Part VI: Providing the Right Care at the Right Time with In Motion Care

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 sixth episode of this series, Andrew Guillemette and Mark Heston of In Motion Care join Matthew D. Edwards to discuss how their startup is tackling the surmounting challenges of 34 million additional baby boomers retiring in 2025 by leveraging technology and data to improve resident care and increase staff efficiency, accountability, and engagement in senior living communities.

Key Takeaways

• Caregivers and senior living communities face several existing challenges that will be insurmountable when even more seniors need care: Access to information, cognitive fatigue, effective and efficient delivery of care, staff stretched too thin, etc.
• In Motion Care has developed technology that provides real-time location of staff and equipment and collects data on when care is delivered that results in real-time availability of information and data – making the role of caregiver easier.
• The startup is seeing great results with its early adopter community as it addresses new regulations, policies, protocols, and benchmarking due to COVID-19.
• By leveraging IoT and geofencing technology, In Motion Care collects data that allows for better decision-making by those running the senior living community and more caregiving time for those working directly with the seniors.

About Our Guests

Andrew Guillemette is a Founder of In Motion Care and serves as technical lead. His strong technology background and entrepreneurial spirit have allowed him to successfully develop innovative solutions for multiple start-up tech companies. Over the past five years, he has consulted with tech start-ups in the unmanned aerial systems, agriculture, construction, and senior living industries. 

Mark Heston is a Founder of In Motion Care and brings 16+ years of leadership experience in the senior living industry to the organization.  His experience also includes founding and building a successful management consulting firm. Mark has a passion for serving seniors and is committed to leading IMC in developing solutions to improve resident care and increase efficiencies for senior care providers.

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Read the Transcript

0:00:57 Matthew: Welcome to another episode of The Long Way Around the Barn. My guests today are Mark Heston and Andrew Guillemette of In Motion Care. Mark and Andrew are founders of a company seeking to positively change not only qualitative care behaviors in the senior care industry, but quantitative as well by changing the way technology enables healthcare providers. By using connected things networks, geofencing and predictive analytics, their solution is designed to make technology an unobtrusive, nearly invisible component in a healthcare worker’s daily life. Imagine a world where systems and activities are self-documenting, teaching and guiding, instead of finishing an eight-hour shift in 10 hours and spending another two to three hours documenting activities and areas. These guys can see that future and they’re testing a solution which may change how work is done. Mark, Andrew, good morning. Thank you for being with us.

0:01:53 Andrew: Good morning, Matthew.

0:01:55 Mark: Good morning, thank you.

0:01:56 Matthew: So tell us a little bit about your company, In Motion Care. Tell us a little bit about your company’s vision, tell us about your mission, tell us about the product that you’re building, tell us about who you are, what is your company and where are you heading?

0:02:08 Andrew: Yeah, thanks Matthew. So In Motion Care is focused on providing a tool for senior living right now for direct care staff to really be able to provide efficient care and proactive care, bring accountability, and really try to focus on trying to make sure that we have staff to take care of our seniors as we’re moving forward.

0:02:43 Matthew: Alright. So Mark, what’s your perspective on this? How do you also communicate the business or describe it?

0:02:51 Mark: Our real vision is that we want to improve resident care and operate in efficiency in the senior care industry. So our focus is senior care, that’s where a lot of the experience of our founders have come from. We all have a passion for serving seniors, we know that it’s not only something that we have a passion for, but… There’s gonna be a growing number of seniors that need cared for, and we need to be not only better at how we do that, but also there’s gonna be a great need to be able to attract and retain staff to do so. And we’re trying to… We’re working on a solution, or solutions, that will help on both sides of that equation.

0:03:41 Matthew: So it sounds like the common theme, based on the things you said, includes staffing, quality of care, just making sure that we have the right people there to provide the right care at the right time. So it’s context-driven, that makes a lot of sense. What does that look like for your company? Tell us a little bit about the products that you’re working on right now.

0:04:01 Mark: We’re using technology that has been developed that will provide real-time tracking of staff and equipment that’ll allow us to be able to collect data, information on when care was provided, and be able to confirm that it was provided, but also be able to provide access to individuals of improved data. They’ll be able to know where their co-workers are, so if they need help, they’ll be able to locate them quickly. And one of the real key features is leaders in nursing, skilled nursing facilities, so DONs (directors of nursing), charge nurses, people who are in leadership positions, currently spend a lot of time, what I call chasing, they’re trying to chase down staff members, they’re trying to get information. A family member calls and says, “Hey, I need some information about the care that was provided to my loved one, my mom, my dad,” whoever happens to be in the senior care community, and they end up spending a lot of time chasing that stuff down. They also end up looking for information on staff that… Are they up-to-date on their training?

0:05:19 Mark: And so what we’re trying to do is provide a solution that makes their lives easier too, so they have access to, and real-time availability to information and data, so they don’t have to do so much chasing and looking for information. What that’s going to allow them to do is obviously, they’re going to be able to focus on things that improve resident care and also improve staff engagement, preparedness, all those things. It’s a time-saver, and it’s efficiency, but it’s also being able to track care and know that care was provided in an accurate and timely manner.

0:06:03 Matthew: A lot of the stuff you’re doing, is you’re building a system or you’re working on a product that enables staff to understand what staffing is needed, where staffing are… Where the staff are in relation to maybe the premises or the daily operation, who’s working on what? And so it sounds like almost a human logistics-type conversation of, “There’s 20 of us here for this shift, where are we? What are we all doing, and with whom are we doing those things?” Am I getting the right idea?

0:06:42 Mark: Absolutely. Those are clearly many of the benefits. One of the other things that gets lost sometimes is the whole concept of cognitive fatigue with caregivers, especially in the time of COVID. It was happening before, too. But you have caregivers who are assigned to and working in a senior care environment, and they just have a lot of responsibilities and tasks. And right now, there’s no real, good way to help them keep track of that and to know what all they should have done really without their charge nurses or DONs, I hate to use the word hounding, but trying to remind them that, “Hey, did you do this? Did you do that?”

0:07:34 Mark: A good example is there’s something called two-hour rounding that occurs in senior care communities, which basically, every resident should be checked on every two hours. What our solution will do is track that and let’s say we’re coming up on an hour and 45 minutes or close to two hours, and a caregiver is in a situation where they’re dealing with something, but all of a sudden, they’ll get an alert that will say, “Hey, you haven’t checked on Mrs. Smith in an hour and 45 minutes, you need to do that right now. Because, and again, cognitive fatigue is a big issue in senior care. They’re just overwhelmed with all these tasks they have to do, there’s really no way to help them keep track of those and to remind them of certain things they need.

0:08:21 Matthew: It almost sounds like you’re creating a system that might include the idea of gentle nudges or just helping people pay attention to, “Hey, this is the backlog or the expectation of things that need to happen today, this is with whom these things need to happen,” … It’s almost a daily reminder or a task reminder. I don’t want to create words for you, but it enables someone to do well during the day, even though they might be getting tired, and they might overlook something, or they might… It’s almost like a partner through the course of the day, “Let’s get through this together.”

0:09:07 Andrew: Matthew, that’s exactly where we’re headed. We have these awesome super heroes called CNAs, and they’ve been on the front lines, especially through COVID, and for them to show up every day to work and take care of residents is huge. But what a lot of people don’t realize is with COVID, comes new regulations, new policy, new dress code, all these new things that happen. It all piles up onto these people who… They’re people, at the end of the day, they’re not machines, especially loved ones. There’s a lot of pressure for these direct care staff givers to make sure our loved ones, our seniors are taken care of. So as you look at what’s in their toolbox today, it’s very hard because their toolbox is pretty scarce. It’s missing that 7/16 socket, there’s pieces just aren’t there, but the job keeps getting bigger, the roles and expectations.

0:10:28 Andrew: And so we see that, especially in the cognitive fatigue portion, you just keep adding on tasks, “Remember to do this, you have to do that.” How are we setting them up for success? And that’s where In Motion Care looks to come into play, is we want to call it the pit of success, we want to even… We want to make sure that after COVID happens, that we can ensure that there’s the people out there who care about providing care, come into the industry and apply for those jobs. And so without providing them any resources, there’s a huge gap and it’s gonna get worse with the baby boomer generation and things moving forward. So our major focus, is if we can provide information based on their location. That’s one of the big features of our product, is leveraging users’ mobile devices and providing them content where they don’t always have to remember, they don’t have to walk halfway down the hall to look at the tablet, memorize where Karen’s supposed to go, walk 10 doors down and then make sure that they provide that right care. We’re not setting them up for success, so that’s where Mark and I had a passion and created IMC.

0:11:53 Mark: Matthew, there’s another thing that’s a key component because… I like the way you phrase it, it’s a partner for caregivers, and that’s a great part. The other piece, is there’s a lot of very good providers and companies in senior living that have expressly said that they want to be data-driven. And right now, that data either doesn’t exist or it’s incredibly difficult to get. So one of the functions that was created is to provide data. And we’ll use it… We talk about it in a micro and macro framework, but micro is specifically we have data on the care that was provided and when it was provided to Mrs. Smith in room 131. Okay, we know… We’ll have that information at their fingertips.

0:12:51 Mark: But then also just macro information, such as how much time on average does it take to complete a task? How much time on average does it take for caregiver time to spend with each resident in an eight-hour shift or a 24-hour period? Those are data pieces that will help providers make better staffing decisions, help them to staff more efficiently, but also as they look at concentrations of time and how they can prepare their staff better to meet those needs. So there’s both the partner people, which is really important, but also we’re looking at this as, “How do we provide data and information to providers that allow them to make better decisions in how they run their communities, but also how they care for residents?”

0:13:44 Matthew: So it sounds like… You and Andrew both have brought up two things, and I want to make sure I don’t lose them. But Mark, one of the things that I think I’m hearing you say is, data, of course, is very important. Data enables us to learn, to see, to discover patterns, to discover opportunities, for tuning change or otherwise. And I think what I hear you saying is that the system that you guys are working on actually collects data in such a way as to say, “Hey, across this amount of time, across this amount of healthcare workers, on average, this particular service or behavior or activity takes about this long.” And as a result, it sounds like you guys are saying you can take that data and just say, “Here’s an averaged norm, and then these other ideas might be outliers,” and that would give you an opportunity to consider additional training, tuning or tweaking, which is, “Hey, this normally takes seven to 12 minutes to get done for people, on average, it looks like it’s been taking you 20. Teach me, what’s going on. How can we improve? What do we need to change? Is my data wrong,” for example. So you’re using the collection of the data to teach, tune and change.

0:15:14 Mark: Yeah, absolutely. That’s what we see as one very important use of the data, there are others. For example, you use… Well, I’ll just provide another example. Let’s say that the average to do a task is seven to 12 minutes, and we find that Andrew takes 12 minutes to do it and Mark only takes four minutes to do it. “Well, wait a second, Mark. Are you really doing everything you should be doing in that task? So let’s talk, let’s… ” So there’s a piece, not only if you’re, “Hey, we need to improve,” but also to verify that you’re doing things the right way and the way they should be, and you’re not cutting corners. And again, this isn’t… The whole idea is not to… It’s not a gotcha, it is how do we improve efficiency and effectiveness? And if I know, “Wait a second. Okay, I’ve been doing it in half the time because I either forgot how I was supposed to do it or I wasn’t properly trained to begin with,” or whatever, all of a sudden now, the nursing leadership, the supervisor are able to step in. Now, that’s going to improve care. But quite honestly, as a caregiver, I’m gonna be able to feel better because I know now I’ve been properly trained and I know how I should be doing it.

0:16:36 Mark: So there’s this piece that… And it’s a holistic view of, “How do we… ” And if we’re improving care, which again, in the senior care environment… Improving care is a goal of every community, they want the best care possible. So if you can improve that, then you’ll just… You’ll have more satisfied residents, you’ll have staff who are more engaged because they have better tools. One of the things that I talk about all the time, is Argentum did a study in 2017 that said that the senior care industry needed to attract 1.2 million new employees in the next 10 years. That didn’t even take into account any that were leaving, that’s just new employees on top of staff that already existed.

0:17:32 Mark: Well, there’s a dearth of technology in senior care. And my concern is… One of my concerns is if we’re not providing technology and solutions that our younger workforce is expecting, how are we gonna attract those people to senior care? One good example… And again, you can cut me off if I… I get a little bit long-winded and passionate about this. But in many senior care communities right now, when staff change shifts, new staff are handed the care plans on paper of all the residents. That’s oftentimes a 20- or 30-page document. What we’re trying to say is, “Gee, that would be nice to get that in their hands electronically because that’s what the newer workforce is going to expect.”

0:18:29 Matthew: So quality of care, that includes initial training, ongoing training, ongoing improvement, and that’s in the best interest of the quality of the healthcare worker, or provider, or teammate, as well as the person that’s being cared for, loved, engaged, and so forth. So that makes a lot of sense. So let me go back to something Andrew mentioned earlier, which was talking about… It sounded like… And I want you to amplify this a little bit. It sounded like you were saying that we wanted to be efficient when we have the system, which is partnering with the healthcare worker, and we want to understand where are our teammates? What are they working on? What should they be working on? Then of course, adding what Mark said, how is it going in context of what’s the normal average?

0:19:19 Matthew: It sounded like, Andrew, you might be intimating making context-driven partnership recommendations. In other words, the software you’re discussing is saying, “Hey, where is this team member in relation to the building and in relation to the people that need to be cared for? And let’s make recommendations based on where they are, instead of them being put into the situation of popcorning around the building,” and then that probably contributes to the fatigue you were mentioning earlier, Mark. But Andrew, is that what you were saying, which is context-driven recommendations?

0:19:57 Andrew: I’ll expand a little bit on that. So it’s more about geolocation. So what we’re able to do with our solution… It’s a hardware and software solution. And basically, what we’re able to do is geofence key areas within the care community. So for example, all the rooms are broken down into their own locations, then the room can be broken down into a living area, an entry area, a bathroom area. And so what we’re able to do, is based upon location, our goal is to provide information. We want to nudge, we want to provide the proverb of information at your fingertips. At this point, there’s no need to memorize anything. If we know where you are, we can provide you with the context that you need.

0:20:56 Andrew: So basically if you’re a CNA, you walk into a room and you haven’t been there that day, we’re able to say, “Hey, take a look at the care plan for this room.” So automatically, we know that they haven’t been there yet, we can provide them and say, “Hey, look over this, check the box,” and they understand what I’m looking at and the care I’m supposed to provide. And then we know that either [A] they’ve read it and we can hold them accountable for the care, but [B] the biggest thing is they don’t have to pull out that piece of paper, the 20-page packet of care information, figure out what she has, he or she has to do for Mrs. Smith. It’s right there. So nudging, real-time notifications; that’s where we want to go, we want to make it easier for them to have access to the information they need.

0:21:56 Matthew: I like the things that I’m hearing, this sounds like a nice, intelligent approach to how to provide quality care. Now, this is all about quality of care, but it’s also about taking care of the health workers, the health team members at the same time. So you guys have talked about data collection and aggregation, you’ve talked about geofencing, geolocation, you’ve talked about cognitive fatigue, if you will. Basically, you’re talking about a holistic approach which could change an entire shift for an entire team of people, and then all of the shifts thereafter, which is instead of receiving a clipboard with 30 pages on it, and then having to figure it out, and then popcorning around the building, then also wondering, “Hey, where the heck are all my teammates right now,” you’re changing this. It sounds like you’re changing the role of data and software to be something that enables a healthcare worker to go love and engage and care for people, instead of making the healthcare worker collect the data, manage the data, carry it around with them, try and figure it out in real-time and then go do the work. It sounds like you’re… This is a paradigm shift.

0:23:05 Mark: Wow, we should hire you as our marketing person, Matthew. We talk a lot about taking and trying to take a very, what is currently a very reactive environment, and providing tools that allow to be more proactive. It’s providing tools, information, data that enables caregivers to care for residents better, more effectively, more efficiently. And then the results… If I’m an operator, “Yes, resident care is important, but what’s that mean to me?” Well, if you provide better resident care, your scoring is better, your results are better. That leads to better operating efficiency, better profits, all those things. If you’re staffing more efficiently and effectively, there’s a downstream result that is not just, “Oh, this is a really nice thing to do.” “This is a really good business decision because we’re providing better care, our workers are more engaged, our staff has better tools, so they don’t leave and our retention is better.” Those things just multiply on themselves till you talk about what your outcomes are, which our outcomes are improved resident care and should be also, increased operating efficiency, which then leads to better financial results.

0:24:49 Matthew: Alright, I’m loving the story that I’m hearing right now; quality of service, which includes taking care of the healthcare worker as well as the person that’s supposed to be loved to start with. So let me change channels a little bit here, change direction a little bit and just ask you… Andrew, let’s start with you, how did you get here? Tell us a little bit about your journey that led you to care about this, that led you to say, “Hey, not only do I care about this, but I want to start a company and I want to build a product that enables a change.” And how did you get here?

0:25:24 Andrew: How much time do we have? Well, just to first start, did I ever think I was gonna start a company or end up in Iowa? I’m from Maine originally, so going from trees and seafood to wide open cornfields has been… It’s definitely different, let’s put it that way. But coming here… I grew up in a very good, supportive household. I learned that family was important, and my grandparents both had some health issues. One, my grandfather, he lost one leg, then another, and then his life to diabetes, and my grandmother, who is the real inspiration behind that, behind why I’ve come into senior living, she had a struggle that after watching her go through what happened with my grandfather, it just bugged me of, “Why we’re sending our loved ones to care communities, to places, and why do they still get sick?”

0:26:49 Andrew: And so as a kid, watching that, I was wondering, it was like I’d visit… I’d carol… I was in the Boy Scouts, I’d carol at the nursing homes, I was there, owned a flooring… My family owns a flooring store back in Maine, and I have installed flooring in 15, 20 different nursing homes, and so I know the environment. But it wasn’t really until my grandmother, Claire, who went into the care community for some rehab, during her time there, she had a incident with diarrhea that went unnoticed by medical personnel, and my mother was there trying to say, “Hey, look, there’s a problem,” and it ended up getting flushed before anyone saw it, and because no one saw it, they couldn’t treat it. So shortly after, she ended up in the ER with severe dehydration, ’cause that’s what happens when you have diarrhea and you don’t get fluids. And from there, that was the turning point, that was the downfall of her health. She was a two-time cancer survivor and she was just such a strong lady, and to see that something so simple gets missed, it really affected me.

0:28:03 Andrew: So as an engineer, and I guess, from day one, I’ve always been an entrepreneur… I’ve always wanted to solve problems, problem-solver, and basically become an entrepreneur, I knew there was a problem. And so that’s when I reached out and met the rest of the IMC team and Mark and said, “Is there problems here to solve?” And we found one. And so we have a… Came up with a solution so that this doesn’t happen to other grandparents out there. I’m not the only case.

0:28:40 Matthew: Right, that’s a tough story. I’m sorry to hear that. Thanks for sharing that. So a motivator… Not the only motivator for you, but a motivator is, “Hey, I want to make sure that we know the things we need to know, when we need to know it, so we can do what we have to do.” And that sounds consistent with the product you just said you were building through the rest of this podcast so far, so thank you for sharing that. Mark, how did you get here? Why are you doing this? Why are you involved?

0:29:12 Mark: Well, my story is a little bit different. I was an executive at a senior living company for almost 15 years and have been involved within the senior care industry for close to 20 now. So when I left that company, I started my own consulting firm, focusing on management, human resources, consulting. And throughout my experience with the senior living company, I heard from many care providers in our skilled nursing facilities about the issues that they faced. And the issues were just a lot about not knowing, we don’t know, and we just don’t know and we don’t have information, and we… And this was something that was consistent over the 14 years, couple that with the fact that the senior living and senior care industry has traditionally not been on the forefront or very advanced from a technology standpoint. So those were two things that I knew very much as I was a part of this. Also, being a part of that really drove a passion for serving seniors. And so I’m very committed to the industry.

0:30:28 Mark: Fast forward, I’m doing my consulting work. I have a client that is a senior care community and I’m doing work with them, and a couple of the people there start talking about the problems they’re having and, “Oh, we’ve met this engineer who’s really bright and has some great ideas about how we potentially could solve these from a technology standpoint.” I asked the question after they’ve told me about… “Wow, this is really… I think this is great. I think it has the opportunity to significantly change the industry in how care is provided and how workers are cared for and equipped to do their job.” So I asked the question, “What can I do or how could I be involved?” And that led to a few conversations, and the next thing you know, I’ve joined the team. So it’s been… Again, I go back to, I think, the one thing that’s consistent across all the groups on our team, is we have a passion for serving seniors and doing that well, we also all recognize the staff need to be equipped better to do that.

0:31:47 Matthew: So you mentioned that historically in the senior living community, it may not necessarily have been on the forefront of technology adoption, technology utilization. Where do you guys see the senior living industry going in the future in terms of digital transformation? It’s products like the one you’re building or that you’ve built that compose a digital transformation or a paradigm shift for an entire industry. Where do you believe this is going? Where is the industry heading from your perspective in terms of technology?

0:32:21 Mark: I’ll start and then Andrew can add. I’ll just… Based on my experiences, Matthew, I know that it’s an industry that is wanting, is ripe for digital transformation. There are what I’ll call early-adopters, innovators who are out there looking for solutions that can help them provide care and do the work that they do better, more effectively, more efficiently. So I believe the industry is ripe. I know that the discussions are ongoing, I know that the associations are supporting this and putting resources into, “How do you develop this?” So I believe the industry is ripe for digital transformation, part of that is just the right solutions coming along that will help them do their work better.

0:33:21 Andrew: Yeah, and I would add on to that, Mark, we’ve seen some changes, and the biggest thing has been, you see mobile computing devices. So we’ve seen taking the one computer, mount it to the wall in the center of the hallway, which had the mouse and the keyboard, to more of touchscreen kiosks. And really, the most innovation you’ve really seen lately is bringing iPad minis and being able to, for the care communities that can try to afford it, allow the staff member to chart on-the-go. That was a giant leap. Not to downplay it, but the senior living industry has been very behind for probably several decades, where our pilot community, a five-star… One of a dozen of a five-star care communities here in Iowa, it still uses some paper. And you gotta get… Think about that, paper to notify and update care.

0:34:37 Andrew: So Matthew, here is a question, I’ll lay out a scenario: Mrs. Smith, in the morning, alright, she goes and visits therapy and they say, “Hey, you no longer can walk with a gait belt and a walker. Your gait’s a little off, we want to put you in a wheelchair.” Okay, so therapy writes that in the changes. And so how does the CNA on the other side of the building, who has a 20-page paper packet, how does that get updated? What happens is you get this telephone tag of care plan updates and information changes, and I don’t know how well you were at telephone tag, I tried really hard, I was a try-hard kid playing that game, but we all know in reality, if you play it… If it’s played in the right way, it turns into something totally different. And it’s not… Not to joke about it, but care might not get updated. So just being able to get some of the most important up-to-date information into this digital age would be huge.

0:35:52 Matthew: That makes a lot of sense. That’s a good call-out.

0:35:56 Mark: How the cognitive fatigue piece can add to that, is let’s say I come out of that meeting and I’m the charge nurse and it’s my responsibility to tell the CNAs who are working off this change in the care plan, and I walk out of the meeting and somebody grabs me and says, “Oh, Mr. Heston, we’ve got the situation. Let’s go deal with it,” and boom, you go deal with it ’cause that’s what you do as a caregiver. And then all of a sudden, it slips your mind that you were supposed to tell the CNAs about this change in the care plan for Mrs. Smith, and that’s how it often works. It’s not… These things aren’t updated until the end of a shift because those things happen. Well, it would be a lot better if it can just happen in real time and through technology. So that’s just one example, there’s hundreds of others.

0:36:46 Matthew: No, it’s a good call-out. And I’ll abstract out just for a moment, so that nobody in the senior care industry feels like we’re poking on them in particular. My whole career has been in technology and it’s just a fact, the more steps that are involved in getting from A to B, the higher probability of not getting there, or not getting there correctly, or not getting there completely, or some combination therein. Also… So that includes hand-offs, steps, the number of people, all of those things. The longer the distance between A and B, the higher the probability of not making it or not making it well. The other interesting thing that we all know from technology’s standpoint is manual anything for any extended period of time, decreases the probability of predictable, repeatable results every time. And if there are manual steps that are done on a regular basis, we have great people with great minds, great education, great experience, and people still make mistakes, and that’s just a fact. It doesn’t mean people are horrible, people are failing, people should be fired or anything like that. People make mistakes, fact.

0:37:58 Matthew: So if I have manual steps, there may be error. If I have many steps, there may be error. Now, include manual steps, manual everything, and multiple people, and I just have higher probability of combinatorial failure. It’s not a fault of any particular languishing person on the tree, but rather, “Hey, life is hard. And trying to remember 12 steps, and 13 patients, and 30 pages, and a whole shift, and a whole bunch of crazy stuff that you didn’t plan on, life can whoop on you, and it can all happen in one shift.”

0:38:36 Andrew: Well, even more than that ’cause all it takes… Some of the tasks are… At the base of it, there are fundamental tasks, repetitive tasks that need to be done every day, but if there’s a fall or if there’s a new admission or any change, the complex… Yeah, it just goes up. There’s no more habits, there’s no more routines. And then if they get behind, how do you catch up? And so… And that’s a lot of where we’re at, is it goes back to being reactive, something happens, we have to react, and there’s not always a lot of time, information or leadership of how can we micromanage the whole situation.

0:39:23 Matthew: Right on. So love it, so love the things that you guys are talking about so far.

0:39:29 Mark: I’m so glad you brought that up because Andrew referred to caregivers as superheroes early. They really… The dedication and the work and how hard they work is unbelievable in senior care, but yet you make a good point, more and more is asked of them, and more and more of it’s manual… And they’re human beings. And part of this is at some point in time, that just doesn’t work anymore, so how do we find ways to make it easier for them and not harder?

0:40:07 Andrew: Really, why does the qualification have to be memorization to provide care and enjoy providing care and taking care of others? We should make it easier to get these other individuals and have people want to join the industry. You’re in the profession because there’s passion and there’s a reason why you want to take care of someone else and… Go ahead.

0:40:33 Matthew: Well, I was just gonna say, this system that you guys have built, enables the paradigm shift, so we already talked about that, and it enables it by including the idea of, you mentioned mobile phones, you mentioned geofencing, geolocation, you mentioned context-driven reminders or partnership for the healthcare worker, so, “Hey, you’re in this part of the building, you’re by this particular resident or elder that’s in our care, they need these things,” so context-driven. And then from the team leader standpoint, where are the people, what are we all working on? And then real-time data collection and real-time data nudging, and that all but eliminates the end-of-shift paperwork. Hell, that so many people in the healthcare industry are plagued by. So you went in planning for an eight-hour shift, you ended up spending 10 hours there and you still have two hours of paperwork after that, and then you need to be back tomorrow. That’s fatiguing for anybody in any line of work, end of conversation.

0:41:37 Matthew: Now, this data-driven approach that you guys have taken also, though, brings up some interesting privacy, confidentiality, security aspects that senior living, senior care, HIPAA. Okay, fine. Healthcare information, no contest, no surprise. What will be interesting to watch in the senior living industry though is this explosion of data that’s going to happen by creating geofencing, geolocation, by collecting data in each unit, and then in different places inside the units. Now, we have an explosion of data collection that’s far greater than just the number of staff times the number of hours and shifts and clipboards and ink pens. Now, it’s many sensors and many locations collecting very much data all of the time about all of the things.

0:42:27 Matthew: Since the senior living industry has not historically been an industry that was an aggressive, bleeding-edge technology adoption leader, but they’re moving into it and they need to get there, and they will get there, what kinds of interesting data, privacy, confidentiality problems or challenges have you had to solve or do you guys see that need to be solved? It’s not completely on you as a software solution provider to an organization, they have a responsibility to run their business, their enterprise, their framework. But what kinds of things do you guys see, have you had to solve in terms of privacy, confidentiality, security or what are the risks that you see? Teach us a little bit about that.

0:43:12 Mark: I’ll start, and I’m not the tech… Andrew’s much more of a techy guy than I am, but I’ll just provide a couple of perspectives. I see the whole security, privacy piece as a… It’s a nonstarter, you just have to have that going forward. I know… And if people in senior care and senior living don’t think that they ever… Believe they’re immune or whatever, I happen to know a company that I work with that was attacked with ransomware last fall. No protected health information was involved, but they ended up getting locked down from an email file system perspective. And between them and their insurance company, they had to spend a lot of money to get that back. And so I think, to me, it’s a… When you bring that up, that’s just a… It has to be there going forward because there are so many potential ways in which things can go wrong in that area. To me, it’s… You have to start there with everything you build because it can’t be an afterthought.

0:44:31 Matthew: That makes sense, that makes sense. You’re right, it cannot be an afterthought, it needs to be by design. Andrew, what are your thoughts, good sir?

0:44:41 Andrew: You’re right, there’s a ton of data and there are an infinite amount of combinations that you can try to analyze it. Just to give you an example, so one of our badges gets five data points, is five XY coordinates a second. So you have a community of 100, or 200, or when you do a whole care community or complex, a couple hundred tags, five samples a second, gonna do that for a year, a couple of years, that’s a lot of data.

0:45:23 Matthew: It’s a lot of data. It’s a lot of data volume, data to store, to collect, but it’s a lot of transmission volume as well, so…

0:45:33 Andrew: Oh, huge, huge transmission volume. And so we do… We take care of some of that by trying to process it on a local computer first. So we try to analyze and do some edge computing locally where if we need a real-time notification of something that’s happening within the care community, like the two-hour rounding report, some of that we can handle locally. But once you start sending data to the cloud, you start opening up yourself for some penetration points, you have some areas where people can try to throw out a net and try to catch some of your data. So from a startup perspective, we’re taking data, the design of our backend, how we’re going manage the data, who’s storing it, how is it being handled on the cloud, how are we integrating with other companies, the HR platforms. We need to think from the beginning, as we’re developing and building our platform to make it scalable, that’s something that we’re taking into consideration early because it’s trust for us. As we go to a care community and as we build out the system and we show what value we can offer, this industry is gonna rely on trust, trust and transparency.

0:47:09 Matthew: There’s an interesting twist to this as well, when companies like yours are building technology and you know you need to do security and privacy, and confidentiality, all the things, and we assume HIPAA and all of that. There’s an interesting over layer which is happening now as well, which is, for example, when one of your clients ends up being a multi-state organization, and each of those states have their own privacy laws on top of HIPAA, it starts adding this amazing, amazing complexity, and all you can do is smile and say, “Yes, sir/Yes, ma’am, let’s go get the work done.” But if you have one client and they’re in multiple states, and they have a privacy law per state, there’s a little bit of extra work to do.

0:47:55 Mark: And thank goodness, that’s why there’s people in companies like yours, Matthew, that can provide organizations like ours support for that. Because you’re right. You have to be concerned with HIPAA or you have to be concerned with this reg. There’s a multitude of layers, and really, I think it’s inherent upon finding the right partners who understand that and get that and can help you build the technology that’s compliant in all those areas.

0:48:26 Matthew: So teach us, where are you in your product life cycle right now? Are you already doing beta or are you already in market? Where are you in relation to where you want to be? People who are listening to this who are in leadership roles at organizations at this point, are thinking, “I don’t know what to do with this stuff,” or, “Hey, I need to talk to these guys because I’m interested in learning.” So where are you?

0:48:47 Andrew: Or they could still be confused about what we do, you never know.

0:48:51 Matthew: Well, it happens all the time.

0:48:54 Mark: So I’ll take this and Andrew, feel free to jump in. We are, right now, in that pilot stage where we’re testing the expandability to cover… We’ve done the proof of concept, it works. We’re doing a pilot, we are adding an additional pilot site in early 2021. And then right now, we’re looking for other early-adopters to help us ’cause there’s things that we’re trying to develop on scalability and all of that. So we are just starting the process of exploring other opportunities to expand that with the idea that we have… And we’re gonna take a phased approach on features rolling out, but that we have a fully functioning… All or most features rolled out by the end of 2021. Early 2021, we’re gonna have a commercially available product that has some of the functionality, but not all the functionality, if that helps and makes sense. Andrew, add anything you’d like to that.

0:49:58 Andrew: Yeah, well, from… To use the startup speak, we’re developing our MVP, the Minimal Viable Product, what can we deliver to care communities today that can make a difference. So as a startup, we don’t do this for free. We have to… You’ve seen Shark Tank and the whole old nine yards. So we have to raise a little bit of money, we have to build the team and build the product and make sure we’re not having feature creep, or… Mark, I really think we could benefit from a pinball machine, “Can I get it?” No. So where we’re at today, is we’re really focusing on the first phase, which is the data. So as Mark said, we’ve done something that it seems pretty trivial, but a lot of people… There’s a name for it called customer discovery. And more or less, it’s an interview, kinda how you’re interviewing us, we go out and we try to talk to a dozen or two dozen, so care communities, and to figure out, “Are you guys jiving with us for the problem? Does this make sense?”

0:51:13 Andrew: And so after doing those interviews and saying, “Okay, what value can we give them early,” we figured out we can do it with data, so we know that these care communities don’t have data. And so what we’re doing right now as our initial phase, is we’re helping with potential complaint reports, we’re helping with an early concept of contact tracing. So we’re doing some… A little bit of the framework and R&D right now of our product. But as Mark said, in 2021, we look to hopefully hand off something… A feature set that has the automated two-hour rounding reports, some activity reports that management can pull and trying to make some real decisions. And one of the big things is we’re trying to look to also see how we can improve staffing methods by looking at resource allocation. So we’re very excited to try to get that to push, but as with startups, we have to raise some of the capital and we have to move forward. So it’s a very exciting process trying to say, “Wow, this innovation, this concept, how fast can we build it? It’s so great,” but then on the other side is, “We need to focus to make sure that we don’t lose the quality of our product and we don’t lose focus of our mission.”

0:52:41 Matthew: That’s good. So you’re actually working with one or more client partners right now, it sounds like, exploring, discussing, testing, validating. And this is a classic problem for all companies, which is: You only have 10 bucks in your pocket, you have 50 people, you told them all you’d buy coffee, how are you gonna spend that 10 bucks? And so the reality, is day one, that MVP, the Minimum Viable Product, doesn’t mean it’s a non-revenue generating, non-useful piece of rubbish that’s gonna be thrown away. It actually means, “I have $10 and I’m going to be ridiculously shrewd about how I spend that $10, then that means if there’s 100 things I need to build, I want to build them. But today, we’re going live with the 20 most important features, and that’s how we’re going to go hot on the first day.” And it sounds like you guys are at client sites actually gathering or validating and testing hard data, it’s real life stuff. So you’re not just making the stuff up in the vacuum and saying, “Pretty sure I’m smart, pretty sure I got a good idea.” This is, “We’re gonna work, just trust me. You have data.”

0:53:53 Andrew: We have data during COVID, it’s battle-tested. I’ll tell you what, as a startup going through this time, not being able to get inside the care community, not being able to check and update our equipment and having to work with their staff on the inside has been awesome. We’re so lucky to have such a great early-adopter. They’re bored and everything, they want to see the industry change, they want to improve metrics and resident care and satisfaction. So it’s been great for us to work with that, and it’s good for them to see, “How can this help another care community like us? What is the basic… What is the Toyota version that’ll get me from point A to point B that can make an impact now?” And it’s… If it’s putting a… Taking a piece of plywood and throwing four caster wheels on it, so I can roll down the hill faster, then that’s… It’s beneficial.

0:55:00 Andrew: And so we have to start early, and so we’re gonna work with great early-adopters that say… Who can help guide us and help provide value to make sure we’re answering the question, solving the problem. It’s not fictitious for us, we need to focus and work with them. ‘Cause I’m an engineer, I have tons of ideas, but when I go and talk to an executive director, or an administrator, or a director of nursing, and we start talking about their problems, resource allocation, do they even know how much money is being spent on this or that? It starts to become a reality. And so it’s going to be a slow driving this to market, but that’s why I say it’s trust and transparency. Being able to provide and show that value, people will follow.

0:55:52 Matthew: No, that’s a good call-out. That’s really good. And so there’s an interesting conundrum many companies struggle with, which is, “Hey, we bought this software or system, it doesn’t really meet all of my needs, I’m happy a lot of the time, I’m unhappy a whole bunch of the time,” and they complain about it as if, “Hey, this was kind of a good purchase, but not so much.” Alternatively, you guys are offering a paradigm which many startups like to offer too, which is, “Hey, we will partner with you. Give us real data, we will give you real solutions, and together we’ll build something that actually solves your problems,” but that takes time also. So you’re giving people alternative. Instead of just buying some commercial off-the-shelf thing and then having to live with it, you’re saying, “Hey, come let us live with you. We’ll collect the data, we’ll do the work, we’ll define the system and build the system in a way that works for you.” That’s a really good alternative, that’s a good call-out. Well done.

0:56:49 Mark: One of the real advantages we have, is our founding team has over 75 years collective experience in senior living. We weren’t a technology company going out looking for a problem, we knew there were problems and we’re trying to use technology to solve those and identify and help them solve those problems. It’s not, “We’re a solution looking for a problem.” We know what the problems are, and we’re trying to develop solutions that will help them, and it’s going to evolve. And one thing I just, I want to tell you before we wrap up, Matthew, is what’s going to help with the digital transformation, people like you who are understanding no technology in the industry and are driving the conversation, and I know you have a passion for seniors and how we can improve senior care. But that’s really important, is driving the conversation. So more people are thinking about this and considering how we can do it because it has to be done, but part of it is, is just finding the right solutions and having that discussion and driving it, so that really smart people like you who know technology can say, “Hey, this is part of the solve.”

0:58:09 Matthew: Okay, alright. Andrew, also?

0:58:11 Andrew: I want to re-touch upon that. People… You hit it right on the head. People sit in their jobs and they’re just saying, “I wish we could do more,” or, “This is stupid, inefficient. How can we make this better?” And we know things are going to get worse. Today we have 34 million baby boomers retired by 2025, that’s gonna almost double to 65 million. So this increase on the demand for the healthcare industry is… It’s coming. And again, going back to the digital age, “How we’re gonna digitalize this, how do we see information,” it’s transforming, but we… And I think that’s why we’re going to be, not to toot our own horn, pretty successful is, “Hey, I’d like a straw. I got this cup, I wish there was a better way where someone made a straw.” Well, you said, “Hey, Andrew, you want to make a straw,” and I create you one that’s straight, nice, it’s a beautiful-looking straw, and you said, “Well, I wanted it to bend.” For us, that’s where our founding team, almost 80 years of experience in senior living, we have such a great breadth of knowledge, and passion that we’re going to be resilient and we’re going to keep working at it.

1:00:01 Matthew: Right on. That’s cool. Thank you very much, guys. So before we take off, is there anything else that you wish I had asked, or you wanted to bring up, or you’d like to touch on again, just some parting thoughts for us before we close this down?

1:00:17 Mark: I’ll just say, again, thank you for the opportunity. We’re very excited, and thank you for driving the conversation, giving us the opportunity. And we’re really excited about where we’re headed and really making a positive impact in an industry that we’ve been involved in a long time, so thank you.

1:00:35 Matthew: Andrew?

1:00:38 Andrew: Well, I want you to know we’re not leaving here without keeping data security in mind, and thank you for the opportunity. We’re very excited, these are very hard times. There’s a lot of stories, there’s a lot of bad press, but we’re trying to change that. So it’s one step at a time, one day at a time. We just can’t lose focus, so thank you very much.

1:01:16 Matthew: I loved hearing your stories about how you got here, I love hearing about the product that you have built and continue to evolve and build, I love the fact that you’re looking to change the paradigm. You’re not looking to take what exists and tweak it, you’re looking to completely turn it upside-down, so that we could look at things in a different way to enable healthcare providers to actually use all of their time and energy to love and care for people, instead of love and care for their keyboard, their shift, their clipboard, their data collection, their hand-offs. These people are going to school so that they can love people, not computers and not clipboards, and you guys are seeking to change that whole thing. I think that that is outstanding. I look forward to keeping in touch again. Thank you very much, both of you, and I hope you both have a great day.