How Excelin Home Health Used Telehealth to Automate Its COVID-19 Return-to-Work System

Between mid-March and mid-August, more than 12.1 million Medicare beneficiaries received some sort of telemedicine service for their health and wellness.

The numbers don’t lie: The COVID-19 emergency has officially ushered in a new age of telehealth in the U.S.

But while in-home care providers and other organizations have embraced telehealth to deliver virtual visits to patients, many have also leaned into it as a way of streamlining operational processes.


One such company is Excelin Home Health, which has been using telehealth to automate the return-to-work assessments the company conducts on a daily basis with its staff during the COVID-19 pandemic. Specifically, Excelin turned to Synzi, a St. Petersburg, Florida-based company that provides virtual visit and messaging tools via its telehealth platform.

“We populate a daily screening questionnaire, and it comes up on [our clinicians’] app every single day,” Alicia Marr, CEO of Excelin, told Home Health Care News. “The clinicians can open that app and answer that line of questions first thing in the morning.”

After completing the questions, their responses are sent back to the Excelin manager for that particular location. In turn, managers can automatically know which staff members are available to safely work with patients based on their symptoms.


Dallas, Texas-based Excelin is a Medicare-certified home-based care provider that has 12 locations across Texas and California. Its service lines include home health, hospice and private-duty home care services.

Currently, the company has roughly 500 employees and serves about 2,000 clients.

Prior to implementing its automated return-to-work assessments, Excelin relied on a manual process to help with COVID-19 staffing protocols.

In order to get an accurate headcount of which caregivers were available to work and which had COVID-19 symptoms, agency administrators had to individually text or call each one of their staff members, using spreadsheets to track responses.

“Think about the time spent calling and asking every staff member those questions, keeping a manual log that risks information being inaccurate,” Marr said. “It was really burdensome for the staff.”

A number of other issues also resulted from Excelin’s previous manual process, she noted.

“Sometimes, the staff member wouldn’t answer all the questions. There would be interruptions, or it would just take such a long time for one or two callers to get through the list of all the employees,” Marr said. “It was a very tedious process. If there was a symptom that was identified, that meant you had to stop, call the manager and reconcile that. That means everybody still left on the list is delayed from receiving a call.”

Having caregivers independently submit questionnaires through the app has allowed for greater operational efficiency, according to Marr.

That’s particularly important at this point in time, when agency margins have been tightened due to rising personal protective equipment (PPE) costs and other expenses.

Additionally, the company’s current return-to-work assessments system has been an asset when it comes to staying compliant with regulatory requirements.

In general, telehealth has been at the forefront of Excelin’s COVID-19 response. The company began offering telehealth services to all of its patients at the start of the public health emergency.

“We were very committed to wanting to support our communities and caring for the COVID-19 population,” Marr said. “When we developed our internal protocol for caring for patients, telehealth was very much a part of that protocol. We felt it was very important to protect our staff, to preserve our PPE and to protect our patients.”

Excelin’s is using telehealth services with roughly 15% to 20% of its patient population. This includes care coordination, medication reconciliation and touchpoints for high-risk patients.

“That was very much a part of the dialogue that we had with our referral sources from Day 1,” Marr said. “‘Let’s talk about telehealth and how we’re going to incorporate it into that plan of care.’”

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