurs obviously are, by definition, moderated or managed risk takers themselves trying to understand, "How can I provide value? How can I enable a profitable experience all at the same time?" Otherwise, they're no longer in business. But they need to offer a value, a good value proposition, or nobody's gonna come calling any way. So while Home Instead is enabling basically an oversight or portfolio management or an enterprise view into how to franchise and enable home care, does that then suggest that a lot of these different franchise owners may adopt some of these new ideas at different velocities? And then does that different velocity… How much autonomy is there and how do you regulate or normalize those things?

16:50 Jeff Huber: Yeah, we could have several podcasts on that topic alone, I think. I sort of view the first 25 years of our existence as really establishing this business model, bringing it to scale, creating this massive footprint that we've developed. We've got a ways to go in the expansion, lots of room there. But in that, we have learned so much from our franchise owners and provided enormous amount of autonomy to them, to help us learn and create the model. I think we're at a point now where we really understand that and we're… Part of the cultural shift I talked about is really moving them from running this business however they want, I'll put an asterisk there 'cause I'll come back to that, to a more uniform way of doing things, more uniform systems and processes that are really gonna be essential for us to unlock a digital future. We can't have thousands and thousands of iterations of how this business operates.

18:03 Jeff Huber: The asterisk I wanna come back to is while we've provided a great level of autonomy, we also have had a very finite set of standards, but we're extremely serious about them at how the business operates at the local level, that really all have to do with the safety and security of our clients. So we're very uncompromising on those things, yet at the same time, exactly how the business operated was a lot of latitude granted at the local level. So again, we're moving from sort of choose your own adventure in terms of systems and tools and processes, to a much more uniform, digitally-enable future. And we've had some challenges in leading people there, but now the network is really starting to get it and embrace it.

18:56 Jeff Huber: And part of your question was… There's always a bell curve with adoption of anything within our system, and so we've got the early adopters and we know who they are, and many of them oftentimes are out ahead of us, frankly, on ideas, we don't pretend that we have all the best ideas, we really try to tap into the ingenuity of the local franchise owner, who was on the front line solving very real problems and they're incredibly innovative and smart. And so we try to tap into what they're doing, breaking those best ideas, and then your resources and bringing them to scale, but so when we're trying to introduce a major change, we really focus on what we call the ready and the willing, which are that front end, help us learn and iterate, and then usually there's a big group in the middle that is waiting and seeing…

19:46 Jeff Huber: They might have some skepticism, wants to see what the ROI is, or how hard this change is gonna be, or those kinds of things, and then usually if we do our job right, they come on board pretty quickly. And there's always a group at the end where we have to get them on board by mandate, so right now, we're really moving in our digital transformation, I'd say from the early adopters to more moving that big middle group on board, we've got a lot of the things figured out, ironed out, we've done a lot of the hard internal work to sort of enable scale. And so we've been sort of setting the table for this for years now, and now it's really time to start leaning into it and accelerating that transformation.

20:33 Matthew D Edwards: Is it accurate then for me to summarize some of the things that you just said to say that as an enterprise organization, you're working to normalize or streamline some things for a number of reasons, and that can be a cost of ownership or general in economic considerations. It may be for regulatory compliance or privacy or confidentiality or those types of ideas as well. But at the same time, you're still wanting to enable autonomy and independence or independent evolutionary thinking at the franchise level. So you're working to, which is a continuous job, evolve both what can be normalized and what should be independent or individual and when? And that's kind of the model that you're evolving on right now. Is that a good summary?

21:22 Jeff Huber: I think that's a really great way to summarize it, and another way to say it is that there's this constant tension between those two things, and at different points of your evolution, you're sort of setting the dial, either more towards autonomy, more towards structure. So that's where we're at. Yeah. That's a great summation.

21:42 Matthew D Edwards: Okay. That sounds like a kind of a normal model for larger organizations anyway, where that cost intention of, "Yes, I want to enable you to do what you need to do, however, also I need to make sure that it's predictable, repeatable, audible, compliant." Let's be responsible here, we wanna be in the newspaper or the media for the right reasons, so let's make the right decisions together, so that makes a lot of sense and it's hard all of the time, as I'm sure you and your team would communicate. So as it relates to the home care industry, a lot of these new technologies that are coming out, there has been technology available for long time in various iterations.

22:28 Matthew D Edwards: Some of the newer things, for example, companies that are implementing connected things or Internet of Things solutions, for example, a single physical device unit that goes inside one room that doesn't touch anyone, but it monitors all behaviors all of the time, collects all of the data, patterns, it finds patterns, it makes decisions, it asserts potential, but it does predictive analytics as well, for example, gait analysis. In order to predict a fall, there needs to be data, the data has to be collected across time, which then creates patterns, which then elucidates or reveals a possibility, which then alerts people so they can make decisions, and that actually sounds spectacular.

23:15 Matthew D Edwards: So that you could know in advance, "Hey. It looks like mom's having some trouble right now, and maybe I'm just gonna go hang out with her for a little bit and we'll go see how the day goes together." With that though, comes a ridiculous amount of information, so for example, when you're talking about your organization and multiple franchises, multiple countries and all kinds of clients, if all of those were operating together and all of that data was being collected just to do predictive analytics on a fall, do you think or have you perceived or do you understand in your own house or in other organizations, how people might be prepared to start collecting more data more often? It is a little bit of a paradigm change between, "Here's what I entered at the end of my shift." Versus sensors that are collecting data 70 by 24 x 365.

24:17 Jeff Huber: Again, you ask really big thought-provoking questions. I think there is absolutely a future where big data, artificial intelligence analytics is gonna play a very predictive and prescriptive role, and for those of us who are out there looking at the future like that, our minds tend to go right there. And in fact, my mind has been there for a while, I'm very fortunate to say that some tables where they're sort of cast in the future for healthcare and those kinds of places. The challenge is, we got a lot of work to do before I think that can happen, and we can't put the cart for the horse.

25:07 Jeff Huber: In fact, in our business, we've had to go back and do a lot of the really nitty gritty, un-sexy work, to lay a foundation that would eventually unlock the kind of future you're talking about. I'm talking about… And this might sound really rudimentary, but remember, we're barely not analog, things like single sign on or those kinds of things. I've learned more about those kinds of things than I ever thought possible when I was wanting us to have a dashboard that said, "Hey. These five clients are at a 95 probability for a fall today, we need to do something about that."

25:52 Jeff Huber: So we have to really start at the very foundational level, so we've spent the last few years really putting in the stuff that doesn't really… Isn't real sexy, you don't really talk about it at conventions to your people, it's quietly happening in the background, but we're starting to sort of come out of that phase, and now we're starting to be able to deliver some of those more value-add things. For us, we'll get there, but we're really starting more with enabling, giving our caregivers new tools so they can do their job better, connect with the office better, connect with family better, having some remote capabilities so we can be more efficient with our limited human resources. So we can get eyes into the home without having to send a nurse across town to be there and evaluate a situation, we can do that remotely.

26:54 Jeff Huber: A lot of the things that require a lot of time and manpower and a lot of friction, we're able to begin to automate and streamline, so that's really where our immediate focuses. But we do have our eye on that end game of being able to use huge data sets, you know $90 million of care and 85,000 homes, and then you give it in 25 hours per week that should… We should be able to unlock, use very powerful data sets to be able to provide more predictive, more prescriptive care. It's just we're not there yet.

27:35 Matthew D Edwards: Yeah. No. The idea of digital transformation is actually an interesting and also useless word, like saying cloud or quality, those words mean something different to anybody that you talk to, and so it's difficult to talk about. But the idea behind digital transformation is really multiple things, and it's the process is it's the tools, it's the people as well as the company as a whole. And so, to just pick up a new Internet of Things device and call that digital transformation is actually completely miscommunication, the whole idea.

28:12 Matthew D Edwards: It's how do we take our entire organization and optimize how we get to the desired outcome, which is to enable people to age in place, to love them where they are, to be helpful when they need us and be out of the way when they don't. And that requires us to talk about everything, not just a trip to the Home Depot or a trip to Best Buy and buy something really cool and plugging into the network, so it's a lot of work, and so you're talking about a lot of behind the curtain stuff that then nobody wants to talk about, that everybody has to do, that maybe some people haven't had to do yet. So yeah, there's a lot of work for the no contest.

28:51 Matthew D Edwards: So when someone like you in a leadership role sees something in a magazine or sees a commercial or an advertisement in an article or whatever it is, along the way of saying, "Hey. Look at me, I'm technology company 12, I've developed this brand new and amazing device or this new software or I have this new widget. And then someone like you and your role probably is inundated with 10, 20, 50 or 100 different companies all coming to you with their particular widget. And some companies will assert, "We have a comprehensive solution." And some will say, "This will fit into your solution." If you take all of that and just say, "Hey, that's fine." Let's put it to the side. In order for you to do what you need to do to love and engage and care for people, what would be, from your perspective, an actual useful way for technology solution providers to come alongside you and work with you and help you solve problems?

30:00 Jeff Huber: Well, that's a good question. And you're right, we are inundated with all kinds of opportunities, and the big challenge for us is sorting through those. So the main thing I did, or we did, I should say, when trying to solve for this, was to really formalize our innovation function. We'd had a lot of innovation, and like I said, we've got hundreds and hundreds of franchise owners out there solving problems. And so we try to tap into their ingenuity all the time and bring the best ideas to scale. And that worked great, but when we were thinking about, "Okay. We really need to take our footprint and our high-touch approach and give it in some digital capabilities." The possibilities for that were endless, and to try to solve that problem, I wanted to formalize our innovation function, so we acquired a digital marketing company that we had a lot of experience and trust with, and kept the digital marketing function alive, but also gave it a charter that said, we need you to help us think about what a digital enabled future looks like for Home Instead, I wanted it to be outside of our organization, because I wanted them to be free of legacy thinking and systems and tools.

31:31 Jeff Huber: And so, that I think it served us really, really well. We've sort of wound down the digital marketing part, we really built up that innovation function, and now that team is part of us, just on the outside still, so they can sort of be free of to, "This is the way we've always done it." thinking. But they now have a charter and a process and a way to evaluate all those, and they're going after sort of stop doing activities, kinds of innovation, that sort of incremental innovation. But there's also the big sort of game changer types of innovation, that's how we sort of think of it, and they've got a finite budget and a charter to do that. And so I sort let that group take on the challenges or sort through as they get process. So to get specifically to your question, if somebody wanted to come alongside us and maybe pitch something to us, the best way I think would be to go through our innovation group who has a formalized way of evaluating all of that.

32:43 Matthew D Edwards: That's fair. So you have an incoming process to filter and prioritize? That's a really great way to do that. Very often do you hear about people saying, "If I buy this tool then… " Or, "If we change this part of our business, then… " And in many cases, they may not fully understand what they want it to look like on the other end of that, but they absolutely feel like if they make this change, then whatever change happens is probably gonna be good. So it sounds like you guys are on the front end of that, you're saying, "Hey. We know we need to evolve, but it needs to be on purpose, so let's go do this on purpose."

33:28 Jeff Huber: Exactly, they've got their charter and where we started, there's about a two-year process. Well, after the acquisition, it took us a couple of years to sort of get the right people and talent in place and sort of the structures in place, and then the big charter for them was like, "Okay. How do we create a digital pipeline into our client's home?" We knew we wanted to get tools into the client's hands, into the home. So then we started looking and knowing that we're a home care company, we're not a tech development company, so we tried and failed at that a couple of different times, so knowing that we really… This is gonna be about partnerships and funding, so that process, we evaluated it, electricity ran through it, and it was aimed at the senior space, I think we took a good hard look at just about everything out there, and at some point you gotta stop evaluating and put in, and understand this is a journey, there's no end point, this is just a continual evolution.

34:38 Jeff Huber: But we made a big move with a company called GrandPad, made a strategic investment in that organization that, one, had a really, we thought elegant solution, they took a very… With a very mature tech leader, founder, so many of these organizations are… Solutions that come forward come from really bright young minds, but it might really be a tech innovation challenge as opposed to trying to practically solve a solution. So this was a very mature leader solving a very practical solution, or problem that he had found in his own life, figured everyone else is dealing with it too. Great value alignment with our organization, and it's been wonderful, and now we're starting to…

35:31 Jeff Huber: We've had to make some adaptations to that tool to make it really a good tool for our caregiver workforce, but also understanding that this is this is an entry point for us, this is not the end, and they'll always be something next, and that's why I'm grateful we have innovation team in place to sort of always be evaluating what the next thing is. The big thing for us, as though we have to begin getting our organization used to using digital-enabled tools and thinking differently about how they provide care, because the current model of one caregiver for one client, going back to these global megatrends, isn't gonna be scalable in the future, we have to create scale and increase capacity.

36:15 Matthew D Edwards: Right. That makes a lot of sense. So Jeff, last question, and this has been outstanding so far, thank you. What we've seen in many industries is a shift to now include on-purpose, amplified and communicated, the role of chief information security officers or some senior leadership role whose job is to enable and ensure regulatory compliance, ideas, information security ideas, privacy and confidentiality in particular. As the industry has changed and even as your own organization has changed, how do you see the role, the public role, the amplified role of information security and privacy changing from yesterday to day and tomorrow, if you will?

37:09 Jeff Huber: Yeah. Well, again, you're asking really big questions and that one, we could go down a number of different paths with, culturally speaking, just as we're all wrestling with our individual rights and privacy and security of our information in this new world, but yeah, part of the nitty-gritty, un-sexy work I referenced earlier had to do with creating a data governance program and understanding how we were gonna collect, normalize, store, secure, and then finally analyze and use appropriately this various data that we're anticipating collecting. And then multiply that against operations in many, many different countries, all with different security acts.

38:10 Jeff Huber: And so, it's been a huge focus for us. And our regulatory and compliance group here, part of our legal team, has grown significantly, we've made big investments and bringing on personnel who can understand and help keep us safe and get the appropriate certifications in that area. So that we are safe and secure, we're using information securely, not invading anyone's privacy or overstepping their… Trust is so important to us, having a philosophy that this is really gonna be all about enhancing care and providing more personalized services, we're not looking to sell this data or use it in some sort of commercial, we're not looking to monetize it in any way, we just wanna do a better job of what we're doing, so that's a bit about… We had to sort of get right in their own minds about this philosophy and approach, and then make big investments in all of those different pieces I just referenced, including making sure we have people who understand that world really well and can keep us in track.

39:25 Matthew D Edwards: Yeah. It's a lot of work, it's a lot of work for everybody. Not just you, whether you have country by country governance, you also have the state-by-state governance, and then you have industry governance on top of that, it's a lot of work and it has to be done on purpose.

39:42 Jeff Huber: It's enormously complex. I think the most important thing is you have a… Really, a philosophy and approach, so many people sort of get big eyes and see dollar signs in when they think about monetizing data, that's not at all been our approach. So we had to get aligned philosophically on all of that and then put those pieces in place. Yeah. And it'll be never ending, and one of the internal challenges is getting… We've been a care company, we support franchise owners in providing care who… These are people who recruit clients or train caregivers and pair them up in a very high in-touch way.

40:31 Jeff Huber: So getting internally an understanding about, "Hey. What the future lies, we have to continue to evolve our business model." Which involved investments in these things that maybe our frontline folks didn't quite get like, "Why are we hiring all these lawyers and what's all this data stuff about?" So it's been a huge internal education, I've had to learn a lot, our whole teams had to learn a lot, we've brought in a lot of talent to help guide us there, we've brought in some outside resources to help guide us there, and then internally and I…

41:07 Jeff Huber: What's really exciting about that is it's been frustrating at times. It's been a learning curve for everyone, but I think we're all starting to get it now, and where I feel like we're starting to reach a tipping point within our network. So that's been a really rewarding journey, and I know we're gonna have other setbacks and other frustration points along the way, but I think we're now aligned as an organization, so that's been a very gratifying experience.

41:40 Matthew D Edwards: That's great. The net of the whole conversation that you've communicated is, "We've had a great journey, and we want to continue having a great journey, and that means we never get to rest."

41:53 Jeff Huber: It proves that constantly, we're constantly having to evolve. And so the key competency for a good home instead team member is the ability to adapt and change and look at that not as a threat, but as an opportunity to grow and evolve. And so I think we've got our collective mindset right there.

42:14 Matthew D Edwards: Very good. Well, Jeff, this has been outstanding. Thank you for taking the time to meet with us to teach us about your organization, about the journey that you've been on and where you guys intend to head and are heading. And man, we look forward to paying attention and seeing where you go and learning from you again, and look forward to talking to you again. Thank you.

42:36 Jeff Huber: Yeah. Well, I appreciate the opportunity.