Voices: Joe Held, Chief Technology Officer, Forcura

This article is sponsored by Forcura. In this interview, Home Health Care News sits down with Forcura Chief Technology Officer Joe Held to learn about his career journey to the world of post-acute care technology, how Forcura is adapting to the new operating landscape under the Patient-Driven Groupings Model (PDGM) and the COVID-19 remote workplace, as well as how the company is uniquely positioned to assist home health providers through the current and rapidly changing care environment.

HHCN: Given your extensive career path in technology, what took you to Forcura? Tell me about your journey. 

Held: I’ve worked both on Main Street and Wall Street for several firms, whether on the payer side of health insurance, or investment products, or in direct marketing and publishing. In all those cases, there were opportunities to make some radical changes to improve the industry, and we just happened to do it with technology. What I like to bring is a holistic view of what the market needs, what’s possible with technology, and then put it in play to win in the marketplace.

One of the highlights of my career was at Aetna HealthPlans in the 1990s, taking a co-leadership role in developing the largest medical management artificial intelligence platform at that time. Our work supported medical protocol development, natural language search of our medical management libraries and clinical risk assessments in support of the certification of care plans and treatments. We made our first step in medical informatics and demonstrated the platform to Congress, the AMA (American Medical Association) and worked with our sales team to close national accounts. It was the first Aetna technology patent and some of the components would still be considered bleeding edge today.


Forcura’s leadership team brought me in to help them develop a go-to-market strategy in post-acute care (PAC) analytics. We also analyzed opportunities over a wider range of services in our markets, relying on a transition from documents to data, information curation, natural language and workflow optimization. There was an open CTO position and I jumped at the chance to join the company because it has an enlightened leadership team with an innovative culture focused on the customer, the best green-field business opportunity I’ve seen in many years, a strong technology team with a seat at the table and leading-edge technology ready to transform the PAC industry.

I was also deeply influenced by my father’s journey from home health care to acute care, to skilled nursing and rehab and ultimately to hospice. I was very impressed with the caregivers, who are truly amazing people. But they were saddled with manual processes, document overload, incompatible systems and a variety of information-sharing processes that harkened back to the 1990s. It was difficult for them to get a comprehensive view of the patient’s circumstances across the spectrum of facilities, systems, manual workflows, care plans and treatments. It would take a village with support from family members to keep this all on track and a great deal of critical information would fall through the cracks. A key motivator for me is to change that, and the opportunity arrived at Forcura shortly after my father passed away.

What are the most crucial lessons you learned in your career that you apply at Forcura?

What I like most about Forcura is that lessons go both ways, and despite the breadth and depth of my experience across industries building digital businesses, it was exciting to see that the best digital ideas don’t necessarily come from me. Occasionally, the best product ideas may even come from my technology team. There’s always a temptation to live within your role “box,” but the truth is that there is no box. The best companies live in a best-idea-wins culture with a great deal of direct and timely communication across the organization. This brings our entire focus on our customers to help them improve patient care, and has served us very well during the recent pandemic lockdown.


Can you talk about what you’ve done since arriving at the company in terms of changing the technology, and optimizing it? What’s coming up ahead in the present-day, particularly with respect to the payment landscape?

Forcura started out as a document management workflow company, and there are many opportunities to expand our capabilities, not only within our current verticals but within other verticals in post-acute care. If you think about it, we are expanding to provide access to more data sources and to provide sophisticated curation of that data, so that we can continue to drive efficiencies in home health and hospice workflow.

That curated and integrated information becomes very valuable to our customers in analyzing referral and order trends, improving operational efficiencies, and then tying that to improve cost management.

In post-acute care there is an opportunity to leap-frog the older generations of technology relied upon by acute care providers. The convergence of cloud infrastructure, SaaS (Software As A Service) offerings, and high-performance public networks have significantly reduced the cost of entry for companies like Forcura. The convergence of these technologies provides the foundation to build and integrate amazing software that can immediately reach a nationwide marketplace. And when it comes to workflow, analytics and patient care, we have the benefits at our fingertips to rapidly bring scale and speed.

For example, we can do more with mobile devices and provide insight to caregivers at the point of decision-making regardless of the time zone, device or format of the information provided. This speeds up approvals for orders and processing of referrals and results in better patient care.

Down the road, we’d like to give providers access to much more of that information so they can achieve better medical outcomes. We had over 120 installations last year and we’re on track to do that again this year — or more.

What is in place and in the queue to boost the performance of Forcura’s core product set? What does that do for clients?

Currently our industry receives information from a variety of sources and formats. This includes electronic faxes from fax clearinghouses via our home health and hospice agencies, data file feeds and direct API connections to intermediaries such as the electronic health records systems providers, images of physician signatures, video of wounds at home health agencies, virtual doctor visits and chatbots, and more. This opens up opportunities for firms such as Forcura that can aggregate and transform the information to provide actionable content and analytics to measure and improve agency workflows.

For example, we have implemented a new natural language and machine learning platform to reduce the time it takes to process electronic fax orders. We are using this capability to do the same for referrals, which will be available later this year.

We have also implemented a state-of-the art business intelligence platform that provides our customers with workflow performance reporting. This enables our customers to evaluate the effectiveness of their referral and order processes and improve them for quality of care and compliance purposes.

Over time, we expect to integrate our information with standards-based health information exchanges – which will provide more patient insight from acute care providers.

Tell me about how Forcura is adapting with all that’s happened under PDGM.

PDGM has had some ripple effects when viewed through a digital lens. Agencies are now required to collect more information, then process, reconcile and track their activities in shorter periods of time. And their activity tracking must be accurate, auditable, defensible and compliant.

For example, the change in payment method with more groupings increases processing complexity. PDGM requires enhanced OASIS care plan documentation to support these new payment groupings. And we now need to reconcile the OASIS plan with the PAC order with the actual services rendered to meet payment criteria in record time. All of this requires a higher level of technology sophistication to evaluate care plan impacts, review the cost of treating comorbidities and track payments and costs.

Many agencies, particularly the small ones, were living off spreadsheets, piles of documents and paper faxes, with workflow managed through their email. PDGM has made it more difficult for these agencies to work this way and operate profitably. The new regulations have now made integrated document management, workflow and decision support technology essential in our industry.

Forcura brings the ability to track all of this critical information in such a way that’s efficient and meets compliance requirements, while providing an integrated view of patient care in the settings that we support.

How does the tech enhancement help home-based providers function in what is now a remote work landscape?

We are a cloud-based SaaS technology company that provides ease of access to our platform for agencies nationwide. We are also device-agnostic which enables all of our customers to work at home, in the office or on the road. This was designed-in from the beginning — including our proprietary secure messaging service. All of this is integrated with ease of installation and use in mind.

Since the COVID-19 pandemic started, our phones have been ringing off the hook for new installations, and our customer feedback has been exemplary. This flexibility and the value we bring for work-at-home is immense. Ease of use with remote training, ease of access anywhere-anytime at a very reasonable price is readily available. These capabilities were once checkmarks on a request for proposal, but are now recognized as a competitive advantage in our industry.

What new business pursuits are on the horizon for Forcura as a result of these changes?

When we analyzed the opportunities in our markets last year, we found a need to improve the continuity of care across acute care providers and post-acute care services. There is also a common set of digital services required to make these transitions smooth, secure and compliant at a cost that is acceptable to payors in our industry. These common services include information collection and curation, workflow, analytics and information distribution to partners and customers. We also examined our workflows and found automated decision support opportunities to streamline the process.

Forcura, with our EHR partners, intends to be the central nervous system — with value-added workflow and insight — for these transitions to empower caregivers to improve patient care.

With so much in flux in the industry here in 2020, what do you think will be the greatest benefit to home-based care providers of Forcura’s technology enhancements?

It’s not just about doing more referrals and orders faster at less cost within a compliance window. It’s also, for example, improving the quality of the patient experience with the insight required to avoid readmissions. Over time, Forcura and its digital partners will provide an end-to-end view of the entire PAC patient experience with the information required to improve decision making. This will avoid the pitfalls my brother and I experienced in ensuring there was a continuity of care for our father last year. That’s the bottom line.

Forcura is a technology company 100% focused on health care, driven to innovate and dedicated to powering your organization through better patient care, improved cash flow and reduced administrative expenses. To find out how, visit us at forcura.com.

The Voices Series is a sponsored content program featuring leading executives discussing trends, topics and more shaping their industry in a question-and-answer format. For more information on Voices, please contact sales@agingmedia.com.

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