Integrating AI and Compassionate Care in Medication Management

Michael Hughes 00:07
Hi and welcome to The Art of aging, which is part of the abundant aging podcast series for United Church Homes. On this show, we look at what it means to age in America and in other places around the world with positive and empowering conversations that challenge, encourage and inspire everybody everywhere to age with abundance. Today, I am very pleased to have the wonderful and fantastic Lisa Lavin on Lisa is a serial entrepreneur with over 25 years of experience building new businesses from the ground up within the healthcare and health tech sectors. And currently, she has a very dynamic and growing business called Ōmcare, which we’re going to talk about, and we’re going to talk a lot about the challenges of the medical condition management or medication management with older adults. Lisa has also been very active in local and national organizations that support entrepreneurialism, if I could pronounce that word, which I usually can’t, and women in business, as you might expect, she’s gotten some recognition for her good works. She is a Minnesota cup division winner, a eureka Award winner for innovation. She was recognized by Minneapolis slash St Paul’s Business Journal as one of the 25 women to watch Minnesota Business is real power 50 and the New York observers, 2020, list of the hottest fly over tech companies in digital health who and so much more to come. I’m looking forward to this. And just a reminder for the audience that this podcast series is sponsored by United Church homes on a center for abundant aging. To learn more about the center, including our annual symposium in October. Visit www.UnitedChurchHomes.com/Parker-center. So Lisa, you’ve met before. I know a little bit about your story. Excited to get into where we are right now with our own care, but you’re a person, and I love to start the podcast this way, because we get to know a little bit more about you and your passion here, you could be doing a lot. You could be doing a lot with your talents. You could do a lot with your experience. You could be putting up to work in a lot of different places. What inspired you to get into this business and really address the issue of medication management?

Lisa Lavin 02:12
Well, you know, Mike, like so many entrepreneurs, the beginning starts a long time ago when we had something in our lives, or someone in our life that was inspirational. And for me, you know it, it really goes back to my grandmother and my relationship with my grandmother. You know, back in the day, my grandmother was one of the most important people in my life. She was the one that I learned unconditional love from. I learned fun. I learned, you know, many different things. And as I saw her age, what I noted was, is that there weren’t the systems and perhaps platforms in place that enabled my grandma to stay connected with family, to to live abundant and vibrantly, as I believe that she deserved to live, and as I saw that process and I saw the end of her life, I knew I wanted to make a change in the world at some point that would actually enable the aging population to be able to age better than my grandmother did. And so, you know, fast forward many years. Here we are, you know, about, you know, just over 10 years ago, when I was thinking about scratching that entrepreneurial itch that I’ve had for a really long time, and when I looked at what I wanted to do, I realized, it really does go back the way back then, that I want to be able to make a difference in this particular segment in our world, because it’s really needed. And so when I was founding this company, I knew that we were going to develop a platform that enabled people to live more connected, more healthy, and live where they want to live longer, and that’s what home care is all

Michael Hughes 04:03
about. That’s awesome. And what, you know, you what, what was your prior experience that kind of brought you into this? I mean, did you have a background in, you know, software design and medication management? I mean, what kind of things do you flex in here with home care?

Lisa Lavin 04:17
So I’ve been in health care, and I’ve been in product development and business development in the startup world. For over 20 years, I started in a big company, right? One of the companies that I spent quite a bit of time at was 3m healthcare, and had the great honor and opportunity to build new products and new businesses within those very large safe walls of 3m health care, and really enjoyed it there. I always knew that I needed to scratch this entrepreneurial itch, but really cut my teeth there, and learned so very much from people smarter than me in those kinds of organizations when I bought it. About 15 years ago, when I really started stepping off of and started stepping into the entrepreneurial world,

Michael Hughes 05:09
and you described, or at least I would describe, home care as this one stop shop for pharmacies to kind of solve that last mile problem that we see with medication and medication and medication management in the home. Can you describe more about what home care

Lisa Lavin 05:23
Does it? Yeah, I would. So we are a digital health technology company. We have created an all in one home health platform that was intended to extend the reach of caregivers into the home, both family members as well as professional caregivers, to be able to monitor a person’s health and help them and assist them in living more healthy. And then to your point, really, the tip of our spear is to help them manage their medications more efficiently. What the own Care Home Health Hub does is it dispenses medication that comes directly home delivered from the pharmacy and home care really serves as that last mile of pharmacy into the home. Because here’s the deal, just because you know medications are delivered to the home, you don’t even know if people are actually taking them, and it ends up being one of the biggest reasons why we have such a high incidence of hospitalizations, such a high incidence of having to transition to assisted living is just not being able to manage medications. So their own Care Home Health Hub promises the right medication, right time, right person. It ensures that the medication that is delivered to the home is actually taken correctly by the person. And

Michael Hughes 06:37
I’ll tell you, I mean, we, I, you know, just in my career and certainly within United Church homes, with our skilled nursing environments, with, you know, experience in home care, I have certainly had, you know, first hand experience seeing, you know, the harms that are caused when you know, you know you got medication, non adherence. And you know non adherence is a combination of factors, very often, just simply not having the ability to go out and get the medication, not knowing about interactions between medications. I mean, I know that one of the top callers is a fall that we see is a medication change. You know, the interaction between that and somebody might be using alcohol or drugs or over the counter medication, you know, supplements, Nutritionals, things like that, and it’s tough, and there’s so many, there’s a lot of factors in medication management, but yes, fundamentally, it comes down to, you know, can you reliably get your medications? Do you know? You know, are you taking them with knowledge of the interactions? Are you taking them? Probably all of those different things. And yeah, you know, we see that improper use of medications, what we see most often with older people is the disoriented, Dizzy fall that causes a hospitalization. So that’s really a big thing you’re addressing, right?

Lisa Lavin 07:52
It is. And actually would like to double down on that, Mike, because when you think about it, many people are having their medications come from many different pharmacies, and you don’t really have that one pharmacy that’s doing that medication reconciliation to make sure that, Oh, are you considering, then, the potential interactions with all of the medications, and even over the counter medications that somebody might be taking? That’s one of the advantages of the relationship in the system that we’ve created with our pharmacy partners is all of the medications come from one pharmacy. They are pre pouched in multi dose pouch packaging. They are mailed to the home. And when that role, that 30 day supply of medication, is inserted into our hub, we download the schedule directly from the pharmacy so we know exactly what is the schedule when people are to be alerted when in the right time for them to take their meds, so they can be assured a I don’t have to worry about the meds that are I’m taking because the pharmacy has already done the diligence that they’re the right meds that I should be taking right now, and they don’t have to worry about taking them at the right time, because our system alerts them when it’s time for them to be taken. And what is more, for those that might be having some memory issues or need just a little bit more assistance, our system actually enables someone to receive a remote medication assistance call via the hub, so when it’s time Mike, for you to take your meds, you might be having some memory issues. I’m going to call you via our hub. I can see the whites of your eyes via our audio visual interface, but because of our multiple cameras, I not only can see you, but I can also see the pill tray. Well,

Michael Hughes 09:42
I’m just trying to imagine this thing that sits in the house. So it’s a dispenser, an audio visual communications hub with Two Way cameras on it. And then you’ve got, obviously got, you know, the data in four. Forms the decision engine there about when to alert this, that and the other thing. But I’m just, you know, I’m so sorry. I can’t just throw up a picture of it on this for you here, but listeners, use your imagination. But I’m right on this, it’s a communications hub, it’s a data center, and it’s a dispensing center, and you’re going to take packs that you have with your pharmacy partner from the outside, load it into your How long is this a 30 day supply? 90? I

Lisa Lavin 10:24
mean, yeah, it’s up to a 30 day supply. And because of the fact that we have multiple cameras, we’re verifying that the right med is being dispensed at the right time. I’m verifying that you’re actually grabbing the medication from the tray, and that there’s no medications left over, and that you’re actually taking those medications. Now, not everybody needs that level of assistance, which is why we just, we can simply provide alerts to somebody if they just want that easy med reminder, or we can also assist somebody remotely to make sure that they are taking their meds.

Michael Hughes 10:57
Sorry, what triggers that assist? Because, you know, the thing that is going through my mind right now is that everyone knows, you know, the trope about the pill tray and getting all the pills organized and things like that. And you know, that’s always helpful but it’s free. It’s a plastic dispenser, and then the families have to kind of leave it to themselves to organize everything. And I know there’s lots. You know, hospitals may help, other people may help, but you take that part out of it. But how do you know if somebody needs help, taking their I mean, how do you know? Do you proactively signal, hey, do you want us to help here, or does somebody else initiate kind of an assistance call?

Lisa Lavin 11:37
That’s actually good, two questions there. First of all, that decision of what kind of assistance somebody makes is a decision that the individual makes, perhaps with their family or with their professional caregiver. You know, in some instances, in some of our use cases, somebody’s just doing their own thing is, you know, getting an alert in the morning, but then getting a call in the evening to help them walk them through their medications. So how does that happen? There is a schedule, a med schedule, on our platform. And if we, if somebody needs a caregiver assist, call via the hub, then they will be assigned, and I will, as a caregiver, receive an alert on my phone it’s time for me to call Alice to help her with her medications, and then I’ll call her via the home care app on my phone. It’ll ring into her hub in her home. We’ll be able to have a little chat. I’ll go ahead and start the process, and I’ll be able to lead her through the medication dispensing process and confirm that she’s not having any trouble taking her meds.

Michael Hughes 12:40
What sort of situations are we talking about? I can see somebody because, you know, somebody who is a caregiver for something with dementia and all that is, well, let me ask a couple of questions here. Okay, in what situations, maybe, outside of cognitive ability have you seen people initiate a call like that?

Lisa Lavin 12:56
You know, it could be the memory issues. It could be developed developmentally disabled that might need some assistance in that circumstance, if you think about the way in which this is achieved today, to do what we do today, you have to do what’s called a door of med pass. You have to show up at somebody’s door, hand on the medication, and watch them take it right? That usually happens in an assisted living setting, but could happen also in a home care setting. Now with home care, I can do that remotely, rather than having to go to your room or go to your home. I can now call you and I can walk you through the process and watch you dispense the meds and take the meds, and there’s different reasons for that. Generally, it usually ends up being a memory issue that is driving that. Yeah,

Michael Hughes 13:48
I’m also thinking about the case where maybe somebody has a brand new medication regimen and they need to understand, but with adherence, I know that. You know if somebody may be on a medication that requires an injection, then you know, they’ll get on a call with a nurse and that nurse will kind of coach them through the injection of that medication initially, until they get used to it. Do you guys provide that as well?

Lisa Lavin 14:09
So what we are able to do is we’re able to manage medications that are both pouched as well as medications that are un pouched. So if somebody is on a bunch of tablets. Those will be in the pouch, but maybe they have eye drops, maybe they have an injectable. Maybe they were just, you know, prescribed amoxicillin, and it’s not inside the pouch. So we’re able to list on our audio visual interface. Here’s all the medications that are being dispensed right now. Now. Here’s all the medications that are not in the pouch that you need to go get and actually take right now, so we can both provide alerts to all of those, but also be able to track adherence to both pouch and as well as on pouch met,

Michael Hughes 14:51
Yeah, and that data is obviously very powerful, and that leads into, I would think, additional interventions if we find that adherence does not have. Right? I mean, do you guys, I mean, if somebody’s not adhered to a medication, is there a certain protocol that you guys will put into place to see if you can coach them? Why is this? Why is this not happening? Do you have some examples

Lisa Lavin 15:10
of that? Yeah. So we, our system, enables a caregiver to be alerted if somebody is non adherent. So if I missed my meds at 8am this morning, my caregiver will receive an alert that, Hey, Lisa, Mr. Meds this morning, and I then have the ability to then call you via the hub and to say, Hey, how are you doing? Right? Is everything okay? I saw that you missed your meds this morning. What’s going on? So that becomes something that’s actionable. We have lots of data that is collected via the hub, and I even understand that there’s analytics that become really relevant here too, because all of a sudden, if you start noticing Alice is taking her medication later and later during the day, and then all of a sudden there’s a fall. Now, all of a sudden it becomes, you know, predictive that, hey, if Alice is starting to miss her meds, we need to intervene right now, because she might be at risk for a fall.

Michael Hughes 16:12
And do you have a database of medications that make, oh, this family, this whole list of medications that they’re not taking regularly that could lead to dizziness, so you would know all those potential side effects. Does your database also kind of do the combination, like, if I’m taking this drug and this drug, I have to take them together, or I should have to space them apart, or things like that. Yeah, that all

Lisa Lavin 16:34
comes from the pharmacy data system. So the pharmacy has all of that information, and is able to then be able to coach via our system in that way. Yeah,

Michael Hughes 16:45
so the data sets that you’re looking at, you’re looking at, obviously, you can see if somebody is adhered to by taking the medications. You can let you obviously know people are getting the medications. You can do some coaching around the actual way you know how to take the medication. You can look at trends about when people choose to take their medication or not, you can probably flag against repeat dosage of taking medication. If somebody’s got dementia and they thought they’d taken their meds and they need to, you know, they’re trying to take the meds a second time in the same day, or something along those lines.

Lisa Lavin 17:15
Yeah. And I would also like to add Mike that we have the ability to integrate with biometric devices, to be able to add that additional layer of information, to be able to track blood pressure, respiration rate, heart rate, so that when those kind of metrics might be going off the chart, we’re able to alert caregivers of a situation with regards to that as well. And soon we’re looking very seriously at integrating camera based biometrics. So just when I call my mom and she’s looking into the camera passively, we can measure her heart rate, respiration rate, blood oxygen, blood pressure, which really becomes very relevant. So not having to then attach and put on devices and these kind of things

Michael Hughes 18:02
embedding some sort of other millimeter wave or K band, or some sort of a sensor inside the unit, they’ll essentially pulse. And because you’re right there with the camera, you’ve got sort of that immediacy series. So it’s a little bit more accurate. You know, I’ve seen systems that are kind of spread around, and some are more accurate than others, but you’ve got to be right there during that camera session, right? Yeah,

Lisa Lavin 18:23
There are companies that have already developed this technology and, matter of fact, well on their way to getting FDA approval of using a camera on any device to be able to measure those biometrics and re measure them consistently. The advantage that our hub has in using our camera is that it’s stationary, so I don’t have this phone that’s shaking, because it has to be very still to be able to leverage the camera in that way.

Michael Hughes 18:47
Yeah, I’ve got two more. I’ve got two more questions for you before we move on to, you know, the final three that we always ask everybody. One’s own kind of skill set around engaging somebody with a cognitive issue. And the second thing is more around, say, AI and, you know, AI both in terms of engagement, in terms of data analytics. I think I’m probably a little more interested in the data analytics side of things. But I think the question I want to ask you about is more towards, you know, the relative costs and comparisons now that deep seek happened a couple of weeks ago. If you have a, if you have a thought on that, what that’s done to upend our assumptions of what it takes to build these models to the first thing though, you know, we’re united church homes. Is a participant in the CMS Guide program. We are actually one of the few that has an established program that is non clinical. So it’s our navigate service coordinator program, which is social determinant, risk mitigation, relational work, and navigating people through local resources. And I think it’s largely built, and I think we feel really competent doing this because our care planning protocols, or nurse protocols or relational protocols are already optimized for longitudinal over time, which clinical plans often are not. But then there’s also, you know, very specialized words, you know, dealing with people with cognitive I would think that when you’re talking about the clinical side of programs like the guide, you know, it’s like, well, when you’re thinking about clinical protocols and dementia care, I’d say, This is me not being a doctor, not going to medical school, but when I see to it, it’s really medication management, right? I mean, most clinical care with dementia is all medication management, then most of its behavior and relieving stress on the family and things like that. So I think that for someone like you, that is, is building skill around engaging people with cognitive issues and coaching them to take medication. I would guess that there is a particular skill set that your people will need to embody or need to learn in order to actually successfully coach folks that may have a cognitive issue: do you have your own training program? Is that something that you’re building? Just know how around it? How do you look at that skill set when it comes to the people that you hire? So

Lisa Lavin 20:58
I want to be clear about our business model. We decided very early on, when we were designing the system that we didn’t want to replace health care providers, but rather, we wanted to be a portal for health care providers into the home, so we are not hiring the providers that are providing this care, but rather, our hub serves as an extension, as that technology conduit for care into the home, and what we’re providing is the means to remove Technology Management off the table, to be able to hit the easy button related to that so that a care provider can focus in on what They really want to focus on is providing the care that is needed to and I’m just getting

Michael Hughes 21:45
It is now, because what you’re doing is essentially allowing a current provider that’s helping to manage the care of a person that may have cognitive you’re hiring a continuity you’re not going to have a strange face, suddenly a brand new person. You know you’re having somebody that has been a health care provider enabled through your Pap platform to do that medication coaching. Okay, I got it, yep. All right, now for AI, right? Because it’s the AI drinking game, we obviously take a sip of water when we say AI, but it’s interesting, you know? I think that, you know, I, myself, for the last year, have been really trying to understand what the limits are of the current AI models. And I’ve come to kind of a cynical conclusion about just the parity that’s out there in terms of, like, the generative chat and the pictures, and, you know, all of the llms, like the anthropics and the open AI and things like that. You know, my view is that they’re just kind of hitting a ceiling in terms of what they can do, and it’s going to take a lot of internet data for them to get to that next level. And then you have, I think the more practical use of AI, the AI that was there before, you know, you know, open AI started marketing, you know, the idea of this huge, massive data set. And let me make some order out of it, and let’s see if we can stop trending against benchmarks and things like that. As you thought about AI in your application. I’m sure you have, everybody has, I don’t know if there have been challenges to adoption of certain solutions that may have prevented themselves from being used in your use case just because of the ability to learn the capabilities of the system or its cost. Now we have this whole up ending of the AI market with deep seek and others who have basically trained LLM models for about 5% of the cost of the latest LLM from open AI. The other part of it, the actual doing part of it, the interpretation and doing it, that cost is almost certainly going to come down. We’ve talked about the cost of this, things come down. More people will use it. Are there dreams that you’ve had without incorporating AI within home care that have been kind of limited so far? You know? Why have they been limited? Do you have hope for the future now that some of these new things are happening, you

Lisa Lavin 23:54
Now, AI is going to become part of everything that we do. We know that for sure. Here’s what I’ll say to me, I see three different layers of AI for us currently, as well as in our future. You know, the current AI is what we do today. It’s taking the data that exists and running it through an analytics platform that makes it meaningful to a healthcare provider. So then, rather than inundating a healthcare provider with data, we’re serving it up in a meaningful way that’s actionable. Okay, that’s number one. The second layer is where it becomes predictable or predictive, right? So we’re using that data that then all of a sudden, it’s not just something that’s happening right now, and, oh, by the way, there’s something happening right now, but well, because of something that’s happened in the past, this is happening again. It appears that this could be predictive of something that might be a bad thing happening in the near future, so alerting to that point. But I see something even bigger that I think is an opportunity, and that has to do with artificial intelligence. Is with regards to companionship. So we know one of the biggest silent killers of humans in general, but especially the aging population, is the disconnection that can happen and the loneliness that can happen as I age, right? And my family only has so much time to talk to me during the day and I live alone, right? I mean putting myself in that position. So, you know, we’re talking about a population that lives alone, that’s lonely, they’re disconnected. How can we help them feel more connected and part of a community? Well, certainly, you provide an easy means for them to be able to communicate via an audio visual platform, one touch access to caregivers and family members. Great. But what if they’re not available? What if there were an entity that was available on the hub that I could talk to anytime, and matter of fact, that entity might even ask me every day, how are you doing today? Lisa, how are you feeling and being able to measure my voice, and be able to be even predictive in that way, to be able to alert somebody, you know, Lisa doesn’t sound right today, you might want to check in, right. So I just see this growing in such a way that not only relieves, that reduces the burden on health care providers, but also serves as a way to increase joy in life as well.

Michael Hughes 26:28
I love that, and I love that sort of vision for the future that you have to be to improve quality of life, because that’s where we’re all in this for you know, it’s just improved wellness, improved health, improves quality of life as that person defines it for themselves for as long as possible. So I love what you’ve been doing. I love where you’re going with this solution. Lisa and like I said before, we like to end our podcasts with three questions just about your own experience with aging. But before I do that, obviously people want to find you. Where can people find you? Where can people find home care? The best

Lisa Lavin 27:00
A way to find home care is to go to our website, which is Ōmcare.com o m c a r e.com and they can learn all about Ōmcare. They can even purchase it today in our store, awesome. You can also find Ōmcare in select senior care providers, and growing national availability through those channels as well. O

Michael Hughes 27:20
M, C, A, R, e.com, correct. Got it all right. Super All right. Three questions. Here we go. All right, so Lisa, this is our first question. When you think about how you’ve aged, what do you think has changed about you or grown with you that you really like about yourself?

Lisa Lavin 27:37
Yeah. Thanks, Mike. You know, I think about building a business and just how intense that has been, it’s easy to ruminate on mistakes in the past. It’s easy to perseverate on what I need to do next and all the things that need to be solved. And I think, more than anything, as I’ve aged, I’m grateful for the life lessons that have taught me to focus more on the present moment, that understanding that I can’t change the past, I can’t control the future, and that it is the present moment that is the thing that is most important now, full disclosure, This is a moment by moment practice, but it is a practice that makes me a better person. So yeah, thank you. That’s awesome.

Michael Hughes 28:28
Thank you so much for that great example for our audience. Question two, what has surprised you the most about you as you’ve aged? Well,

Lisa Lavin 28:36
You know, I have to say there have been so many times in my life that in my arrogance, I believed that I was infallible and immune to both sickness as well as aging. And I remember looking when I was younger, seeing an older person receiving assistance to help them walk, and then arrogantly saying to myself that will never be me. I will never be that old and, you know, I just realized as I have gotten older that, yes, you are fallible, Lisa, you are absolutely human, just like everybody else. But that doesn’t mean it’s a bad thing. It actually, what I’ve learned is I’ve become more vibrant with age because I’m a little bit wiser with age that the chains of insecurity and self absorption have fallen off a little bit more that has released me and opened my eyes to be so much more and as I age, the more surprised and delighted I become. That’s

Michael Hughes 29:38
sort of, that’s kind of a richness of life experience. Now, right? That’s sort of that really cool part about reflection and context. And you know, really knowing the things that you value and all of those things, and I love the fact that you feel that you’re aging more vibrantly. Now, vibrant is a great term, and I love that. So let’s talk about our last question. Then let’s talk about. Other people that might have inspired you to age with abundance. I mean, is there someone? Has there been anybody in your life, or someone that you’ve met that has really set that good example for you as an agent? Yeah, clearly one for other people. But who’s inspiring you? You

Lisa Lavin 30:13
I know Mike. A number of years ago, we invited a dear friend to come live with us. Her name was Kathleen. She had just turned 80, and she was just recently diagnosed with terminal brain cancer, and, you know, at that stage in her life, and given the stage of her cancer, her options were limited, but what she decided to do is she decided to go ahead and do some chemo and do some radiation to extend her life, maybe even just a year. This is what I learned from Kathleen, that in the midst of all of those burdens and barriers and pain and suffering and losing her hair and becoming very ill, what was most important to Kathleen were the people in her life, and she made that a priority. She made it a priority that she was going to continue to love and inspire her family and friends on a daily basis. And you know, I’ll just never forget this stream of people coming in and out of our home on a daily basis, just to have a little bit of time with Kathleen because of who she was, she was a beacon of light and love to everyone around her. And even in her death, she was an inspiration to all of us. And so I think about Kathleen that never let a moment of life go by to live and to love. Well, wow, I

Michael Hughes 31:38
I really appreciate you sharing that with our listeners. What a wonderful place to end on this podcast. And I just thank you so much for giving up your time and being part of this. But of course, more appreciation to our listeners. They have given up time as well, and hopefully you guys think that this is time well spent. So thank you for tuning in and listening to this episode of The Arc of aging, which is part of the abundant agent podcast series from United Church homes and please, what did you think of this episode? What questions do you have about things like medical management for a loved one? Where do you see things going with AI, who is your abundant agent hero? Please talk to us and let us know at abundant aging podcast.com you can also find other episodes of the series on abundant agent podcast.com as well as on our YouTube channels, you can search under United Church homes. Lisa, once again, where can people find you in home care?

Lisa Lavin 32:28
Ōmcare.com

Michael Hughes 32:31
Ōmcare.com Awesome, everyone. Thanks for listening. We will see you next time!