Compliance Checkup: How Technology Can Positively Affect Compliance: An Interview with an Innovator

By Laura F. Fryan on May 21, 2019

I am excited to introduce you to Bharath B. Reddy Bynagari, an entrepreneur and innovator in the health care industry. Bharath has founded four technology companies that serve clients in the health care industry, from physicians to post-acute and long-term care facilities. His most recent company, CareAscend, LLC, focuses on helping medical directors and the facilities they serve to maintain compliance in key areas.

After reading the Compliance Checkup about medical directors several months ago, he contacted me. Since then, we’ve discussed many issues in the health care industry, like how technology will continue to affect the delivery of health care. I want to share with you an interview with Bharath that contains many insights into achieving compliance through technology.

Laura: What is your background and how did you become involved in the health care industry?

Bharath: I am trained in IT. I did my Masters in Computer Science at the University of Texas at Tyler. I wanted to be an entrepreneur for as long as I can remember.

During my last job, I was working as a manager for a product engineering team at a health care data company. My team’s job was to take ideas from our VP of Engineering and run with them to make a product to sell to our customers. I learned how to execute an idea and implement it in real life.

During this time, in 2007, one of my twins got sick in the evening. I talked to the after-hours on-call pediatrician and realized how disjointed the practice of medicine can be despite technological advances. The on-call pediatrician had no idea who my son was and what his medical history was. This incident made me realize that there is huge gap here. I came up with an idea for an app platform that provides on-call doctors with a snapshot of the patient’s history and a way for them to easily document the care provided. I partnered with Community Health Network in Indianapolis and created Diagnotes (www.Diagnotes.com), a secure communication platform for healthcare providers using voice, text, and video.

This is how I started my entrepreneurial career and foray into the health care industry.

Laura: That’s a great beginning to your career! Describe the companies that you’re involved in and what need they fulfill in the industry.

Bharath: After developing Diagnotes, pilot testing it, and implementing it at hospital systems, I became part of a team that developed a brand new care model to help patients with depression, dementia and early onset of Alzheimer's disease. We tested the new care model with 200 patients, and I designed and developed the software for this care model. We then applied for and were awarded a CMS Innovation grant to expand the care model to 2,000 patients.

During this time, I came to know Dr. Arif Nazir at the Indiana University School of Medicine. We became good friends as we both have the itch for innovation. We wanted to work together to solve several problems in health care.

 In 2017, in his new job as a Chief Medical Director of a post-acute care facility company, he shared the challenges he faced in the long-term and post-acute care world. We created a prototype of an application to solve certain problems, and then we presented our creation at a meeting with AMDA – The Society for Post-Acute and Long-Term Care Medicine. The CMOs in attendance were very excited about our application platform, known as CareAscend.

CareAscend keeps all parties involved in the financial transactions with medical directors in compliance. Medical directors can add a task and time spent as they work at a nursing home facility and at the end of the month, we can link that time log to the accounts payable department for prompt payments to the medical director.

CareAscend also has free features where you can search for any facility and see the CMS 5-star ratings and quality metrics for that facility.

We have created several dashboards within CareAscend, one for a chief medical officer, one for compliance, and another for administrators. You can easily audit all tasks, time, and payments to medical directors.

In the post-acute and long-term care world, I’ve seen a need for the chief medical officer and medical director to be on same page with the quality of care to be delivered at the facility level, as most of the time a medical director works part-time at a facility. In CareAscend, we have created an Orientation Package for each medical director’s onboarding process. The chief medical officer can create and manage the training he/she wants to provide.

We also added a Facility Evaluation Report feature to CareAscend. The medical director, Director of Nursing or others can assess the facility against the evaluation features customized by the chief medical officer. You can track the facility evaluation over time and manage the facility issues easily.

We partnered with AMDA, and our goal is to bring all membership benefits like CME training and others to the user. After that, our goal is to be able to do a fair market value assessment for the medical director’s compensation.

I am also working on another idea to collect objective patient reported outcomes data during clinical trials through a company called DigiBiomarkers (www.digibiomarkers.com).

Laura: It’s fascinating to hear how those companies started and how you took an idea and turned it into action. What are the most difficult issues that your clients face?

Bharath: Two major issues with care providers in nursing facilities, home care, and palliative care: uniform delivery of high quality care and compliance with regulations:

• Uniform delivery of high quality care: In the long-term and post-acute care world, facilities have several armies of care providers. The goal is to have a unified army of care providers serving the patients.
• Compliance: Financial transactions with physicians are one of — if not the most — high-risk areas for a health care provider. In order to maintain compliance, health care providers not only have to enter into transactions with physicians that are at fair market value and address needs, but they also have to ensure going forward that the physicians are meeting the terms of the contract. This includes completing assigned duties, meeting the minimum number of hours specified, submitting time sheets by their due dates, and not exceeding the contractual caps for payment.

Laura: I’d say you’ve identified two extremely important issues there. Moving forward, what is your vision for how technology can improve health care delivery and operations?

Bharath: In health care delivery and operations, there are several data points that the provider has to know and apply. Most important of them is the latest research on diseases, treatment plans, and how that knowledge applies to the patient in front of them. On the other side of the equation, there are so many rules and regulations that they ought to know. Our goal with CareAscend is to automate the non-clinical items like compliance, time tracking, orientation, training, CME credits, facility evaluation, etc., to allow physicians and facilities to focus their time and efforts on providing the best care possible to patients.

Laura: What is the most important issue you believe should be addressed by the health care industry now that will affect health care delivery and operations in the future?

Bharath: Care coordination and having the patient and the family at the center, I believe is the key issue that needs to be addressed.

Taking care of a patient holistically, along with the input from the family members and caregivers, is very important. Health systems should and need to realign their care processes and care models such that information flows smoothly between their care teams, the patients, and their families.

Patient goals have to be in the center of all care workflows and accomplishing those goals for the patients has to be the metric of successful care delivery. These goals should include a focus not just on medical goals, but also on key social determinants such as access to food, affordability of health interventions, patient safety, and much more. 

Thanks for reading this interview with Bharath. I love hearing about how technology can positively influence compliance, and most importantly, patient care. Let me know if you want to see more interviews in future Compliance Checkups, and be sure to subscribe in time for the next issue in two weeks!

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