Transcending Home Care: AI and Change Management

Courtney (0:00 - 0:26)
And so the Beverly Challenge also becomes a workforce retention strategy because we don’t want to lose the Beverlys. We don’t want to burn them out, make them feel left behind, because they carry so much organizational and institutional knowledge that you just can’t recruit back its equivalent. So hospices can start thinking about, and home-based care agencies can start thinking about, inclusive design.

Tony (0:32 - 3:13)
Welcome to another edition of Transcending Home Care, Transcend Strategy Group’s podcast, where we discuss hot topics in home-based care growth models and just the larger state of play within the industry and the community. Obviously, a big focus, if you’ve been listening to our pod over the past couple of months, and it’s also within the larger industry itself, is the topic of AI. In fact, the last podcast we recorded, if you’re listening to these sequentially, was with a gentleman called JJ Ram, who works for an AI company, and he gave us a little bit of an inside view from Silicon Valley.

And that conversation, I think, is one that we’re going to be hearing more and more of throughout the industry in the years, months, heck, to come. But there’s a component to this that I wanted to dive a little bit more into today with my partner in crime and good colleague and friend, Courtney Penn, who’s a COO here at Transcend. And Courtney is our change management expert extraordinaire.

She’s got change management certification. She spends a lot of her time thinking about and seeing around the corners for the human elements, and home-based care, all varieties, is a very human business. And I want to talk about, and I talked about this a few weeks ago, the Beverly problem with Courtney, which is all of the change that AI and tech more broadly can support is amazing.

And the potential to discover efficiencies and put the joy back into caregiving for a lot of folks is real and tangible, and it feels like it’s never been closer. But if we don’t make it accessible for the people, it’s not going to work. And I have built this persona in my head called Beverly, who’s sort of the 60-year-old person who has worked in admissions forever.

And she’s a little bit of a late adopter to tech and has been asked to change EMRs two or three times. And in the end, instead of leveraging the tech, she writes down the referrals in her notebook because that’s what’s worked for her for the last 30 years. So I wanted to have Courtney on to have a discussion around how we can leverage this AI boom that is here, but how we can make it work first and foremost for people like Beverly.

So with that, Courtney, welcome to the pod.

Courtney (3:14 - 3:16)
Thanks, Tony. Glad to be back.

Tony (3:16 - 3:18)
Always good to have you here.

Courtney (3:19 - 3:33)
Yeah, absolutely. I’ve been hearing you chat with others about Beverly, and I know you are especially passionate about AI, and you’ve inspired me and others at Transcend to explore it head on. So really glad to be talking about this topic. It’s an important one.

Tony (3:33 - 4:18)
Yeah, absolutely. I think so. I’m so excited for your perspectives.

And Courtney, I’ll just dive right in. From what Transcend is seeing, and even you and I, we’re on Teams all day between the two of us saying what we’ve asked Copilot to help us with, just in terms of helping us be more efficient. Transcend is lean and mean.

There’s 10 of us, and we’ve got a lot of clients to support. So we are adopting this at an accelerating rate, even within our firm. From where you sit, do you think home-based care providers, our clients, the broader community are ready to implement the change that AI promises at a frontline clinical perspective today?

Courtney (4:19 - 7:16)
I think a question to ask, and I think a lot of us here at conferences, the question being asked is … are clinicians ready, right? But I think we should think of it from the lens of are organizations ready to support clinicians? And if we think about it through that lens, then we can more effectively pave the way for change and enablement.

Change management and change enablement go together. I think enablement really focuses on ensuring that the right people have the right training, the reinforcement, the redesigning of the workloads, not just handing people new tech. And I don’t think anyone intends to just turn on that light switch, right?

But depending on the delivery of the news of AI or this new tech tool, it can really feel that way, especially to the Beverlys in our industry. If we just take a step back, and I know your previous podcast talked about this, AI is accelerating so much faster, and you just talked about this too. Even though hospice and home-based care adopt tech at a pretty much, I would say a slower rate than other industries, this is still going to feel like whiplash to people.

Think of how long it took to adopt EMRs just industry-wide. Think of how long it took to adopt point-of-care tablets and software and get used to that. AI is coming so much faster, and frontline readiness for that, I think, is a little uneven.

But the truth remains that clinicians want relief from administrative burden, right? But they worry that AI is going to create more complexity, not less of it. EMRs promised a lot of efficiency and ease, and in some ways, it’s really complicated things, especially for the Beverlys.

So I’m glad we’re talking about Beverly as a persona, but I don’t think the challenges are limited to the Beverlys. I think we need to look at the past and reflect on the promises that have been made that haven’t necessarily come to fruition and acknowledge that this is, you know, their trepidation or their skepticism is founded and need to promote what AI is going to do for their workflows. So I’m not sure that clinicians are ready.

I’m not sure that organizations are ready to support clinicians just yet, but I think now is the time to get there because AI adoption and home-based care is no longer optional. Payers, EMR vendors, regular changes are all driving us towards it. So it is about the what’s in it for me for the Beverlys and clinicians.

And like you said, how do we get them on board? Because without them to enact it, it’s really not going to go very far, you know?

Tony (7:17 - 9:07)
Yeah. And I love what you’re saying about just as an administration team, if you’re listening to this, we need to be thinking about this now. And one of the key reasons for me to that, you know, and this transcends focus, but this can unlock growth.

It can unlock growth in a number of ways. If you do this right and support Beverly through it, there’s a potential for one RN to be able to see more patients and not have that be stressful for them. You should be able to find those efficiencies.

You should be able to lower your turnover. And so a lot is riding on getting this right. If you take a conservative approach to this and just wait until somebody else has figured this out for you, you’re probably too late with it, I think.

But Courtney, can you talk maybe next a little bit about what are some of the tangible ways, you know, you sort of like mentioned the ways we should start selling this to staff, but beyond that, when it’s time to implement it, you know, it’s three years from now and every EMR platform is more or less fully AI enabled. We’ve got ambient listening. We’ve got, you know, pre-filling out of prognoses and diagnoses and all the supporting stuff for the LEDs or LCDs, excuse me.

How should we start getting Beverly used to this slowly now? What are some of the tangible ways we can make it so that it’s not a light switch, but a process that Beverly and her coworkers feel involved in?

Courtney (9:08 - 12:47)
That question. And I think if we acknowledge that Beverly represents the backbone of hospice, decades of clinical judgment, deep relational skills, irreplaceable wisdom, but the risk with tech-driven innovation is that it can unintentionally alienate or overwhelm them. And I think we kind of know that, but I think it’s important to just like say it.

How can you bring Beverly into the design process early on? We understand and empathize with the fact that some providers want to save clinicians from the AI or the tech or whatever it is until it’s time to roll out, but we would encourage you to include them in that design process. Like it’s never too early to get buy-in.

That’s just good change management, I would say. It also helps reduce some of the intimidation around it. And the Beverly’s talk, the Beverly’s are like this echelon of hospice and home-based care culture.

And you want early adopters and ambassadors for this. So I think that’s a great way to do it. Also, role-based adoption pathways.

What I mean by that is not everyone who’s using the tech needs to master every feature. So consider the role of who’s going to be using the tech and tailor training to that role. Because just imagine like almost no one uses their EMR to its full potential, right?

So during rollout training, if you try to cram every feature into training for people who’ve never even seen it before, oh my gosh, their brains just kind of shut down. So really think about the pathways that your individual roles or disciplines are going to be trained on how to use this new tool. And then micro-learning, screen share coaching, repetition.

Don’t leave it all up to your AI vendor, your EMR vendor to do the training. That’s why it’s important to get super users on board very early. Plan to repeat some of this.

And not in a condescending or patronizing way by any stretch, just like have it in the plan. Say, you know, we’re going to start out here, we’re going to revisit here in two weeks, we’re going to do some in-the-field coaching and training, we’re going to have you repeat it back to us. Adult learners, as you know very well, Tony, learn differently.

And we have to modify our approach to ensure that they’re retaining this information, not just, we’re not just checking off an education checkbox. And then trying to like reframe the narrative of it all. You don’t have to slap AI on every single thing, right?

AI comes with its own sort of stigma, especially for those who are conservative or really attuned. You know, there’s already a skepticism surrounding it. And just, you can say that this is a tool that helps you practice at the top of your license.

Not, this is a new AI fancy system, please adapt, learn, or get out. And I know there’s not a verbatim of that going on, but really help explain how this helps them practice at the top of their license. But if it does create double work, if it does create unnecessary steps or more steps than Beverly’s doing now, she will probably check out.

So really work on those workflows, those role-based adoption pathways and inclusive design from the get-go. And you probably stand a better chance of turning Beverly into a fan rather than a skeptic.

Tony (12:48 - 14:47)
I love that. So many of the things you said, and maybe this is just a rephrase of your point, but you know, one of the things we’ve done, and I’m going to brag on your husband a little bit, is for those who don’t know, Courtney’s husband works in IT and tech, but he was generous with his time and came in and did for Transcend recently within the past month or so, just like an overview of Copilot and how to use it and how it integrates with Office 365 and just a couple of use cases that weren’t like core to the business, but were efficiencies or opened up new lines of thinking that you may not have thought you could use AI for.

And I think there’s some benefit to that as well for home-based care agencies. If you’re at Case Conference, if you’re at IDT and somebody has figured out a cool novel use for these that is compliant, that is not abusive or exposes the company to risk, but just helps everybody do something a little bit better or think more creatively, foster those organic connections. Get Beverly to sell Charlotte on the fact that this is a useful tool.

Peer-to-peer engagement can be a huge way to break down some of those barriers as well. And that’s what we’ve done. And I think we’re seeing adoption within our agency because of things like that from people who otherwise might not have gone down that rabbit hole themselves.

Well, Courtney, I think you’ve given us a lot to sort of chew on. The last question I have for you is, what are some ways that you’re using AI these days to amplify your productivity or capabilities? Where are you using it in your workflows?

Courtney (14:49 - 17:33)
Just to tie a bow on the pace of all of this, right? Think about last year, Tony, when we were just like, we could probably dabble in the ChatGPT. And now I think the two of us are using Copilot in particular in many ways.

One to help structure early strategic decks or versions of them, proposals for client engagements, analyses, specifically synthesis of information across different sources, especially for our GRO Assessments, which are so helpful for clients to see things clearly with an objective point of view and helping to prioritize recommended action steps to unlock barriers to growth. One of the ways that we do that, or part of our process, is to intake a lot of documentation, a lot of materials that help us create a picture in our minds of what the organization’s current state of play is. And AI can be useful in helping us synthesize that information and highlight or showcase things that we need to flag.

It’s just really useful in a time-saving capacity. It helps us explore options for narrowing down a certain recommendation, but drafting emails sometimes, especially if we’re trying to nail a certain tone or executive summaries after a long working session or even conference reports. Our clients know that we use AI to record our meetings so that we’re present in the moment and we have notes that are taken for us and then shared with all so that we’re all sort of on the same page.

So those are some things that I use AI for at work. And I will just say, personally, I use it for trip planning. Jeff and I follow a plant-based meal plan that AI generated for us last summer.

It’s kind of crazy. Or summarizing long articles or Cliff’s Notes versions of books that we want to understand very quickly. Organizing thoughts before big meetings.

I’m really fascinated by all the potential. And I try not to move forward with intimidation. I know that there are risks and I know that it’s growing faster than any of us anticipated or are maybe ready for, but I am embracing it, Tony.

You would be proud. AI doesn’t do my job. It accelerates the parts of my job that are repeatable so that I can spend more time on judgment, analysis, relationship building, and then the strategic thinking that’s necessary to do my job.

Tony (17:34 - 18:41)
Wow. Yeah. I don’t think I could have wrapped that up any better at all, Courtney.

So thank you for doing that. I think a lot of the work that I do with it is much the same these days. Helping jog my memory before I jump into a client meeting.

Maybe we haven’t had a call in a month and I need a quick synopsis of, you know, what are the last couple emails I sent to this client? AI is great at that. You know, the things we should check back in on.

I think we are starting to use it more for new business as well for the things that are standardized and repeatable. And there’s some really cool tools out there to help you do, you know, cold calling outreach and stuff. So that’s good for firms like ours.

Usually I end these podcasts with a gripe. Ah, Courtney, do you have one? I don’t.

I, you know, I mean, I could do one about the weather, like it’s rainy and related to that. Okay. Yeah.

Take us out with a lighthearted complaint to end the podcast.

Courtney (18:42 - 19:05)
So I live in North Carolina and we have had three days of like 70 degree weather. And what does that mean? Pollen.

Pollen has already started. So my eyes look a little puffy. Tony, but that is my complaint.

Just pollen is going to be with us for the next two months. And I’m just not very excited about it, but I’m glad for the warmer weather. So there’s that.

Tony (19:06 - 19:26)
Here, here. That’s perfect. I don’t think I could have another gripe beyond that. I agree with you.

I’m ready to be to go back out to my fire pit outback and have a nice glass of wine, especially it’s Friday. That would be a wonderful way to end the day. But the mud would basically go all the way up to my angles if I tried to go out there right now. So.

Courtney (19:26 - 19:26)
Get your waders.

Tony (19:27 - 19:48)
Exactly. Yeah. Cry me a river.

Anyway, Courtney, thank you so much for joining us. I always appreciate your deep expertise on change management and tech. You help our clients with this in such elegant and nuanced ways, and it’s always good to catch up.

So I’m sure you’ll be back on the pod sooner rather than later, but thanks for joining us. And thanks everybody for listening to Transcending Home Care this week.

Courtney (19:49 - 19:50)
Thanks so much, Tony.