Home Health 360: Presented By AlayaCare

Bridging the Healthcare Gap with Dave Marchand

• Erin Vallier • Season 1 • Episode 77

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Dave Marchand reveals how New Day Healthcare's Carelytics platform bridges critical gaps in the traditional home healthcare delivery model by unifying patient data across service lines. Through advanced analytics and proactive interventions, this approach transforms care delivery from reactive, reimbursement-driven episodes to comprehensive patient journeys that identify early decline indicators and prevent catastrophic health events.

• The traditional healthcare model operates reactively, with treatment only beginning after a significant decline
• The Carelytics platform connects data across personal care, home health, and hospice service lines
• Care gap programs focus on specific patient populations and trigger appropriate early interventions
• Unified healthcare data model creates a complete "patient journey" view spanning years, not just visits
• New acquisitions maintain their existing platforms while gaining immediate access to innovation
• AI technology enables the identification of complex patterns and orchestrates appropriate interventions
• Single service providers can develop similar approaches through strategic partnerships

Episode Resources:

If you liked this episode and want to learn more about all things home-based care, you can explore all our episodes at alayacare.com/homehealth360.

Dave Marchand:

We look at patients in terms of visits and episodes right, that's it, that's what we get reimbursed for, that's how we look at them over time. But when you look at someone over the years and they go into and out of service lines, into and out of systems, having all of that into a single data model allows us to do things we were never able to do before Look for patterns in that data, look for other indicators that we would have never seen because we didn't see all that data in one place, and that when we look at it and we combine what's traditionally in those service lines, like personal care or home health or hospice, with the data that's in these care gaps that we're going after, we call that the patient journey. What are they doing, how are they doing it? And can we look at all of that data and look for other patterns, look for those gaps and see what we can do to keep them healthier and at home?

Erin Vallier:

Welcome to another episode of the Home Health 360 podcast, where we speak to home-based care professionals from around the globe. I'm your host, Erin Vallier, and today I am joined by Dave Marchand. With a career spanning almost 40 years, dave has successfully leveraged state-of-the-art technology to drive enterprise innovation transformation. State-of-the-art technology to drive enterprise innovation, transformation and process optimization across several industries globally, with the last 25 years focused on all sectors of healthcare and the last 15 years specifically focused on the home health sector. Dave is currently the Chief Information Officer at New Day Healthcare and he holds a bachelor's in science and electrical engineering from the University of Notre Dame. Welcome to the show, dave.

Dave Marchand:

Well, thank you for having me, and it's a pleasure to be here.

Erin Vallier:

I am super excited to have you on the show. I know you are wanting to talk about addressing gaps in care and the home health delivery model and with your resume, I'm sure you have seen the gamut of how things can fall through the cracks. People can fall through the cracks, so I'm very interested to hear your perspective. So I'll start with a question what do you see as the challenges with the current home healthcare delivery model?

Dave Marchand:

And if you look at our delivery model, it's really driven by payers, whether that be Medicare, medicaid, commercial payers and their reimbursement models. What are they willing to reimburse for? And typically those are divided into very discrete service lines, from personal care, home health and hospice.

Erin Vallier:

Now, is that a bad thing?

Dave Marchand:

I don't know if it's a bad thing, but reimbursement models by their very nature are reactive.

Erin Vallier:

after the fact After the fact, and why would that be an issue?

Dave Marchand:

If you look at someone's health care or health, you can see it progress over time and it starts to decline and it gets worse over time. And if you wait till the point where it's bad enough that you are now going to reimburse for it, you've waited and you've delayed the interventions we can do, and that increases the overall cost anxiety on the patients and everything else. And so can we get to a more proactive model.

Erin Vallier:

It sounds like we should think about it. But this reactive model that you're speaking of, isn't this the model that the healthcare industry has pretty much followed for decades?

Dave Marchand:

Yes, it has, erin, and that's what we think is one of the problems. If you look between these traditional service lines, there are gaps, what we call care gaps, and taking care of the patient during these care gaps is really what's needed to keep them healthier and deliver fast intervention and keeping them at home in a care setting that they're more comfortable with.

Erin Vallier:

Gotcha. So care gaps, let's dive in a little bit there. So I imagine the current payer-driven model they're not going to be proactive about paying for some of this stuff. I see that as potentially an issue with filling the care gap, like providing care in that space. Can you talk to me a little bit about that?

Dave Marchand:

Yeah, absolutely. Probably. The best way, Erin, is to look at an example. Imagine we have a patient who's receiving personal care services and our caregiver notices that patient is all of a sudden having a hard time with balance or walking or to decline, and would cause a clinician to talk to that patient and possibly proactively bring them a physical therapist or an occupational therapist, with the whole goal of reducing a fall or fall risk. Now when you look at that patient population, he realized they're seniors with multiple chronic conditions. When they fall it's usually a pretty catastrophic event. They usually break something, they go into the hospital and the cost and the impact on the patient is so much greater in that reactive model than it would be in a proactive model where we're looking at early indicators and trying to intervene as quickly as we possibly can.

Erin Vallier:

Which seems like the better approach. Let's prevent the broken hip and all of the hospital bills and the trauma to this person. It's potentially life-threatening as well, as we age to break things like that, so it seems like the reimbursement models need to catch up. So I'm curious how are you, at New Day Healthcare, addressing these care gaps?

Dave Marchand:

We focused on building what we call Carelytics. It's our advanced technology platform that specifically focuses on these various care gaps that are out there and what we can do to address those care gaps.

Erin Vallier:

So how does Carelytics address those care gaps?

Dave Marchand:

In two ways. One is, if you look at it, our Carelytics platform. The basis for that is a unified healthcare data model and when you look across multiple service lines, across multiple years and multiple systems, you never really get a single view of that patient. It's scattered among all these systems. Bringing all that data into that unified data model gives us something that we can start to work with. And then, on top of that right, we have our programs that are focused on a very specific care gap and what we can do to address that specific care gap, and we can add multiple programs to address different care gaps over time.

Erin Vallier:

Gotcha so many questions. So you have this layer of IT on top of all your platforms, pulling out the structured and unstructured data and pulling it into one unified record to show the full spectrum of care being provided and what could potentially be flagged as a decline.

Dave Marchand:

Yes, it's the looking for the early indicators of the decline, but it's also trying to keep them healthy, maybe through education or anything else. The two parts right. What can we do to keep them from declining? But then how do we notice when they are really first starting to decline, and can we intervene then, versus waiting till later on?

Erin Vallier:

Can you give me an example of a care gap program?

Dave Marchand:

Yeah, absolutely. We talked a little bit before about the full risk, but one of the best ones is probably our CDM program. And if you look at seniors who have multiple chronic conditions and their health is starting to decline, it will decline to a point where they need hospice care. But a lot of times what we first try to do is establish goals that we're going to improve their life, and whether those are physical goals, spiritual goals or social goals, can we do things to impact that, that they can do stuff like go out on a date for the first time in six months Maybe that's through care coordination with all of their physicians or whatever we can do or bringing them transportation that they can get to it.

Dave Marchand:

How do we focus on that? But at the same time, we know that no matter what we do, their health is going to continue to decline over time. And if we can notice that point when their health has declined to a point that they need hospice care, can we deliver hospice care as quickly as possible? Out of all of our service lines, Erin, the one that people deserve to have as quickly as they can is hospice care. At the end of life, we need as much care as we can possibly get.

Erin Vallier:

Absolutely much care as we can possibly get. Absolutely what a cool program finding ways to give somebody support as they're slowly declining. Where, as you have aptly stated, is a gap in care is where we typically just discharge somebody and see them when they come back after a catastrophic event. I'm curious how do you go about defining a care gap program? What's involved?

Dave Marchand:

I'll try to simplify it but hopefully not oversimplify it. There's really four parts or a pattern that we go after, and the first one is the population we want to focus on. That population could be anything from everyone in a specific service line in a given state with a certain demographic, Even maybe all the members that belong to a specific payer, right? What's the population we want to focus on, what's the data we're interested in? And whether that data comes from our database, whether it comes from a clinical observation, whether it comes from our customer service team calling and talking to the patient or their caregivers, what's the data that we're interested in? And then what are the triggers? That says, if the data falls into one of these states, this is one of those early indicators. And then, ultimately, what's the action we want to take? Is it refer them to another service line? Are we clinically talk to them and see what we need to do? Or some combination of it?

Dave Marchand:

Bob, they all follow those patterns and so, really, what we want to do is say what are the things we're really focused on. Over time and this is the interesting thing as we built this, we've expanded what we think of the care gaps from when a patient first becomes a patient and someone calls up and says there's something wrong with my mom and dad. I don't know what it is and I don't know what they need. And I don't know what they need and how can we guide them among all the things that they're eligible for and what's the best service for them at that time. And then, after we discharge people right, normally they fall off the radar screen. Can we keep following up with them and keep seeing how they're doing and if their health stress is declining, can we help them again more proactively than reactively?

Erin Vallier:

I love that. Can you tell me a little bit more about this unified healthcare data model and the role that that plays specifically in developing these programs?

Dave Marchand:

The hard part with this is, if you think, in our traditional model, we look at patients in terms of visits and episodes, right, that's it, that's what we get reimbursed for, that's how we look at them over time.

Dave Marchand:

But when you look at someone over the years and they go into and out of service lines, into and out of systems, having all of that into a single data model allows us to do things we were never able to do before Look for patterns in that data, look for other indicators that we would have never seen because we didn't see all that data in one place, and that when we look at it and we combine what's traditionally in those service lines, like personal care, home health or hospice, with the data that's in these care gaps that we're going after, we call that the patient journey. Right, we look at it in terms of years, not visits. Sometimes you'll hear a call to launch an attitudinal health record, but we like the patient journey right. What are they doing? How are they doing it? And can we look at all of that data and look for other patterns, look for those gaps and see what we can do to keep them healthier and at home?

Erin Vallier:

Now, why would you go about building your own unified healthcare data model? Why wouldn't you just find a technology vendor or a partner? Because you guys acquire different businesses and I understand you allow them to stay on their platform. So talk to me a little bit about that. This is sort of a different approach.

Dave Marchand:

It is a different approach and, having done this for years and converting everyone to a single platform, there was a lot of business disruption with it and when you look at multiple service lines and multiple states, there's really no one vendor that does a great job with all of that and has a platform that allows us to put innovation on top of it really quickly right.

Dave Marchand:

So we needed that flexibility to focus on these gaps, and it's kind of unfair to have a vendor who has an existing client base and they're trying to go after the market in a certain way to do everything that we want at New Day right. So we wanted that layer in between that we can build innovation. We could take advantage of whatever our partners had. If they had a great hospitalization risk score, could we take that into effect when we're looking at reducing hospitalizations. But really, what we wanted to also do is enable our business not to go through that disruption. So, as you said, new Day continues to acquire other companies, and one of the things that was so important to me was that I didn't force our operators to have to convert a new acquisition to a single platform. If I could just map that system into our unified data model and instantly they got all the innovation we've built on top of that. That's a faster way to innovation and it lowers the overall cost of innovation, which we think is probably a better model going forward.

Erin Vallier:

I think you may have just answered. My next question was like how specifically does your Carelytics platform give you the ability to leave those acquisitions on their platform? So, essentially, it's extracting the data that you need to build that unified data model. Is that correct?

Dave Marchand:

It does, erin. It's the how can we map the view of patient inside one system into this unified model? And I know it sounds simple. It's not usually that way. You know this. No matter what we do with any system, it's how people put the data in. So a lot of times we have to do some translation to do that mapping, but that is so much simpler than converting everyone over into one, changing how everyone's used to doing things. It makes it a lot simpler and easier to acquire new companies and bring all this innovation to them quickly and really it's really from the perspective of the patients. How can we start serv them, not requiring you have to be on this specific platform in order to make that happen. We just felt that gave us a little bit more flexibility as a company and it was probably better for looking at the patients and what we can do and the speed to which we can bring new solutions to them.

Erin Vallier:

Yeah, time to value there, and my brain wants to just dive into oh, do you need open APIs to pull this data? All the technology questions. But I'm not going to bore the listeners with that. I do want to talk a little bit more about the Carelytics platform. It sounds way more than just a technology platform. There's a lot of moving parts there.

Dave Marchand:

It is Anything else and I know it sounds cliche, but you always hear this it's people processing technology and it really is. The technology platform and this unified data model gives us the ability to look at data and look at patients in a way we never have. But our programs are dependent on either our clinicians interacting with the patients, our customer service reps calling up and talking to them and interacting with them in some way, and then the processes we use to say oh, that was a trigger. What do we do in response to that to address these care gaps that people process in technology, where the technology becomes the enabler to build all of these other programs on top of you still need that human touch to identify really what the need is when you have people calling in and looking through the unstructured and structured data correct.

Dave Marchand:

Gotcha.

Erin Vallier:

So I know there's a lot of talk and there's a lot of hype actually about AI. How does that fit into your strategy with Carelytics?

Dave Marchand:

It's like any new technology, right? I started doing AI, Erin, in the 1980s and back then Dating yourself. I know I am, I know, but back then the hype exceeded the ability, even though a lot of the techniques are still the same. But what has changed is our underlying computing power, just our hardware platforms and everything. So now we're at the point where there is still a lot of hype and there's still a lot of people who say they have an AI driven system when they don't. Still a lot of people who say they have an AI driven system when they don't.

Dave Marchand:

But we're at the point now with this technology where it is truly transformative and can we fundamentally change how we're doing what we do and, from a healthcare perspective, how can we do it to improve how we treat our patients? And there are really two aspects to it. One is generative AI, which is for the first time. We can take a software and if it knows A and B, it can infer C on its own. Before we always had to train it and now they can look at enough data and train it and ensure what's next. And that is so important because the complexity and the volume of what they can look at greatly exceeds the capability of any individual.

Dave Marchand:

And then, corresponding to that, as you hear, it called agent-based AI, which is really around complex patterns that we want to do if we see a trigger, an event. Complex patterns that we want to do if we see a trigger, an event. We want to process things in a very complex way. Can these agents take care of that for us? And you see them now, with personal shoppers and all this other stuff, and they perform a set of very complex tasks orchestrated, and those two technologies alone. Can they be disruptive to our industry?

Erin Vallier:

technologies alone. Can they be disruptive to our industry? Oh, I think they can. How do you envision using it in the platform itself? I'm sure you have ideas.

Dave Marchand:

Absolutely, and it goes back to that unified data model.

Dave Marchand:

When we can bring all of that data on a patient, and whether this is data we pull from other sources like pharmacy data or anything else, can we bring it all together? Can the generative AI now start to look for unlocking complex patterns we could never see before and identifying more cure gap solutions than we could right? Can it start to look at stuff almost exponentially that we're looking at linearly today? It's exciting because I would love to be able to tell you I know everything it was about to do, but I think we're seeing that this technology is creating stuff that we even didn't think it could do, but a lot of it is the data that we're training it on, and so, for us, we're feeding our data into it, looking for these other patterns that have the biggest impact on our patients' lives, and then, once we discover those patterns, could we use something like the agent-based AI to then process and do a whole lot of things for us so we can do more for those patients in a shorter period of time, address more care gaps, and this really does move us away from a reimbursement model towards a patient-centric care delivery model.

Erin Vallier:

Yeah, that's the way it should be and it's super exciting. It's sci-fi. I feel like I'm stuck in the future. Wow, I'm just super impressed with what you have developed, and I'm sure that our listeners would love to know if I don't have a platform as robust and complex as this to layer on top of even my one single EMR, how can they think about identifying where the gaps are in care? It seems like it might be difficult, like you might actually need to have a tech stack. What are your thoughts there?

Dave Marchand:

That's a great question and, like any other great question, the answer is usually well, it depends, but I think what you can do is there's some patterns that are simple. If you've got one service line, you can look at the things that's going to drive your patients into those services and can you do it more proactively. So there are more simple patterns based upon one service line. However, if you've got multiple service lines, you will look at patterns that span years and all of this other data. That technology platform is the enabler to do that. It's what we can build the AI on top of, the enabler to do that. It's what we can build the AI on top of. We can build just other patterns and we can build the ability to look at these programs and execute more of them so we can fill more and more of these care gaps.

Erin Vallier:

So what I'm hearing you say is, if you're a single service line, maybe look at something as simple as your quality assurance program and see where you fall short and get to a root cause analysis there and maybe build a program around where you're not holes in your care, maybe people are falling more frequently. But if you have multiple lines of care, that becomes way too complex with a good technology stack.

Dave Marchand:

It does. And if you're a single service line, maybe one of the solutions is partnering with somebody who has another service line. Because maybe one of the solutions is partnering with somebody who has another service line because a lot of these care gaps fall between two service lines and they really help move the patients proactively from one to the other. And if you get a single service line, you're trying to figure out how to move your patients and give them better care. So it's moving it into your service line. But it may also look for patterns that they need other care and maybe that is accomplished by partners.

Erin Vallier:

At that point, yeah, that makes sense. Well, I really do appreciate you coming on the show, Dave, and sharing your wisdom and also giving some people who are not as technologically advanced as New Day some ideas to identify their own care gap programs. Such a pleasure speaking with you.

Dave Marchand:

Erin always a pleasure, and you and I have known each other for a while and they were really excited about what we can do to keep improving patient care and to really move it back to a patient-centric delivery model. So thank you so much for having me on today.

Erin Vallier:

You're so welcome and I can't wait to see what you guys are going to accomplish in 2025 and beyond.

Dave Marchand:

Excellent.

Erin Vallier:

Home Help 360 is presented by AlayaCare and hosted by Erin Vallier. First, we want to thank our amazing guests and listeners. Second, new episodes air every month, so be sure to subscribe today so you don't miss an episode. And, last but not least, if you like this episode and want to learn more about all things home-based care, you can explore all of our episodes at AlayaCare. com, slash, homehealth360 or visit us on your favorite podcast platform.