Making Healthcare Efficient (ft. Savannah Lee James)

In this episode of Making Healthcare Efficient, Savannah Lee talks about growing up in Boston, why she changed majors in college, starting her company Hopforce, and what motivates her when things get tough. Savannah is the founder of Hopforce, a software development company specializing in tools to help healthcare providers. Her first app, the PDPM calculator was developed to help Nursing Home Healthcare Professionals (Administrators, Nurses, Therapists, Admission Coordinators, MDS Coordinators, Case Managers, Nurse Liaisons, and many other team members) identify the reimbursement and care level of a patient.

Savannah Lee James works at Hopforce Inc.

Listen to the previous episode of Making Healthcare with Tim Coan here.

TRANSCRIPTION

DP: Healthcare is changing. And our goal for the Making Healthcare podcast is to capture and share the stories of innovators and disruptors, who are shaping the future of healthcare today. They’re making healthcare safer, making health care affordable, making health care innovative. I’m David Park CEO VirtuSense Technologies and the host of Making Healthcare. 

Today’s guest is Savannah James, a healthcare expert, co-founder and CEO of Hopforce, which is a software company specializing in automation and optimization of healthcare. 

Three fun facts about Savannah include that she is the eldest of four sisters. She speaks Russian. And my favorite of all, she is a huge Boston sports fan. So welcome to Making Healthcare Savannah.

SJ: Thank you so much for having me.

DP: Please introduce yourself to our audience.

SJ: So I grew up in Boston, or in the North Shore, in Massachusetts. I recently graduated from Tufts University with a degree in computer science and psychology. And in 2019, I started Hopforce, you might know us as the PDPM calculator. And we created a calculator that allows people to calculate the reimbursement they should expect, given a patient diagnosis under the patient driven payment model.

DP: Fantastic. I’m so excited to talk to you because we share the commonality in Boston. And PDPM is such an integral part of our clients. And that really transformed the industry in the past 18 months or so. But before we go on, let’s start from the beginning. So were you born in Boston?

SJ: Yeah, I was born in Salem mass. I grew up in Topsfield, which is a little town.

DP: Yeah. For our audience. There’s a Topsfield fair and it’s a really fun gathering every year. It’s okay, so tell us more about what life was like growing up in Salem, Topsfield, Andover.

SJ: So yeah, I mostly grew up in Topsfield. There was a farm at the end of my street. So it’s a quiet, small town. And, but the influence of Boston sports is everywhere. So we’re a huge sports family. We all played sports. So the proximity of Boston you feel that influence. So everyone jokes, most people that are even remotely close to Boston, they’re gonna say, well, we’re from Boston, because you kind of want that to be your identity.

DP: Even more so we identify with “Oh, we won today,” as if we actually had any part in playing the baseball game or the football game. So you mentioned, you’re the eldest of four sisters. Just what’s that dynamic? What are some of the most memorable events that happened growing up with your sisters.

SJ: It’s really fun. I mean all of us are so different. The age gap between me and the youngest is 10 years. So it’s fun to learn from each generation. They make fun of me because I’m the oldest and I’m so old now. I don’t get their jokes anymore. Like, even with one of my siblings we’re only two years apart, but I still miss certain jokes. And it’s funny, but I learned from each one of them and each generation. So I like to make fun of it. Right? 

DP: And also like to think that as you’re leading a company, you don’t have as much time for pop culture as he wants to say five years ago, right? 

SJ: Definitely not.

DP: So what do your parents do?

SJ: So my mom is also in healthcare. It’s kind of how this came about. She has her company Harmony Healthcare International, where she does consulting in nursing homes. She’s really a specialist in the government regulations and Medicare Part A and all of Medicare. So she helps nursing homes navigate that.

DP: So, where did the speaking Russian come from? Where did the desire to learn to speak Russian come from?

SJ: My grandparents so my grandmother, super Russian or she was and I so I kind of grew up in that culture—Russian polish. So we’d have pierogies and nalesnikis. In high school, I was actually able to start taking Russian because of her and she thought it was so cool. She doesn’t really speak it. She knew a little Polish a little Russia to kind of is intertwined. 

DP: You must have gone to a really good high school because not many schools offer Russian in high school.

SJ: I did. I went to Phillips Academy, which is in Andover. So they had a lot of language options. So I was lucky to choose Russian. 

DP: Okay, so your mother’s in healthcare. So when you decided to go to Tufts University, what was your major going in? You came out with computer science. So it wasn’t always the path for you.

SJ: It was not because of Russia. And actually, in studying that in high school, I added a huge interest in international relations and Russian culture. So I actually went into college wanting to do that. So Tufts has such a huge healthcare focus, and I also grew up with a healthcare focus at home and I kind of got there and I still stuck with Russian, but I kind of knew I wanted to study psychology … computer science was something I never tried. So I guess I kind of got distracted, but I still kept my Russian focus. But there were so many new things to try. And I was close to Boston, and in this healthcare hub, and in this tech hub, so I kind of … 

DP: You don’t just go say,  “I’ll think I’ll take computer science.” Not many people do that. So help us understand more. You’re quite a unique individual.

SJ: I think after my freshman year, I kind of looked around, and a lot of the friends that I had made, they were all studying computer science, and I thought we think alike, and we have that same kind of brain and this is what they’re studying. So I feel like I would like this, I should try this. At least to try it once like one class. So I took my first intro class over the summer. And I was enthralled with it. I just thought it was so cool. I liked math, but it’s different from math, but it has the same kind of pathways. So and I just had to stick with it. I wasn’t going to give it up after that.

DP: That’s great. So I also attended Tufts University. And my major was international relations. For our audience, Tufts has a fantastic IR program. The Fletcher School of Law and Diplomacy is a top notch program. So I think that’s kind of like, you know, where we all kind of started. That’s very interesting. So okay, so computer science, psychology, you’re graduating. So when did this Hopforce idea come about?

SJ: It was the spring of 2019. So I was finishing my junior year. Because I was close to home, I was able to go home a lot. And my mother, we have whiteboards in the house, big whiteboards kind of my mom will go through problems and work and outline them. So I was like, What are you doing? Like, there’s all these whiteboards were out when I came home that spring, and I was like, What is this? What’s the new thing? And she kind of started talking about PDPM. And I was like, okay, that’s new. That’s cool. And then I was how are you going to navigate this? How does the healthcare industry now learn these kinds of things? And she was like, well, we normally would have this Excel spreadsheet that we would kind of pass around. And I was like, well, I could code this, I think that would probably be better. I don’t know how you’re going to do before we worked with RUGS (resource utilization groups), the previous Excel spreadsheet could cover that kind of material. But this new analysis is way more complicated. I got excited because I was like I actually have a skill set that I can, we could work together and I have something I can offer. So that’s kind of how it became.

DP: So tell us the journey of founding the company. It started from your home with a whiteboard conversation with her mom, you identified a problem, you have a skill set to do that. But then take us through the journey of starting the company and bringing in your co-founders.

SJ: I learned a lot from an internship. I had a previous summer with Ed Faulkner. And I was like maybe he would want to help me with this. This is going to be a huge undertaking and everything I knew thus far about app development was from him. So I went to him and asked Would you be interested in doing this with me. And he was. 

DP: What’s his expertise?

SJ: Computer science, software development. He has an extensive background in cybersecurity, as well. So, he agreed. And then also, something I forgot to mention was, my grandfather, who’s also a mathematician and electrical engineer would work with my mom in these whiteboard sessions because he could take them material and condense it and make these Excel spreadsheets. He really likes Excel. So he became a part of it. 

DP: Your conversations at home must be fascinating! That is one interesting household.

SJ: We have a lot of fun.

DP: Yeah, yeah, that’s great. It really fosters, you know, curiosity and exploration of ideas. That’s amazing. Okay, so then, on this journey, and so the company is about almost two years old now. 

SJ: Yes. 

DP: Okay. So during that, during that time, as an entrepreneur, we have all these ideas, and we’re very optimistic, and we believe that we can really make our mark in society. So going with that optimism, then leading the company for the last two years, what have you learned about yourself, as well as the industry that you’re transforming?

SJ: What I’ve learned, yeah, so I think it’s interesting. My relationship with technology, given my age group, is different than somebody maybe five years older and 10 years older than me. So I think that was a huge learning point. Because as we were coding this and working on the user interface, things that were obvious to me to navigate, because I’d seen it so many times weren’t necessarily obvious to everyone else, given how they interact with technology every day. So I kind of had to learn to unlearn the things that I was used to and think about it from a different point of view, like, this makes sense to me, but will it make sense to everyone? Like why is this certain button or this kind of mode obvious to me? And why is it not to somebody else? I think I kind of learned more about how everybody interacts with technology differently.

DP: Fantastic. Any insights into the healthcare space?

SJ: Yeah, so I think it’s interesting. PDPM is something that it comes from, they’ll fill out an MDS form, which will take three, four hours, and tons of data points. And then they’ll condense it, they might look at an Excel spreadsheet, and then I condensed it into my calculator. So I know that that’s kind of a transition to go from a way that is normal and has been used for years to something new. So I’m kind of navigating that transition has been big for us.

DP: Okay, the PDPM calculator is just one component of what you’re doing at Hopforce. So when you talked about it in your introduction, your company is helping to automate and optimize. So tell us more about the solutions you’re providing.

SJ: So the most important outcome or output of our calculator, is the reimbursement. So I guess to optimize the MDS form takes a long time. Like is it actually going to even give you that reimbursement calculation? it’s going to take a while to get that information back. So to optimize that process, like if you need to know, right now, based on a patient that has these diagnoses, what’s that reimbursement gonna look like? We’re going to be able to optimize that process for you and make it fast. So you really need to, we’ve condensed to the exact information points that you need to fill out to get that accurate information, your HIPPS code and your reimbursement. So we kind of optimize that process by giving you this usable, easy calculator that can get that information for you. And also, automate. We’re gonna make it faster, and it’s a process that was just not as efficient before, at least to get that data point to get that reimbursement.

DP: Who’s the primary user of your solution?

SJ: MDS coordinators, mostly, and nursing home facilities.

DP: And are you also doing the business development aspect or do you have people doing that? Tell us more about how your organization is structured.

SJ: Yes, so I’ve coded a lot of front ends. So because I’ve been able to sit with my mom and learn PDPM so I’ve done that and then I’ve done marketing, and engaging with clients and taking questions and feedback. And the feedback’s been really great. And that’s helped us a lot. So yeah, I’ve done most of the business development as well.

DP: So you mentioned doing this, your junior year. Prior to that, was your idea to just kind of become a coder or a programmer at a tech company?

SJ: I think at that time, I thought that would be something I would do to reach my eventual goal of becoming an entrepreneur. I think growing up with my mom as an entrepreneur, that I assumed I always wanted to do that same thing. The entrepreneur lifestyle is something that makes sense to me, because that’s what I was always exposed to. 

DP: That’s great. That’s great. I got the entrepreneur bug a little bit later in life, when I started, work with my mentor, also strategic consulting, and we went separate ways for a while. And then he called me up because he started a VC firm. And then he reached out and asked if I wanted to join him. So that’s kind of where I got into the starting up new technologies, spin offs, and etc. and knowing what I know now, I would have gone back back in college and focused on entrepreneurship. So I’m glad you got a very good early start. 

So along the way, clearly, your mom has been a tremendous influence in your life. What other mentors? You also mentioned, one, but do you have other mentors that you would like to give a shout out on how they help on your journey?

SJ: Yes, I’m one of my advisors at Tufts is Ming Chow, he was kind of when I was embarking on this journey to start Hopforce, it was also in the same period of time, my junior year where everyone gets their big internship and software. And so that internship a year later would typically lead to a job offer. And so I was taking a different path. And I was a little nervous, because especially when you step into our computer science buildings, Halligan. So when you step in there, basically your junior year from September to May, everybody’s asked, Did you get a job? Did you get an internship? You know, that’s everybody talking about that. So I was doing something totally different. I was kind of apprehensive. And Ming was the person that said to me, “Savannah, this is huge. Do this, Chase this, you don’t need to be doing what everyone else is doing. This opportunity is unreal.”

DP: that’s great. Because that’s, you know, the picture of all the fish swimming in one direction, but you’re the lone fish swimming the opposite direction. And I can totally relate to you when you say everybody’s talking about, Hey, get this job. But then the fact that you had your own course you stuck with it. And that’s what you’re passionate about. I think that’s a long way for you. So congratulations. So also on the journey, there’s tremendous obstacles, like what has been one of the most challenging times for you, as you’ve been launching the company and growing your business?

SJ: I know, I talked about this a lot. But the feedback’s been great. But also, I’ve been noticing a lot of times that people are like, Well, where’s this button? How do I do this thing? And we go back to the drawing board and redesign the UI and say, Okay, this, we put this here and nobody’s seeing it. And to me, it made perfect sense. And to other people, they’re not even getting to that point on the page. So that has been one major challenge. And then also, Medicare Part A and PDPM are extremely complex. So learning that and seeing how this is evolving, and how people are working with this new system, and then us making sure we’re up to date and accurate, has been, like our challenge and also our mission. 

DP: What do you think about PDPM? Has it been a success? Or is there more to go? What are your thoughts on that?

SJ: So me and my mom will talk about this a lot. We think it’s going to evolve. And I think on the one hand, it’s good in the sense that you want people … it motivates people to code accurately, but also makes it harder to do that. You know, because the reimbursement will correlate and that will kind of make more sense once it’s understood. But then it’s in Medicare Part A and then Medicaid might also adopt it. And then also there’s the piece of, it’s federal right now, but on the state level, some states might not even go in this direction, or they will and they’ll modify it. So I think there is a ways to go and at the federal but also the state level.

DP: If you’re in charge of pdpm where would you like to see it in three to five years?

SJ: That’s a great question. I guess our job is to reduce the complexity of it, or seemingly understand it and present it to people in a way that is digestible. I don’t know that pdpm would become less complex, or if that would even be advantageous. So I guess, for the industry, the goal is to have everyone be more comfortable with it, and within three years. And the more we understand that, the better I guess, me, and even my mother would know, okay, this is really what needs to change.

DP: But can you tell us about a success story for one of your clients?

SJ: Yeah, it’s great. We get a lot of client feedback. People email us and just say like, so for example, again, this is the tech thing, but someone was having trouble logging in, and I was able to help them. And it was a small issue. But there was this kind of panic, because they’re like we need a file of our forms. They’re working on their MDS forms and stuff that day, and they needed to know, the reimbursement. And it  felt really good to know that people are really dependent on this tool. And it changes their day to day operations, like being able to login and navigate our app is going to dictate their day. And it really helped them save them time. and they tell us  this app saves us so much time that they can now they can use that time to give patient care. 

DP: So what’s next for you in terms of what’s the big strategic objective for Hopforce in the next three to five years? Where do you like to see your company be? 

SJ: We’ve got a couple of features in the works that we’re really excited about. I mean, within the next year, we want to be able to assist our users along the patient cycle … their 100 days they stay in the home, so that they get kind of documentation cues, like, Hey, are you monitoring for this, are you documenting this? Have you seen this symptom pop up, kind of thing. So features like that kind of assisting people throughout those 100 days is something that we want to achieve. And I guess that’ll be one of the big things, and just kind of keep doing what we’re doing and expand. And we can only get better as we continue to optimize and make things easier for everyone.

DP: Fantastic. What’s another fact about you and the company that you’d like to share with our audience?

SJ: We also have a five star calculator that we released that we spent a lot of work on and spent a lot of time on, that we’re pretty excited about. And we want to keep optimizing to be better as we pulled from the datasets that we have available. And as more and more data comes out with five star, that process will become better and better. 

DP: Is this to help the skilled nursing facilities to earn the five fifth star?

SJ: Yes, so it’s going to calculate the hours they need for the nursing hours for LPN and CNA. 

DP: So what are the different inputs that you can control to increase your probability of increasing your ratings?

SJ: Yeah, to increase your ratings, you kind of need the right combination of nursing hours, whether it’s LPN, CNA, or your total nursing hours, dependent on your hours per patient per day. hppd. Just tons of acronyms. So, yeah, you need to optimize your hppd, I think it also matters, where you are like what state you’re in too, because they have different hppd averages, I believe.

DP: Okay. So what motivated you so your mission is to help to automate, optimize, make these complex things more more clear for the users? What motivates you and your mission when times get hard, where things look very topical?

SJ: I think, especially in the age of COVID, and this pandemic, I think about these healthcare providers, so swamped with COVID patients, and then also pdpm is new and all this new information. And I mean, it’s been a tough year for healthcare across the world. And so I think about them and I think about how I can make their jobs easier, and their lives easier given all of the things they’re facing.

DP: You mentioned earlier that where you are in your life stage is different from somebody five years or 10 years older than you. And for companies, the future is that generation, right? We’re always recruiting the 20 somethings out of colleges. What do we need to learn about how to recruit the best? Or how do we recruit the people that are right for our company? And what motivates them? And what keeps him motivated? Which we learned about that from your demographic?

SJ: It’s a really good question. I think our demographic is, we grew up in this weird time where, so growing up, like my little sister, she had an iPad, I didn’t, we didn’t really get the technology until we were entering High School. And then we did and we had all this access to information. And we’re so much more aware. And I think what draws us to companies is we grew up with, okay, there’s these efficiencies, changes that are more and more efficient. I think we really like efficiency. We also like companies with awareness, that are up to date with what’s going on in the world, because that’s what we’re so used to.

DP: Okay. And what’s once, you know, how do we retain that talent? We can attract them that way to make sure that you know we’re with it, we’re aware of things that’s going on, we’re diverse, inclusive. So what would continue what keeps you your demographic like, Alright, I want to continue to work at this company, I want to be part of this. What does that?

SJ: probably, like a unifying mission, I mean, I know that, I guess I also am in a unique position where I haven’t really been recruited, because I kind of came out the chute doing this. So um, when I think about places that I want to work, like I remember when after George Floyd and all these massive protests, you saw Hulu and Netflix dedicating their homepage to Black Lives Matter. And while they might have been aligned with these views, even before then, it was kind of a moment where we’re all looking at this. And let’s make sure that like, this is on the top of our radar, this is what we’re talking about as a company, this is what we care about. So that kind of resonated with me as you’re navigating the internet and you kind of knew, okay, this company cares. This one. Maybe doesn’t, because there’s nothing about it on their homepage. 

DP: As we close, fill in the blank 10 years from now, I will have made healthcare blank. 

SJ: More efficient.

DP: Excellent, excellent. speed round, first word that pops into your mind. What is your chief characteristic?

SJ: Determined

DP: What would your friends say about you?

SJ: They would probably say that I’m tenacious and passionate.

DP: Who’s your favorite character in fiction?

SJ: Katniss Everdeen

DP: Tell me more.

SJ: She’s in The Hunger Games. There’s a book that I read growing up. And then it became a huge, like, bunch of films with Jennifer Lawrence. But it’s about this world where there are12 districts and it’s kind of like after the end of its futuristic, so there’s the end of some nation that now are divided into 12 districts and they don’t all have equal access to resources. So she comes from the 12th District that’s kind of the poorest with the least resources. And they have all the kids every year they have an annual hunger games where it’s really kind of disturbing. They have all these kids from different districts come together and fight to the death and one wins.

DP: But what about that resonates with you?

SJ: It was one of those prominent things where you had a heroine come in, and she actually, every year they pick from, I don’t know a bowl of names and the person from each district that’s going to go to the games and her little sister’s name is picked. So obviously she steps in in the name of her sister, so that resonates with me just immediately because I have three little sisters, but then also, she goes on to fight against a really authoritarian dictator regime that’s ruling over all of the districts and saves a lot of people 

DP: Very, very important question. Belichick or Brady?

SJ: I have been in such disarray with that. I think Belichick is a genius, but I like both. I can’t choose. Brady has the raw talent. I think they need each other in some regard. Absolutely. I like the way that Belichick turned football into chess. But Brady also the power of his brain, the way that he focuses the way he trains. I read his book. I don’t know. So it’s hard to pick.

DP: They’re both amazing. They’re dedicated to their craft. Finally, what life lesson would you like to share with your current generation as well as the generation that’s coming Right after you?

SJ: I guess I would say that failure isn’t the worst case scenario.

DP: It’s interesting, because, you know, I lived in Boston for 20 years. And in Silicon Valley failure is it’s not a bad thing, as long as you learn from it. But at the time, when I was in Boston to DC, it wasn’t viewed that way. So I’m glad that you shared that life lesson.

Well, there you have it. So we have Savannah, who is making healthcare more efficient, and she understands that every opportunity is an opportunity of learning whether it’s a success or failure. 

So thank you for joining us and for making healthcare efficient.

SJ: This is great. Thank you for having me.