This article was originally published on Home Health Care News. This article is based on a Home Health Care News discussion with Sundar Kannan, CEO of KanTime. The discussion took place on November 16, 2022 during the HHCN Home Care Conference in Chicago. The article below has been edited for length and clarity.

Home Health Care News: Sundar, tell me a little bit about yourself what KanTime does, and just a synopsis of you in the business.

Sundar Kannan: KanTime is an EMR software. We are the only product today in the market, which we call a platform play. What we mean by that is that we have an EMR across all lines of businesses, homecare or non-medical, home health, hospice, pediatric, self direction. You have pretty much everything on the same platform. What I’m going to be talking about today is longitudinal care, what we think that industry is heading towards, probably in 2023 and forward. KanTime has been in business since 1997. We started off as a technology consulting company so we understand technology extremely well.

We got into the home health in 2006 in the homecare business, non-skilled, and in 2010, we completely got out of our consulting, and we became a product only company and that’s when we introduced the skilled platform. From then on, we’ve been in this business for a long time.

HHCN: What is longitudinal care and how does it help care providers with different service lines across homecare, skilled care, hospice, and other settings benefit.

Sundar Kannan: Until today, if you were to really look at the way the industry is working, for every line of business, I actually do what is needed for that line of business, keeping in mind my claims processing, able to collect my money, do the payrolls and all those different things. What we have missed out is that the patient is your center of attraction, that patient is the most important thing. When you look at longitudinal care as a patient as a central element, then the way you need to start from a technology angle, and from a different base, how you want to provide services, you need to think of the patient to have information about the patient in a centralized way.

You keep all the patient data centralized in terms of patient demographics, the allergies, the diagnosis, the medications, and all the different things that DME supplies, immunization records, and all those different things, which is actually code to the patient. Once you keep that as a centralized methodology, then it really doesn’t matter in which line of business you’re trying to serve this particular patient, you’re able to just provide that service.

Longitudinal care is something a lot of EMRs talk about, but not everyone has been able to do it and today, if you were to really look at this industry, you have best of breed, they call it as, were extremely good in non-skilled care. You buy this EMR, and we are the best in home health, we have this in the hospice. People actually define it like that, but if you were to see how the industry is progressing (and we are in many RFPs and large agencies publicly traded and not) so what we see is that the care has shifted in both directions on the home side.

On one side, if you see a lot of ambulatory care coming in, wellness visits for home health that palliative care visits are by the physicians to hospice and things like that. You have an ambulatory setting that is coming up, then you have a home health setting, and then when you look at hospice, you also get into the facility based like that. If the patient’s symptoms are not able to be controlled at home, you transfer to an intermittent facility, stabilize the patient and bring him back home.

If you really look at it, how the movement of the patient is now, you need to have a singularity as far as the patient is concerned. The way we are trying to do this business is very silo-based and home health-based or hospice-based or homecare-based and things like that. Longitudinal care is how we think and what is the patient journey? That is the most important thing. Somehow, we missed that point, I think with all the products we have in the market today.

HHCN: How will longitudinal care change the way providers operate and then deliver care?

Sundar Kannan: This is the first most important thing in terms of the thought process change. The thought process change isn’t just not only in the clinical thought process, operations is the most important thing. The more efficiently you run operations, the better you are. If you were to really look at operations, where you can make a little bit of savings or efficiencies is only in the back office, in the front-end be it a caregiver or a clinician or whatever, whatever is the market value, you need to pay for that one.

The only thing you can do is that for the front-end people, you can only make sure that your documentation styling is easy, fast, efficient, they’re able to do more visits and things like that. That’s all you can do, but you cannot really do the cost saving. Operational efficiencies that you need to bring are only at the back office. In the back office if you were to just take an example, say this particular branch office has, say 1000 visits today, and we are not even bothered about what kind of visits, is it a homecare visit, home health visit? It really doesn’t matter. The 1000 services I need to provide to my patients in the field.

If I’m going to provide these 1000 visits from an operational angle, if you were to just break it down, I just want to know if the visit happened today or not. If it happened, I just want to know, did it happen by the EVV for that particular state. This state requires this EVV. It did not comply with the EVV method, so I did the recent code, action code and everything, I adjudicated that visit. Then at the end of the day, if I can send it to the aggregator and get it cleansed and accepted or declined, I get it back, clean it up.

When you talk about operations as just a simple operation really, we don’t want to complicate it. Once it has come back from your aggregate, it’s ready to bill, and you can get 100% claim back and things like that. If you look at everything from clinical to operations, you need to be able to really look at it more in terms of operational efficiency, doesn’t matter if it is a skilled visit, home health visit or hospice visit, 1000 visits this branch office has to do, and have they done it or not done it, and then you move on from there.

Similarly, if you look at all the other operations at the back office the same way, how you really look at those things. I think those are the methods, the operational efficiencies, you start off with the longitudinal care and then you can start doing the silos of operations rather than the silos of business. The larger agencies I go to, I have a home health team, back office, and the front-end team, I have a hospice team which is back office and front-end, I have a non-skilled team, which is back office and front office.

You need to be able to take it off, and you should be able to look at process management. I’m a process engineer by profession, and hence, I’ll be selling processes, but if you were to just think of processes as the vertical lines, you will be able to add any line of business as a horizontal. I’m doing only home care today, I want to get into home health, I want to get into pediatric nursing, I want to get into pediatric therapy so whatever that might be, you can be able to add, as long as you’re able to map the processes, so it has efficiency, efficiency and efficiency. That’s the name of the game.

HHCN: Something I feel like we’ve touched on quite often today is technology in longitudinal care. What role will technology play in helping providers succeed in this new paradigm?

Sundar Kannan: The way this industry is running is that the demand for services is continuously increasing. The older population is only increasing, and the demand for any kind of a delivery of services is increasing. One of the problems is that the money is only so much, and hence the reimbursement rates are going to keep coming down. You need to create efficiencies across everything so that the law of averages works for you to be in that business. Technology has to also start looking at operational silos.

I should be able to see auto management as an operational silo, a QA as an operational silo, did my visit notes come back completed, or not as an operational silo? If you were to just look at that, and you change the mindset the way we currently run the business in some of the line of business silos into operational silos, I think the technology has to help you to make sure that you’re able to get that efficiency, and you’re able to get that visit done, and able to take it all the way across, and build, and collect, and do the payroll. I think that is the most important thing in my opinion, that technology can play.

HHCN: What can people look forward to when it comes to KanTime, and 2023? Is there anything else that you’re excited about, or looking forward to, or just on top of mind?

Sundar Kannan: One of the things that’s happening even for this audience also is bundle payments. The ability to take the shared risks in patient care. All those different things are now going to happen. How does it work for different agencies is that you’re going to partner with the ACOs, or hospitals or things like that. The method is that, how do I reduce the cost of care for that particular patient?

It really doesn’t matter in what line of business I service this particular patient, but how do I get the cost under control overall for that particular patient? The more and more you look at it that some level of a capitation is going to happen, and somewhere somebody is going to say that what are the normal, and what are the outliers in the patient expenditures, and that kind of a thing, which is already happening behind the screen, but it is going to happen more, and more.

I feel that in 2023, or 2024, we will start seeing that, the new challenges for the non-skilled is already using the EVV, and the aggregator, and all that. The skilled care is now getting into that fun stuff starting from next year. I think this industry has a lot of things to do. They keep all of us busy.

KanTime is a home health and hospice EMR solution that aims to streamline all aspects of the care agency from beginning to end. To learn more, visit: