Bringing Algorithms to Post-Acute Care: Russell Graney and Aidin

When Russell Graney founded Aidin almost a dozen years ago, he proceeded cautiously, step by step, in contrast to some of the people he went to college with.

Russell Graney, founder and CEO of Aidin

“I am not a typical founder of my time,” commented Graney in a recent interview with Managed Healthcare Executive. “When I was a Harvard undergrad I was there with all the people who were running off to Silicon Valley and starting some of the massive businesses that exist in the world today.”

And those Silicon Valley wunderkinds were?

Well, Facebook founders Mark Zuckerberg, Chris Hughes, and Eduardo Saverin, to name three that Graney mentioned in a follow-up email. Also Nate Blecharczyk, who co-founded Airbnb.

But venturing into healthcare and, more particularly, into post-acute healthcare and its labyrinth of providers and payment, required a different mind-set, said Graney, who began his career at Bain & Company, the powerhosue consulting firm.

“Going into healthcare, we had a very clear vision that this is actually a space where we’ve only have failure when it comes to transformation,” Graney said. “We don’t have success. We don’t have examples to point to that could tell us that we won — that healthcare is better than it was before they showed up. So we’re going to very humbly enter this space.”

Algorithms meet case management

Graney’s explanation of Aidin (pronounced “aid-in”) begins with a jargony generalization about it being “enterprise marketplace for healthcare goods and services.”

But as he gets rolling and starts to talk enthusiastically about what his company does, Graney starts to put Aidin into sharper focus.

“We are here to connect that whole massive amount of healthcare purchasing that's happening by healthcare organizations, through case management. We want to help those folks to guide patients to the best quality provider every time, on time,” he said.

The company’s website talks about streamlining and structuring workflows “to help case managers accomplish daily tasks faster and transition patients to trusted care providers.” Graney says the myriad of interactions between healthcare organizations (hospital to hospital, hospital to skilled nursing facility, hospital to home healthcare agency, provider to payer, and so on) are “business critical business transactions done in a million and one different ways” with little, if any, standardization and often by individuals.

Part of Graney’s pitch for Aidin is that its data and algorithms can help hospitals decide fast and efficiently which facilities they should be referring their patients to and then collect and analyzing data on that process and the results.

"We're interested in tracking not just the steps and the timing that I’m (the hospital) responsible for but also my external partners — what I am holding them accountable for and so building a workflow that tracks and times every step of the way.”

In Graney’s telling, the Aidin's humble entrance into thickets of U.S. healthcare meant bootstrapping the business, raising relatively small amounts of money, carefully calibrating results and making adjustments. Aidin's tortoise-not-hare pace meant three or four health systems a year as clients.

In early 2020, Aidin had a team of about six people and had accumiulated roughly 50 hospitals as clients.

Then a previously unknown respiratory virus started to spread, wreaking havoc and causing serious illness and death in the U.S and around the world. Like many organizations in healthcare, Aidin was transmuted by COVID-19.

“What we learned in the pandemic was how much our clients were depending on our services when it was really an emergency, getting patients out of the hospital,” said Graney.

Another pandemic-triggered revelation was that “old systems and processes that people had in place did not work when the system was stressed.”

So or Graney and Aidin, the pandemic has meant additional funds and hires. By August, he says Aidin will have 84 hospitals on its platform and by the end of the year, close to 100. The team has grown from half dozen to 20-25 people.

Patients discharged from the hospital who need post-acute care can, of course, be referred to a variety of facilities and types of care: skilled nursing facilities, rehab hospitals, long-term acute care hospitals, home health care. Home health care is, hands down, the most common, say Graney: “If there is a service that is required when a patient is discharged from the hospital, before and after the pandemic, the most common service is going to be homecare.” Graney said there has been some shift in getting patients in skilled nursing facilities discharged and into the care of a home healthcare program or service. He also mentioned a decades-old trend of post-acute providers taking care of people with more complex medical problems.

Results of several value-based programs have shown that post-acute care is often where variability occurs. The lengths of stay and the types of services used can make the difference between hitting or exceeding financial benchmarks and falling short.

“I think, generally when it comes to bundles or just the general financial health of a health system, your partnership with your community of partners — and I would extend that beyond SNFs (skilled nursing facilities) and home care to your entire ecosystem of providers around your health system — is essential to your success.”

He plugged Aidin’s algorithms as having the capacity to match populations of patients with the post-acute care providers that are best suited for them instead of “hundreds of people who are responsible for learning that and remembering that every day and executing on that.” And if a health system wants to remove a post-acute provider from its network, it can be done with a keystroke or two instead of, said Graney, a months-long training program.