This article is sponsored by Element5. In this Voices interview, Home Health Care News sits down with Joe Randesi, Co-Founder & CEO at Element5, to learn how his organization is helping home-based care organizations automate cumbersome administrative processes. He explains how automation can help providers operate more efficiently so they can focus on delivering quality care and improving outcomes.
Home Health Care News: What career experiences do you most draw from in your role today?
Joe Randesi: I co-founded a home care and hospice EHR startup in 2007, DeVero, and ran that business for 10 years as head of product, ending my tenure as CEO and taking them through an acquisition in 2017. That positioned me well for the next chapter in my life for a couple of reasons. One was just understanding the market. I’ve now been in this market for 15 years, and in building an EHR, I came to understand the clients and other pieces that make up the market.
In this role, I also learned about the operations of home care and hospice providers, and understood what was required for them to deliver care and run the business. It positioned me well to bring automation to the market.
Tell us the story of Element5. What did you see in the market that led you to launch the company?
Randesi: In my tenure running DeVero, I saw the unbelievable amount of manual, cumbersome processes that exist within these operations — repetitive tasks that are required to get their work done. These inefficiencies are derived from many external factors such as the burden of complying with larger health systems, compliance, regulatory and payer entities. As a result, providers are forced to have manual processes within and between existing vendor solutions.
I know and appreciate the value of the existing systems in place, like from the EHR companies. I was one of them. But there are automation opportunities outside their core domain that they will never solve. That sparked the idea to start Element5 and focus fully on automation as a service for post-acute care.
You recently raised $15 million in Series A funding. What does that funding allow E5 to do, and how will it enable the company to grow?
Randesi: The funding allows Element5 to dedicate more time and energy to this market. We are an intentional vertical play, focusing 100% on the post-acute market. It also allows us to go faster and offer more direct value to this community. We know this is a target-rich environment for automation opportunities. With more funding, we can proactively attack more pain points. We can build more robust automations for our clients.
We know that the more workflow automation we have to offer, the more the market’s going to benefit. They’re going to elevate their staff because of automation, and their workforce will be able to spend more time focusing on the delivery of care and improving outcomes. Element5 can take care of all of those redundant administrative processes in between.
What are the most important workflow areas home health organizations should automate?
Randesi: Focus on anything administrative in nature that’s repetitive and has volume. It doesn’t make sense to automate something that’s highly subjective and doesn’t have a pattern. The word volume is there because our strategy and our goal is to price our workflow automations delivering direct ROI.
We will come in and say, “Look, you’re doing process A to B right now and it’s costing you X. If you automate it with Element5 it will cost you something less than X, and we will deliver direct ROI back to you.” That’s where the volume comes into play. We try to target those larger pain points.
A good example of this is authorizations. Typically, providers have numerous FTEs handling the administrative side of authorizations. It’s extremely labor-intensive and mostly repetitive. If you have a payer on one side and the EHR on the other, you probably have FTEs going into your EHR, extracting information, looking at it, going into the payer side, plugging in that same information, waiting for a response and moving the response from the payer side back to the EHR. That workflow is ripe for automation, and it will deliver direct ROI.
Element5 has a workflow automation-as-a-service strategy. We will understand that workflow, we will deploy the product, and we will start to act as if we are an extension of their human workforce. Our workflow automation product will start processing the exact steps to deliver the same outcomes as your current staff and eliminate that repetitive workflow from your existing team. We sell our product on a workflow by workflow basis, and that workflow will automate a process and deliver direct ROI.
Another strong example is compliance and audit checklists. Almost every single provider, regardless of the systems they use, uses external checklists before they send claims out. Typically, they might audit 10%, looking at maybe 10, 20, 30 data points within a chart or claim and checking the same 30 things every single time.
There’s no reason why they can’t leverage automation to perform those checks. Instead of doing 10% of your charts, why not leverage the automation to do 100% of your charts?”
Give me your top three areas of workflow automation for home health agencies.
Randesi: Authorizations, compliance and audit checklists, and connecting systems: Those are the three big ones. There’s a flavor of connecting systems in the authorization world, but there’s a lot of examples where you have to connect your EHR to system A, B, or C to keep it up to date or process something. People are using Element5 for that connection when traditional connection methods like APIs don’t exist.
What are some of the measurable outcomes that home health agencies can witness through automation?
Randesi: Direct ROI is really important, but I think there’s almost more value in the indirect ROI. It’s harder to measure, but the automation is built to perform on par with your top-performing staff member 100% of the time. What you get from that is consistency. Our automations never take breaks and are always there when you need them.
We process records faster than anyone can with a human team, so your timeliness increases. We can also improve cash flow and accuracy. Again, we target logic-based workflows. We are not going in there to figure out how to care or document care for a patient; we are targeting administrative, logic-based workflows. Our accuracy is extremely high because we don’t make mistakes if we write that code right.
This equates to a fully scalable digital workforce. There’s no onboarding, no offboarding and no tribal knowledge you can’t unlock. When a key employee leaves a company, the company is in a really difficult position because they have to extract all that knowledge. When you automate some of these processes using our technology, you eliminate that risk.
How do you see work changing within home health agencies in the near future?
Randesi: I think providers are going to become more reliant on technology. We see what’s happening in the space, and time and time again we hear that revenue is not keeping up with expenses. People cannot continue to throw bodies at new regulations and new requirements. I think providers absolutely have to become more technology-focused to survive, and Element5 is revolutionizing how work gets done within these operations.
Our company mission is to have a direct impact on the staffing crisis in post-acute care, improve employee satisfaction and allow providers to focus more on their core mission: delivering quality care and improving outcomes. We want to partner with our clients and say, “We can take care of the administrative overhead. We can allow your current workforce to elevate and focus on why you’re in business.”
Without technology like Element5, it’s going to be difficult to keep up with the demand that the market puts on these providers to get their work done or work processed.
Coming into this year, no one knew fully what to expect in the home-based care industry. What is the biggest surprise this year, and what impact will that surprise have in 2022?
Randesi: To me, this impact and these pain points are kind of the same year over year. The biggest surprise for me was the true burden of regulatory compliance. At Element5, I’ve had an opportunity to dive in with our clients, and the amount of pain that they go through with regulatory alone is unbelievable to me. It’s only getting worse.
For example, Review Choice Demonstration continues to expand throughout the country. The states that have it today had a staff supporting their census. All of a sudden, a new, government-mandated requirement is introduced for them to satisfy Review Choice Demonstration. That’s just added work for that staff. It’s hard as a business to say, “You have to do more than you did yesterday.” And these are common scenarios we witness everyday that have tremendous potential to be automated.
I was also surprised to see how much regulatory compliance overhead our clients have to deal with. It continues to grow, and we know it won’t stop. There are new rules every year and this burden is going to get larger and larger.