• 00:46 - Factors and Trends in Healthcare
  • 03:22 - How Technology Solutions Can Help
  • 05:24 - What is "Intelligent Automation"?
  • 07:22 - Using Insights to Fill Vacant Shifts
  • 10:22 - Customer Outcomes Using Technology
  • 15:21 - Change Management in Healthcare
  • 19:00 - What's Next for Andgo Systems?
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Laura: Hello everyone.

I'm Laura Dearing with Beckers Healthcare.

Thank you for tuning in to the Beckers Healthcare podcast series as we discuss the current workforce challenges in healthcare specifically around absence onboarding in filling vacant shifts.

We are thrilled to be joined today by Tom Ross, co-founder and CEO at Andgo Systems to discuss how Andgo is helping Healthcare organizations address these challenges.

Welcome to the Podcast Tom.

Tom: Thanks for having me on the podcast, Laura.

I am very excited to join and discuss these complex Healthcare Workforce challenges and that angles I have been working on for a number of years now.

Laura: Fantastic. Well with that, let's jump right into today's conversation.

To begin. Can you tell me more about the problem of absence onboarding? What are the factors driving this trend and how is this trend manifesting in healthcare organizations specifically?

Tom: Yeah, absolutely. So, absence onboarding is a problem that certainly is not a new one, you know particularly in healthcare.

When we say absence onboarding, what we are referring to is the entire process of an employee communicating that they will be missing a scheduled shift.

So, either calling in or calling out sick, depending on geographically where you are located or how you refer to it.

So once this happens, what are the subsequent processes of filling the resulting vacancy?

When you peel back the layers and actually look at it, it's quite shocking how manual the process is currently relied on to solve this process is even with the more sophisticated health systems out there, quite often it's managed via post-it notes. What we call the sunflower approach.

And what I mean by that is we've all seen it. You go into an office, and you see a bunch of post-it notes around the edge of a computer and then it kind of looks like a sunflower over time.

And so, it's very reflective of large manual processes. Not only is this traditional approach highly manual and tedious, one of the many limitations is just this lack of visibility across the entire organization.

And that's something that we'll talk about a bit more later, but that's become more and more important is getting a sense of what is the full picture of your employee absences organizational-wide or health system-wise? Why that's important?

From the trends impact, this problem has exploded because of these recent workforce trends. Workforce and staffing are commonly listed by sources such as Beckers, yourself, as well as the orgs we've talked to, is one of the top things keeping healthcare executives up at night.

So, in terms of the pandemic impact, it only magnifies things further just in terms of context.

At the height of Omicron, one of our customers had 3000 absences in a single day.

So, you can think of the tedious labor process to manually receive these and then jot them down on post-it notes and then inform and update the impact of stakeholders. It's just simply not sustainable.

To summarize, there's an order of magnitude, more absences, and less employees to fill them. The processes that are relied on to onboard and find these replacements for these absences are surprisingly still a very manual task.

The reality is you can't fill every one of these shifts. So, in healthcare, you better be able to have line of sight into which ones are most critical to fill.

Laura: Yeah, absolutely. That is really such a challenging problem to have.

And how can technology solutions help healthcare organizations solve this problem if they can? How so?

Tom: Yeah, the short answer here Laura is, absolutely yes.

Technology and software can help, kind of just deconstructing the process.

There are four main stages that occur from the point of receiving an absence call to finding a replacement to fill the vacant shift. All of these stages involve several Tedious, typically manual tasks that can be automated by software.

This process, one of our customers refers to it as death by a thousand cuts. A lot of little, small tedious tasks that and of themselves aren't that challenging to overcome but when you're doing it 3000 times in a day they certainly amount to a massive headache.

Where this becomes challenging in healthcare is that there are a lot of nuances and complexity around organizational requirements ensuring you get the right person in the right shift.

And so, you just don't want to be in a situation where you're moving workaround.

You've solved this problem but by solving this problem you've inadvertently created another situation that requires more manual input and effort.

And so, kind of looking at it comprehensively and being able to be flexible and accommodating enough to automate these tedious tasks in line with these requirements, it's basically eliminating them completely.

The other aspect here is if you're only automating one part of those four different touchpoints that are created, you're just sort of speeding up a portion of the assembly line. And so, this potentially could have cascading negative effects downstream.

And so, these are the things that you want to be aware of. And so, in essence, this is a problem that's not unique to healthcare. But one thing that's magnified is the complex operating environment within healthcare and then also just the high volume.

We're kind of in an interesting time where it's really unprecedented the amount of absences that are occurring and just the staffing levels that we have to fill them. Operating within these complexities. Dealing with this volume requires an elevated level of automation and something at Andgo that we refer to as intelligent automation.

Laura: Got it. And what do you mean by the term intelligent automation?

Tom: It really speaks to a more sophisticated holistic approach that fits in line with organizational processes and requirements. Elevating automation impact on a limiting task entirely.

Not just shifting the workaround. Kind of building on that idea that I mentioned earlier these complexities and the volume that healthcare requires you need to zoom out and not just optimize tasks but automate workflows in line with the organization's rules and requirements.

Intelligent automation provides more of a seamless integrated workflow. Basically, the overall outcome here is we're all just trying to drive actionable decisions rather than adding another siloed system or workflow to your ecosystem. It's not the answer.

It needs to fit in and be an extension and operate within. And so, from an intelligent automation standpoint getting that visibility into all of the vacancies across an organization allows you to prioritize, get some insight and prioritize which ones are the most important, and which ones need to be filled first.

So basically, intelligent automation provides the means to enable that effective management of the real-time staff movement.

This is where we see organizations struggling. The scheduling systems that are deployed really do a great job of setting and planning and creating the schedule. But as that date comes closer to the scheduled shift that that's planned and if there's any turnover and churn that occurs the subsequent real-time movement of staff is really that challenge that we're honing in on and being able to effectively manage it is a massive opportunity for the organizations to better utilize their existing resources.

Laura: So once an organization has a line of sight to absence across the organization, how can they actually use that information to fill the vacant shifs?

Tom: Great question. And it kind of comes back to that, that idea of being able to integrate directly with the core scheduling system.

At Andgo, we've integrated with a number of scheduling systems. UKG is one a lot of customers here probably have, or listeners probably have.

What this enables is that with that absence coming in, there's built-in pre-configured logic within Andgo that we can then map and update automated pay codes and automate the changing of these pay codes.

So, the automation process has already started that use case of that employee calling in sick, depending on where they're calling in sick and the reason why behind the absence, we can then take that absence and update it automatically with the appropriate pay code and update the scheduling system right away.

And so, this certainly eliminates some of these manual tasks that go into supporting that initiative, but then also creates a ton of benefits down the road is being able to unlock and empower your administrative staff or scheduling staff to focus on more value out of work.

A couple of other elements that we look at in terms of onboarding a shift is, is a replacement required for the shift? Some of these units, some of the levels, you don't need a replacement. So, what are the rules around that? How can we action that automatically?

A lot of our customers, when we talk about sort of this holistic view, you look at that sunflower approach and really sort of the siloed fragmented approach where folks sort of view themselves kind of scheduling in the dark, not being able to see that full picture.

And so how can you make the best decision if you're only dealing with a sliver of the information in terms of those total absences that you have to fill?

And so, getting that visibility into that, having that holistic single dashboard means that staffing units are able to identify different patterns, they're able to get that full clear picture of demand across the org not just in the phone calls that they happen to be receiving, but everything, and then actually make real-time insights and using this data to sort of drive and prioritize where to fill.

And so, you combine these insights with these configured workflows that update, I guess, the non-value added, like receiving that sick call and updating the scheduling system with the person in the shift that they're going to be missing in the corresponding pay code that should go with that.

The software can do that. So now this frees up your scheduling staff time to be able to unlock and focus and look at the data holistically and make informed decision making around these efficient processes.

Laura: That's so helpful to know it and think about.

Now, do you have any stories you can share with respect to outcomes that your customers have seen from this technology?

Tom: Yeah, happy to share a few quick stories and anecdotal outcomes that we've experienced in the market.

So, kind of first to understand some of the value that's here, let's understand the old process, the manual process of receiving that phone call manually updating schedules, manually informing impacted stakeholders, and doing the subsequent call-out on a one-to-one basis. Or maybe you're using WhatsApp Messenger or Facebook Messenger to alert people of a vacancy.

So typically, what we see is that process start to finish, it takes about 30 to 40 minutes of effort per event, that's a manual effort for your staff, your charge nurses, all that. And so, we're able to reduce that down to three minutes, right?

So, we can eliminate all that busy workaround so that these folks can come in, just add the value strategically for the shift with the most suitable applicant and carry on with their day.

That's sort of one of the big value points that we see. Additionally too, the way that folks are calling in and the way that they're being notified of available vacancies, it's all really standardized.

The process is standardized and it's completely transparent. And what I mean by that is every action is logged, accessible, and viewable by all the impacted stakeholders, so employees can see what's happening in real-time to the shifts that they're being notified for, for the shifts that they're applying for.

And this transparency just does wonders in terms of building trust between your employees and your scheduling system and your organization.

And so, this certainly leads to an increase in satisfaction. And then of course too, this solution provides a lot of flexibility and flexibility is the new currency when it comes to working with your staff and creating that positive environment.

And so being able to give them the ability to engage on their schedule easily, making it more accessible, it certainly helps with that.

A couple of the other things too is, one thing I think that's pretty telling is that Andgo, we've been around since 2014 and over that time we have a 100% customer retention rate. Just sort of shows the stickiness of the problem.

Similar to like once you start with the email, you're not going to go back to writing letters. And then similar to this, it's like if you're automating these processes and work all these different steps for absence onboarding, you're not going to go back to a manual light, you're just not once you sort of seen the light.

So, I think that's pretty powerful there. Specifically, so our very first customer, the problem that they were solving was every day they had 300 unplanned absences and each and every day in their words was Groundhogs Day.

They had 300 unplanned absences. They would receive those phone calls; they would update the scheduling system and then they get on the phone to try to find people to work and they never get to the end of the list right there’s always just they didn't have enough capacity to get through it.

So, it just over and over it kind of happened. And so, with Andgo, what we're able to do is sort of just unlock that efficiency, automate all those tedious tasks, and elevate just the level and calibre of work that they're doing there. And so, there's a big result there.

And I think one of our customers said it best we need a new perspective fueled by automation and data. Basically, you can't hire your way out of this. You can't buy your way out of this. Which I thought was pretty astute in terms of that.

At the end of the day, the kind of thing that really gets us excited about the results that we're providing for our customers is just removing some of the strain and stress on employees, on healthcare employees.

If you think about giving your nurses 20 to 25 % of their day back, what is that going to do for improving patient care? What is that going to do for delivering services?

Subsequently, if you have a better way to leverage your existing staff getting to those outcomes, what is that going to do from a percentage standpoint in terms of filling more critical shifts and then also with your internal resources? So maybe he's not dependent on those external resources.

Andgo is not more nurses, we're not more staff, but we certainly enable our customers to leverage their existing resources more effectively.

By automating these processes, you can then notify and alert folks in real-time of the subsequent vacancies and giving them the flexibility to show up.

It's just something that has an astronomical impact directly on our customer's bottom line, which is pretty exciting in terms of quality of life and improving care and then ultimately driving operational efficiency.

Laura: That is exciting to hear. Now, what does the change management process look like for healthcare organizations that are looking to adopt this type of solution?

Tom: Change management is certainly something that’s very crucial with any project in healthcare.

There are a lot of folks out there. The keyword transformation has kind of become a scary one, especially since just the exhaustion that folks are feeling.

But the reality is that the healthcare industry is in crisis mode, particularly with respect to the workforce.

So, when we think about transformation, the real risk lies with the status quo. When you have that kind of comparison to kind of work back and forth on it like well, inaction is more dangerous than action. In this case, a couple of things too.

From our standpoint, we've been doing this for a long time, and we certainly understand healthcare's unique ecosystem. So that's certainly an integral part of all this.

Ultimately, from a change management standpoint, no matter how big or how small the change, you have to have an effective plan in place.

I think what's proven out most effective for us is just identifying strategies and methods that basically map to what we call quick wins.

So, these are the users to put yourself in their shoes and ask what's in it for me? And being able to quickly provide and deliver value for them certainly drives adoption and uptake, which is incredible, incredibly important.

Beyond those quick wins, obviously what are the medium-term gains and the long-term value for health care customers.

I think obviously having alignment on KPIs, like understanding the reason behind this and then the desired outcomes from the onset certainly helps with all this.

One thing too about Andgo, which is kind of interesting, is that adoption is not a barrier like you see in other software projects, the frontline employees’ schedulers or managers, they're desperate for tools that make their lives easier.

In saying that though, to my earlier comment, you don't want to just introduce another siloed technology that they have to actively engage in.

I think kind of integrating into the ecosystem, integrating it directly, naturally into their workflows is going to make their lives easier. It improves their workflow and their work life.

The other thing too is when we talk about communication, we talk about notifications and responding to this.

This is a technology that they're familiar with in their everyday lives. In many other aspects, being able to integrate directly into our customer scheduling platform, behaving as a seamless extension of the pre-existing environment and then just not basically a shiny tool that will sit on a shelf giving folks the flexibility to engage with their schedule, engage with these absences is certainly something that is being sought out and expected almost from your employees at this point.

I certainly don’t want to minimize the change management. There's always a bit of a lift when it comes to process improvement. But at the same time, we have the deep domain of expertise in this area.

And the bigger thing too, is there's never been an easier time. And what I mean by that is that each day that you wait, it builds up and builds up and so it's never going to get easier. And the pain points and the pain from that you're currently experiencing is simply not working. And so, this is something that we can help with and make huge improvements on today.

So that's really kind of our approach to change management and how we've seen it be effective.

Laura: That's really great to hear.

Finally, before we wrap up here, what's next for Andgo.

Tom: Yeah. So, you know what we talked about here today, Laura, really kind of centers around this whole shift filling automation piece, which is incredibly important and valuable for our customers.

One thing I will say though like as good as this technology is and the value that it provides, one limitation is that it is reactive. It is dependent on an employee calling in sick to trigger these workflows.

And so, where we're looking at this is like, well, how do we become more proactive? How do we start to predict when these events are going to occur? But more so importantly, predict how your available staff are going to respond to these changing needs.

Obviously, there's a ton of great work being done in the space as far as predicting and analyzing and developing those optimal staffing levels. And that's fantastic and that's great.

What I think Andgo can add to the conversation and where we're planning to add to the conversation rather, is around that predicting that real-time movement of your staff, specifically around the response to these changing needs as they emerge.

A lot of our managers that we work with, again, kind of going back to that earlier comments, it's like scheduling in the dark and it's like, oh, I have a float pool of 50 people, yet how am I not filling this vacancy?

And if we kind of look at the data, we can say, well, of the 50 people you have in this folk pool, perhaps maybe 25 of them aren't active. Don't pick up shifts in your unit. Maybe further evaluation, you can see that ten folks are working and five aren't. Ten folks are working and five are on vacation. So, you only have an available pool of ten. And so, is that going to be enough to fill a vacancy?

So, sort of just driving those data insights to kind of uncover what that right staffing mix is and more. So again, this is focusing on the response to these changing needs. So, becoming predictive and sort of proactive to complement this shift filling process that we provide.

And the other aspect here too is sort of this reality that, listen, not every shift is going to get filled. That's something that has become very clear here recently.

And so given that this is the reality, well, Andgo could perhaps act as that bridge into those labor pools. I know organizations are set up and sometimes those travelling nurses are directly in the system. But for those one-offs where you need to go externally from an open office standpoint to other labor pools, Andgo connected that bridge.

At the end of the day, with Andgo, we're filling every one of your shifts. First thing we're going to do is optimize and drive the internal utilization of your existing resources. Hopefully that ultimately leads to lesser dependence on external resources.

Second, we're going to use the data to get out in front of us to take a look at the different items in terms of what are those problem areas that are coming up, how do we respond to them ahead of time instead of sort of in that day of the moment.

Then finally, once that's all done and been optimized and resources has been exhausted and there's still vacancy there being that seamless integration into those labor pools so that you always have the option, you always have the ability to go and find someone to come in and work is sort of that next step.

And so ultimately what that provides is that Andgo is going to give you that ability to fill every one of your shifts. That's kind of where intelligent automation is headed.

And then we're constantly evolving our product suite. This is locked up with the trajectory of Andgo at an organizational level and ultimately, we're tremendous growth in the last two years here just in response to the significant demand for these types of solutions.

Just given the environment that everyone is operating in so yeah that's a little bit about where we see sort of those future horizons.

Laura: That's so helpful to know it and think about. Thank you Tom, for your time and insights today.

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