Voices: Annie Erstling, Chief Strategy Officer, Forcura

This article is sponsored by Forcura. In this Voices interview, Home Health Care News sits down with Forcura Chief Strategy Officer Annie Erstling to learn about Forcura’s entré into artificial intelligence, how the company’s new summit aims to bring health care providers together and how she used a personal tragedy to fuel her journey into health care technology.

HHCN: You have a really interesting background, with elements of health, design and volunteer work. Explain your journey to this point as Forcura’s chief strategy officer — what binds all of your experiences?

Erstling:I have a pretty diverse background, and on first appearance it might seem random. When I look at many of my peers in this segment of health care there are a lot of people who have come up through the post-acute health care ranks. My journey to Forcura has been less direct, but it’s led me exactly to where I’m supposed to be, doing exactly the work I am supposed to be doing. 

I started work right out of college with a singular idea in mind: I wanted, in some way, to make the world a better place. In addition, I have also always loved the challenge of achieving business objectives. It’s kind of like a puzzle to me. A company has a goal, and you have all these pieces to choose from to put together to see the whole picture.


Lastly, when I was 26, I lost my mom to cancer. Watching her, as a single mom, navigate the health care system while taking care of herself, and making sure me and my sisters were okay while also spending an exorbitant amount of energy ensuring that all of the doctors she worked with had the information they needed to deliver coordinated care in the fight of her life was really awful. Trying to help her bridge the communication gap between her primary care physician, oncologist, the specialty cancer center she went to in Chicago, and then hospitals when there would be urgent events, and ultimately hospice — it was really stressful, to say the least.

I remember sitting in a hospital with her after one traumatic event, waiting for her to be discharged, and just being so frustrated by the inefficiency of the system. It created an immense amount of unnecessary additional stress to this already incredibly painful part of our lives, and I remember thinking, “One day, I want to fix this.”

The Forcura mission is straightforward. It’s to empower better patient care. And we have a lofty vision: to be the standard communication platform for post-acute health care. These two facets of our strategy drive everything we do. About a year ago, we were sitting in a meeting talking about Forcura’s commitment to drive continuity of care, and the huge opportunity we have in front of us to actually move that needle. I had this realization that I’m doing what I set out to do, which is to be in this position to use my personal and professional experience to make a real difference for people at some of the most vulnerable points in their lives.


One of Forcura’s major goals is facilitating continuity of care, with safe care transitions and a focus on interoperability. The company is now launching its first-ever product using AI: “Referral Automation with IQ.” What is it, and how does it support continuity of care?

Forcura is all about getting the right information to the right provider at the right time, so that the patient gets the best, most appropriate care. Our entire platform is about workflow, with a big emphasis on referrals and moving patients from one care setting to another. From a referral standpoint, most of this patient data has moved back and forth via documents between acute and ambulatory settings into home health and hospice organizations. What Forcura has historically done is ingest all of that paperwork, digitize it and given our clients tools to manage that workflow through a process that works best for them.

The Forcura platform has been very timely at this point in the evolution of the home health and hospice industries and has been instrumental making sure everyone within an organization has a holistic view of what’s happening. With Referral Automation with IQ, we are adding jet fuel on what we already have and making the process much faster by introducing artificial intelligence into referral management.

As soon as a referral document moves into Forcura, we’re recognizing it as such and putting it into a referral-specific queue. This seems pretty simple, but often referrals are faxed into home health or hospice organizations and they sit in a pile with other documents. It might be lab results, radiology reports, or even lunch menus faxed in from area restaurants.

Recognizing referrals immediately makes a difference, especially in the hospice world, where every minute counts for getting new patients onboarded. We’re seeing this simple step is saving hours of time, enabling clinicians to see patients faster.

Outside of PDGM (Patient-Driven Groupings Model), what are the biggest benefits that Referral Automation with IQ provides to home health agencies?

One of the biggest benefits is the second component of this product, which is using natural language processing to read all of the patient’s demographic information on the document and match it with existing patients in the EHR (electronic health record). If an existing patient exists, then that referral information flows into the EHR. If it doesn’t exist, then Forcura is using that information to create a patient in Forcura which then flows directly into the EHR. This moves everybody closer to scheduling a visit to see the patient.

At the end of the day, we are using artificial intelligence to speed up the time that it takes to transition a patient into home health or hospice, as well as making that transition safer by reducing manual entry and opportunities for errors. We’ve gotten great feedback from our partners and our clients.

The next phase is to work more closely with our EHR partners to capture not just patient information but all of the information that is needed to start seeing patients. Through our API (application programming interface) integration with our EHR partners, we can then eliminate as much manual entry as possible. We also see a huge opportunity to use all of the information on these static referral documents combined with client-specific business information to provide predictive analytics, allowing our clients to make instantaneous decisions on referrals as well as directional care plan guidance.

What is the product’s biggest benefit with regards to navigating PDGM?

The entire health care industry is driving toward value-based care. It’s obvious that in order to survive, especially in post-acute health care, you can’t do it without technology. Everything we do is driving toward efficiency and being able to deploy staff in a smarter way allowing teams to focus on higher level functions and on patient care.

Everything we’re doing around referral management — and this is a huge add to our toolbox — is about increasing a client’s cash flow while also building their reputation and reliability with referral sources. Being able to communicate with referral sources effectively, being able to accept referrals more quickly and being able to provide analytics gives our clients a competitive advantage over what has historically happened.

Let’s talk AI. This is Forcura’s first product with artificial intelligence. Why enter this space now?

Forcura works to deploy the most modern technology possible in a way that our clients can actually put into practice today. We have a solid workflow platform that makes moving patient information back and forth seamless. We have great relationships and rapport with all of our clients. We’ve got integration partners that really matter.

We are at the right point in terms of our tech stack, our talent and the sophistication of the market to introduce artificial intelligence. It’s the right time at our company, it’s the right time in the industry and it’s our job to anticipate our clients’ needs and deliver solutions that meet those needs and exceed their expectations. Technology deployed with the right people and the right process is a game-changer for our clients.

How do agencies react when they hear about home health products using artificial intelligence and machine learning?

If you replace “artificial” with “augmented,” it totally changes the conversation. AI isn’t a black box — it’s a tool that helps our industry do more and do it better, whether that’s expediting workflows, or better management of wound care or oversight of population health. In general, our clients have been thrilled when they see what we’re doing. It’s going to reduce staff burnout and improve their efficiency, and, at the end of the day, it should boost their profitability.

Why is this the right time? It’s not just because the market needs it. We also have Joe Held, our new chief technology officer, and he’s been developing AI tools for the health care and finance industries since the 90s. He’s authored patents on machine learning. He’s really a huge asset to the organization and gives us a competitive advantage on how we are thinking through and developing more AI-enabled tools.

If the industry better understands AI when you say “augmented,” how about caregivers? Is there any trepidation on their part regarding the learning curve?

Almost everybody has encountered artificial intelligence, yet most of the time we don’t even realize it. From our standpoint, for caregivers and other users, as a decision-support tool, AI should always be in the background. It’s never going to replace the clinician. The clinician’s decision is paramount.

What are Forcura’s key strategic objectives for the next 12 to 18 months, and how has COVID-19 impacted them?

As a company, we have three key objectives: growth, innovation and a commitment to our culture. What’s really important to us is connecting the people and ideas in health care that make a real difference.

Given COVID-19, its impact on our industry and the light it has shed on the importance of connectivity, Forcura could not be more relevant. To that end, we are hosting our first ever virtual event, the Forcura CONNECT Summit, on August 28. We’re bringing together people from across the entire health care landscape to have meaningful conversations about the continuity of care. It goes back to what I said a moment ago. For us, it’s not just about the technology. We are an enabler, and we are genuinely committed to empowering better patient care by pushing forward new ideas that can be supported by our technology.

What Forcura does is ensure that people like my mom don’t have to stress as much about getting personal health information to the right place at the right time. We want them to spend that time focusing on what really matters, and empower their providers to deliver the best, most appropriate care. To be here in this role at this point in my career is so personally and professionally rewarding. And I’m getting to use my love of creativity and strategy to do it, which is just fun. It’s a great place to be.

*Editor’s note: This interview has been edited for length and clarity.

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 [email protected].

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