Valerie V:            Hi everybody, Valerie V Show, and today we are interviewing Lee Horner with Synzi. I’ve been talking about this for a long time. I know that you guys all understand net telehealth and virtual health is really taking off. There’s never going to be less of it. There’s probably always going to be more of this. We’re here today to learn from Lee Horner, CEO of Synzi. He has a very long and prestigious background. I’m not going to go into all that, because I’ve already posted a ton of things. But, he’s going to tell us all about Synzi and their telehealth, and all the cool virtual stuff they’re doing. So welcome, Lee.

Lee Horner:         Thank you very much for having me, Valerie.

Valerie V:            Thanks for being here. Why don’t you start by telling us what is the history of Synzi?

Lee Horner:         Yeah, so I founded the organization actually in March of 2016 under a division of Stratus Video. We actually started as Stratus Video Telehealth Division. I was fortunate enough to grow the business. In late 2017, we decided to make the decision to form a new company, which we named Synzi, and took on new equity, and have really been exploding ever since. Really, January of 2018, we launched the new brand, and things have just been exciting. As you mentioned, this market is incredibly exciting right now, and there’s a lot of really neat things going on.

Valerie V:            Yes, and I know a lot of home health agencies are probably knowing and sort of reading all about this and thinking, “We got to get into it. We got to get into it.” But they have no idea how to even start doing virtual visits. So, how can home health agencies use the Synzi platform to increase staff productivity, just use it in general?

Lee Horner:         Yeah, so it’s a great question, and it’s what we get hit with every single day. I think the first thing is be smart when you’re looking at making investments in technology. There’s a couple key factors that we really focused on when we started in this marketplace, that we thought would drive significant value, both to the organizations that were looking to use the technology and especially the patients, right? Because at the end of the day, it is about the patient experience, and being able to use technology to provide an equal experience as if you were in person, right?

So, one of the things that we really always talk about, is keeping it simple. That’s what we really pride ourself on. We built a platform that’s allowed for organizations to really take advantage of our technology. And it’s really because we’re keeping it simple, to where patients will adopt it, they’re able to use it, it’s simple to access, it has low costs associated with it, and it provides high value. And it’s really taking over. We’re staring to see, not necessarily the replacement of organizations using individuals and nurse practitioners or RNs to go to patient’s home or care management, but really to supplement and augment it. The ability to just be able to put a set of eyes on the patient more frequently, but not necessarily have to be there in person and get in the car and drive to that person’s facility, is really what’s driving the change.

Valerie V:            Awesome. So that leads me to, how can home health agencies continue to deliver that compassionate care? ‘Cause we know that one-on-one care is just so important, but how can they do that while using a video-based platform?

Lee Horner:         Yeah. So, what we’ve found is, again, if you kind of fall back on keeping it simple. So first thing, from a patient perspective, you not only have to have technology that works and it’s easy to use, but you don’t use necessarily proprietary hardware. So we run on everyday devices. People that use their iPhones or their Android devices or a Windows device, we run on all of that.

So from a patient perspective, really it’s the ability to speak with their care team or care coordination team out of the convenience of their own home without necessarily having to be at a scheduled appointment or wait for someone to be there, but the ability to … Maybe they have a question or they’re not feeling well that day, and maybe the care team is not supposed to be onsite. The ability to be able to access those individuals with a simple click of a button, and those individuals be able to put a set of eyes on the patient, becomes really powerful for both organizations.

Valerie V:            That is super nice. My husband and I have had very limited experience … I’m a nurse by trade, but home healthcare in our home has been very limited. He had surgery one time, had to have home healthcare, and boy, would I have loved to have been able to just hit the button and say, “What do you think this is?” Or, “Is this okay?” You know, “Am I doing this right? Well, you’re not here, I don’t want you to come here, I don’t want you to have to schedule another visit, but just tell me if this looks okay.”


Valerie V:            So let’s talk about home health agency staff members, because again, that nurse didn’t have to make another trip to my house after hours. I just would love to have been able to turn that iPad around and say, “Is this okay,” without her having to get in the car. So how will the platform enhance the quality of life and job satisfaction for home health staff?

Lee Horner:         Yeah, it’s a great question. So, this idea of today, what we’ve learned is that staff spend many, many hours a day just commuting from patient’s home to home, right?

Valerie V:            Mm-hmm (affirmative).

Lee Horner:         And that’s very strenuous and tedious, and it puts a lot of strain and pressure on the individual that’s caring for the patient themselves. So the idea of that care manager or the home health individual supporting that patient, being able to be at a stationary location, one, they can provide a better quality of care, which is easier for them, because they’re not having to get in their car and deal with either commuting traffic or things that are challenging, and the risk and the liability around that.

The second piece is, they’re able to see more patients. What’s really starting to drive things, as you know, is there’s less population in regards to RNs and physician staff in order to support the growing population that we have. So we have to get more economically savvy around both what we’re providing, but also the economics of scale of how do we provide more with less.

That’s really what we’re seeing. We’re seeing these organizations be able to do three or four times the amount of work, and it’s less stress on the individual that’s trying to support those patients.

Valerie V:            Absolutely, drive time is huge, especially in big metro areas or even in rural areas where you have to drive 50 miles to get to a patient, or 25 miles. But in urban areas, we’re talking about traffic and transportation issues. It’s never ending, and it’s always getting a little bit worse in the urban areas.

Okay, so let’s talk about return on investment. If a home healthcare agency is going to invest in a platform like this, what is the return on investment when using virtual care communications platforms like Synzi?

Lee Horner:         Yeah, so we obviously work hand-in-hand with these organizations every day to really understand where the real value is. In many cases, there’s reimbursement models. But where we’re seeing the biggest return, to be perfectly honest, is going back to the piece that we just spoke on. That is the ability for organizations to leverage their staff to be able to keep them stationary and be able to see, in many cases, three and sometimes four patients in the time it takes them to see one. So the economies of scale with that itself is tremendous.

Then you also have to take into consideration from a company perspective, the cost associated with mileage and transportation around mileage. In addition to that, the liability of the individual that’s driving from location to location. When you add all of that up and you really look at what’s happening, we see anywhere on the low end, three times your return. In many cases, it’s five or six or even more. And that’s just scratching the surface on how we really look at return on investment. You start to apply the reimbursement model and the ability to basically remove and mitigate the readmittance component of where there’s a lot of cost associated with that to both home health organizations and hospitals, all of a sudden you start to have a pretty sizable ROI associated with everything we do.

Valerie V:            Absolutely, especially those large hospital organizations or even small, that helping folks stay home, get past that 30-day mark, avoiding those readmissions, that is huge. And being able to see someone and know just by seeing them, “Yeah, they really do need somebody to come out there right now.” Or, “Well, you’ll be okay.” It’s going to be all right. There really is … just amazing the technology and how we’ve advanced.

And teaching seniors, or I’m sure we see all kinds of folks. I mean, my husband’s not a senior yet. But teaching folks how to use these platforms doesn’t have to be that difficult. It’s not the challenge that it used to be. So if they have any kind of device … and that’s what I also like. You said, “If they have any kind of device … ” Maybe it’s a smart phone, maybe it’s an iPad, maybe it’s a laptop, they can use the Synzi system with that. It’s not a specific device they have to have.

Lee Horner:         That’s exactly right, and it was intentional, right? A lot of organizations support specific OSs or specific types of devices. When you start to look at the population across the U.S. and the world, you have a really, really diverse demographic around technology that’s being used.

You add that to one other facet that we really focus on, and that’s, it’s not just about having the device that you’re trying to use, but we also have found a way to provide high-quality video services across low bandwidth cellular. And when you start to look at those rural areas that you talked about, there was a lot of limiters in years past where people were trying to use video technology. They would have to be either on wifi or dedicated connections.

Now, with our technology, we can run on 3G communication across a cellular connection and put not only two people on a video call, but three and four people on a video call simultaneously. It’s really [inaudible 00:10:50] in the way it’s being delivered.

Valerie V:            Absolutely. It’s amazing, too, if you travel at all, you know that there … especially if you travel to rural areas, you know that where there used to be no cell service, typically now, there is a cell tower within reach. Most of the time, we are to the point where there are more and more cell towers going up so you don’t lose that connectivity the way you used to. I know there are still spots that are dead, even in the middle of town, but for the most part we can connect with each other.

We just took an 11-hour road trip with the kids, and they may have been without wifi for 15 minutes of the whole trip. And we went through some really rural areas. Of course, they hollered as soon as the wifi was down, so I knew that.

Lee Horner:         [inaudible 00:11:37]

Valerie V:            But we were in some really rural parts of Mississippi going down to the Gulf Shores area, and they had wifi the whole time, very good wifi. So absolutely, it’s becoming more commonplace.

Okay, so what are some examples of Synzi’s partners or use cases as it relates to home healthcare? Tell us about that.

Lee Horner:         Yeah, so I mean, we’re obviously partnering across the country. We talked a little bit, we did a press release just recently with an organization out of Florida, a home health organization that basically spans the entire state of Florida, named Trilogy. You know, Trilogy is using us for multiple different communication components. They’re using us both, as we’ve talked about a lot here, from a virtual perspective to be able to …. you know, the ability to connect video communication with patients and caregivers.

But they’re also using us for a communication platform that allows us to send out notifications, whether that be just from an engagement perspective of wishing their patient and members happy birthday during that period, or notifying them of, “It’s flu season,” and “Think about getting a flu shot.” Just that steady, constant contact with patients and keeping them engaged and being able to use an automated platform like ours to be able to deliver that, has really boost value. They’re outliers, but what they really drive are brand awareness and patient satisfaction, right? So, it’s great to have a video component, but there’s also different modalities and different ways to continue to help drive patient satisfaction and branding.

There’s an organization in California that we use that, as you mentioned, they allot 45 minutes each commute, so a roundtrip commute for them is an hour and a half per LPN in order to go see a patient, and that excludes the ability just to spend the time with the patient. So in all, it’s an hour and a half for them to be able to … or I’m sorry. Almost two hours to do a full commute of to the patient’s house and back and actually spend enough quality time with the patient. So again, being able to, again, not replace, but subsidize the ability to maybe be able to see that patient two or three times a week versus, in some cases, only one time a week. It’s become really important and really valuable to the organizations.

Valerie V:            I like what you mentioned about the brand awareness, because reaching out, all those touchpoints, whether you’re texting me or sending me a little short video or you’re communicating with me, most of us are on our mobile device all day long. And so, when I get a text from somebody, I am much more likely to A, read it, or B, answer it, than I am even a voicemail. I’ll always listen to my voicemail, but I see that instantly. If there’s a link associated with it, and I can go schedule an appointment real quick to get a flu shot, or just get in the car and go, then I’m much more likely to do that.

So, I think the brand awareness part, from my marketing background, that part really is exciting. I love the fact that they can use it for more than just the virtual visits. This is really neat. I mean, there’s a lot more to this than just virtual visits. So that’s pretty cool.

Lee Horner:         Yeah, and if you take it one step further, right, the beauty of our technology and what we really focus on, is the behavior of the patient. Everyone talks about how it facilitates better communication and better video, but you also have to understand how patients behave. The things that we really start to look at, is different demographics and cohorts of patient populations respond differently based on the modality that you use. There’s some [inaudible 00:15:21] really love the idea of using texting, as you described, right? The ability to get the text, click a link, and route to scheduling a flu shot is very important. Others like the idea of being able to do a video call and just have the conversation with someone, right? Others like email. Me personally, I don’t. I’m not a big email fan, ’cause you get thousands of them during the day. But I’m on the text side as well.

But understanding that behavior of how patients want to be communicated with, instead of the days of the past where we communicated one way and we were all about the organization and how the organization communicated. I start to talk about things called choice, and patients are looking for that. They’re looking for choice, they’re looking for convenience. They’re looking for things that will allow their lives to be more effective and really fall in with how they live their lives day in and day out.

Valerie V:            Right, and imagine a big hospital system, or even a small one, who owns many, many doctors or physician practices, being able to text all the patients and say, “It’s flu season. It’s time.” A home health agency doing it is awesome, but having our hospitals understand the importance of some of that communication choice stuff is amazing. I mean, I wish our hospitals would text me and remind me that it’s time to blah, blah, blah, or whatever. Or text me appointment reminders even. Oh my gosh.

So yeah, I just think this is amazing. I’m so glad that you came on the show to talk to us all about this. It’s the virtual visit stuff is so important. It’s going to be important moving forward. Can you tell me, is there a specific size of home healthcare agency that really benefits the most from Synzi, or can it be a small all the way up to $20, $30, $40 million in billing or … is there a size that really fits the Synzi model better?

Lee Horner:         Yeah, there’s really not. We kind of intentionally did that, right? Again, we took the approach of keep it simple. When you think about engaging with patients and allowing patients to use the technology, from a staff perspective or an organization perspective we work with very small organizations and we work with the largest of the large. That was intentionally done. We wanted to make sure that … patient care is just important. So why not allow patient care to work in a small home health organization as well as a large home health organization?

Taking that technology further is ultimately our goal, right? It’s how do we continue to provide technology to individuals that traditionally may have had a tough time being able to get the right care, to now being able to provide them that care. Not really looking at it from a discrimination of whether they’re in a rural community or in a high populated area, the ability to support all patients equally.

Valerie V:            Yeah, absolutely. And it’s very nice that a small home healthcare organization can benefit from this and use it and afford it and see a return on investment just as much as a big one can. You know, not only for a patient care perspective, but from a marketing perspective, this is going to start to become something people are looking for. “Can we do visits virtually?” It’s just going to become commonplace. So the more folks you engage with Synzi and get enrolled in that system, the better their marketing will be, the better that message will resonate with people who are used to being able to doing everything, as much as possible, doing stuff virtually. So that’s great.

Lee Horner:         Yeah, absolutely.

Valerie V:            All right, well Lee, thank you so much for coming on. We’re going to put this video out there for all of our folks to see. It’ll also be in our Home Care Daily newsletter. So thank you so much. I appreciate you coming on the show today, and I’m sure we’ll talk to you again soon. If you have a big announcement, let us know. We’ll get you back on the show.

Lee Horner:         I will Valerie. Thank you very much.

Valerie V:            All right, thanks.

Lee Horner:         All right. Talk to you later. Bye bye.