Curantis Solutions, LLC

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June 26, 2017 Issue



Electronic Medical Records Billing Solution for Hospice and Palliative Care Providers



John D. Carreker, III

Chief Executive Officer


Curantis Solutions, LLC


Interview conducted by:

Lynn Fosse, Senior Editor, CEOCFO Magazine, Published – June 26, 2017


CEOCFO: Mr. Carreker, would you tell us the concept behind Curantis Solutions, LLC?

Mr. Carreker: The concept is to provide a Best in Class EMR (Electronic Medical Records) billing solution and overall a comprehensive hospice management solution to the hospice and palliative care sector.


CEOCFO: What are some of the challenges with technology that might be specific to the hospice as opposed to another segment of the medical community?

Mr. Carreker: It requires a very mobile healthcare delivery model. Probably about 90% of the hospice patients are in homes, nursing homes or hospitals. Most hospice providers must go to the patient to provide care. Mobile technology is very important that is adaptable to the environments and works well with an application. That is probably one of the most unique things in terms of technology that our sector has not done a good job in servicing and that is a big focus of ours. Another is the end-to-end connectivity of the clinical and billing capabilities so the clinicians can do their job and be able to stay within compliance guidelines but not be encumbered by workflows or requirements that an EMR may require from a documentation standpoint; the clinicians are in front of the dying patient and a lot of times there is drama and tension and all kinds of environmental things that these clinicians are having to deal with. Having a system that is has good ease-of-use and makes their job easier so they can focus on the patient -- yet connecting all the data all the way through the system even to the billing system, is very important. All EMR billing systems ultimately should do that but hospice has a unique reimbursement and workflow model, so that is why competitors that have tried to come into this space from other sectors had to adapted their solutions. It has been much more difficult to achieve that goal.


CEOCFO: I always thought of hospice as a place to go and stay, but you mentioned you can provide care in a person’s home. Has that concept expanded?

Mr. Carreker: Most hospice services have traditionally been provided in nursing homes or hospitals but more and more in the healthcare sector they services are being pushed out of the hospital. Post-acute is a broad term and covers many kinds of models of healthcare. Hospice is there to push for more and more services to be rendered in the home if the patient so desires, if it is safe. I think that is more of a macro trend inside of healthcare but I think in general hospice over the last ten of fifteen years has been trending more towards services rendered where the patient lives.

CEOCFO: Would you give us an example of how you can streamline so if someone is with a patient, the right information can get to them during a crisis mode?

Mr. Carreker: What we try to do is make the workflow of the software very intuitive such that it mirrors the workflows that clinicians use to provide hospice care on-site. One of the key success factors we have had is with our chief marketing officer Denise Stamos, RN, MSN, MBA, is a clinician and clinicians from our beta partners have been heavily involved as we built the software to really make sure clinicians to enable you to do your job to capture information once and flow value to an assessment when you go see a patient. That is the essence of what we have tried to do and in creating a plan of care focused EMR.


CEOCFO: Would you tell us about the patient centric orientation?

Mr. Carreker: All of healthcare by and large is curative. The clinicians and doctors are all aimed at trying to solve the diagnostic-driven processes and therefore the software is built that way. A hospice is plan of care centric and what that means is you do an assessment but you are building a plan of care that serves as the plan to care for the patient with advancing symptoms, the medications they should ease their pain, or other things that are important to the family either social, bereavement and even spiritual. Care needs to go around as part of this whole patient centric process that the hospice tries to address. They are not trying to cure the patient; they are trying to manage symptoms. They are trying to make the quality of life as good as it can be as they go through the end-of-life stage. They evaluate the patient’s plan of care as a group at least on a two-week cycle.


CEOCFO: Have caregivers been looking for a better way?

Mr. Carreker: Seven to ten years ago, several EMR providers started to focus on the hospice sector. There are about 4000 hospices across the US. Some of the larger ones that have aggregated and bought several hospices had started to automate. Over the last seventeen years, many things evolved and changed. Software services have become more the norm and mobile technology has become much more advanced. Many of the original EMRs were built from groups that had built software for other sectors and are trying to address this in hospice with a more diagnostic model. They came to market with a server-based diagnostic model software that was deployed in the hospice and did not have a very high customer satisfaction. Several the hospices we have spoken with across the industry have been very dissatisfied with their current EMR situation, so there is a material amount of turnover or refresh occurring in the hospice sector now for new technology, SaaS-based solutions, and true mobile solutions software that is built for hospice. Now there is a hand full of us that are focused on that. Some of the others are more of a traditional server-based model that probably will not evolve as software because they have so many other sectors they are trying to allocate R&D to. There is a real unmet need in the sector so we are trying to fill that.


CEOCFO: Do most of the users take advantage of all the features?

Mr. Carreker: We are in our beta program. We have beta partners that we are working with. We have probably had conversations with 75 plus hospices in the industry. I believe that we are aimed at features that will be the top of the market. There will be some features that will probably not be utilized but what we try to build into the solution is the right level of configurability versus taking a customization approach.


CEOCFO: What has been the feedback as people have started to use the system?

Mr. Carreker: The feedback has been very positive from an ease-of-use standpoint, from learning how to use the software to the power of connecting the clinical and the billing data. We still have a few software maturity things we are working through. We are putting more work into the UiUx (User Interface, User Experience) to make it even better. We are continuing to work on our mobile delivery capability to make even more performance possible. It is a constant innovation and improvement cycle for us.


CEOCFO: Are you looking for partnerships or investment?

Mr. Carreker: Not right now. We have a close group of funding sources. They are all somewhat involved in the business, and we are very blessed that we have a great set of stakeholders around the business that have continued to be behind us. We have had a strong Advisor Board you can see from our website, leading healthcare strategists and practitioners people that are providing strategic guidance for our firm as we build our market presence and evolve our solutions so right now we are in good shape.


CEOCFO: What have you learned from your past ventures?

Mr. Carreker: When you combine early-stage and software, you will likely encounter just about any challenge possible. I think you must have the talent engaged with experience of the next stage of where you are going to go but you must balance that with the talent that wants to be involved full-time in an early-stage company. It is clearly a very different dynamic to be in a large technology company or even a medium sized technology company versus an early-stage/start-up software company. Having that talent in place to start and having the domain expertise is key; we had a lot of good domain expertise from our beta partners but we had not built a hospice software so we have learned a lot of things quicker than a lot of our competition did but still some of that is why some of our development cycles went a little longer than we wanted them to go. Thirdly, a combination of finding the right scope of prototype for the first product you bring to the market. We built too much scope on our first one, as the objective was to get prototypes out and get client’s feedback. The key is about hitting that optimum scope of the solution, learning from market feedback and adjusting to refine the best GA solutions quicker.


CEOCFO: Why is Curantis Solutions an important company?

Mr. Carreker: We are providing a very important solution for the hospice and palliative care sector that is going to enable those entities to be a bigger part of the solution and helping patients manage end-of-life care and enabling our healthcare system to embrace the challenges in that sector. End of life is probably one of the biggest costs and unfortunately out-of-control dynamics in our healthcare industry; effective utilization of hospice and palliative care is a big part of that solution. It is about building a strong solution to enable them to be successful and paint a bigger picture for how that needs to be a bigger part of the solution early on in a patient’s journey as they are dealing with chronic diseases and end-of-life changes versus reactive solutions the last five days of someone’s life. There is a lot of work being done now in the industry to help people understand the importance of doing that well and the data & analytics associated with how patients need to manage those chronic diseases. Being in the middle of that is an important mission for us and it is something that all our employees and stakeholders are very excited about. We have lots of strategic partners that we are starting to talk to that are affirming that strategy. We believe our mission is strategic given the several rings of influence beyond where we are right now that we hope to grow towards.


“We are providing a very important solution for the hospice and palliative care sector that is going to enable those entities to be a bigger part of the solution and helping patients manage end-of-life care and enabling our healthcare system to embrace the challenges in that sector.”- John D. Carreker, III


Curantis Solutions, LLC



Denise Stamos








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