May 24, 2022

The National Institutes of Health (NIH) noted earlier this year that the nursing field is still facing persistent shortages because of lack of educators, high turnover and inequitable workforce distribution. That problem has long existed because of the aging population (and workforce), burnout among nurses and poor staffing ratios, but the pandemic and the healthcare all-hands-on-deck situations it created could snowball into a true crisis if not managed with innovative technology, including how and when nurses are paid. Speaking with PYMNTS’ Karen Webster, Clipboard Health CEO Wei Deng acknowledged these longstanding issues in nursing, saying the pandemic sped up “discussion around nurse burnout and people wanting more flexibility, both in terms of their schedule, but also in choosing where they want to work, having more choices and more options, as well as getting paid faster than historically what they’ve been able to, which is usually once every two weeks.” Deng doesn’t have a background in healthcare. In 2016, she started the process of launching a student loan refinancing app. Meeting with various groups, she spoke to nurses and found that many of them — especially recent graduates — were struggling to find first jobs despite the shortage. “Many of them couldn’t get essentially the equivalent residency program in hospitals, so they wanted help with their resume and coaching,” she said. “I thought, ‘this is a real problem faced by real customers, so let me try to solve that, rather than my more theoretical financial product.’ Turns out nobody actually wanted [the refi app], but all the nurses wanted help finding a better job.” Fast forward to the depths of the pandemic, when hospitals, urgent care facilities and medical practices wrestled with extreme shortages in the most crucial areas like intensive care units (ICUs), where the sickest COVID-19 patients were, often without enough nurses on hand. That situation veered erratically between travel nursing being paid up to four times nurses’ normal wages and elective procedures being canceled nationwide at nursing homes and surgery centers. “During that time, a lot of the nurses were getting furloughed even as there was this surge of demand in other parts of the hospital, even sometimes just down the hall,” she said. Seeing a better application of her original vision of helping people manage their lives with a multifaceted digital platform, Deng launched Clipboard Health. An Rx for Nurse Preference Deng told Webster about a recent conversation with a client who had been in the industry for more than 20 years and never had a problem with staff retention before. Now, full-timers are quitting to get more flexible work, and they’ll work at his facility using an app like Clipboard’s. “Even within the full-time jobs, now you’re starting to see facilities or hospitals use some type of software, or most of the time doing it manually, allowing people to pick the times that best work with their schedule,” Deng explained. It’s allowing nurses to create their own schedules and balance their lives, “to work the hours that make the most sense for them,” she said. The platform posts available shifts, and nurses choose when they want to work — many end up clocking 30-plus hours a week, dividing the time between different facilities. She calls it “a more hands-off approach where we don’t make recommendations, but we allow the workers to see all shifts in one place. A lot of it’s around aggregation and then to select the ones that match with their preferences. We can notify them of shifts that come online and things like that.” As it pertains to credentialing, Clipboard Health automatically checks licenses and certifications, and technology plays a big role in letting it onboard workers more quickly. That’s an important differentiator. From early job board pilots, Deng learned that medical staffing agencies were often rejecting qualified nurses for scheduling reasons. “They’ll say, ‘This nurse is great, but they could only work the Monday to Wednesday shifts but not the Thursday to Friday ones,’ or they needed them to be on call for Saturday and Sundays, and they couldn’t be on call.” When she saw how manual scheduling was crimping the flow of nurses where and when they were needed, Deng decided to cut out the middleman. “I decided to call their end customers — the facilities themselves — and just asked, ‘Do you care if the same person shows up, since you’re working with the agency anyway?’ And the answer’s always something like, ‘It’s nice to have continuity of care, but the reality is since we’re [a] 24/7 business, we’re going to have different people anyway,’” so, better “a nurse” than “no nurse.” “That’s different from industries where the monogamy matters more, like a cleaner. You want the same cleaner, etc.,” she said. Clipboard Health makes its money on take rate from nurses who use the platform. The facility pays the nurses, and depending on the contract terms, the company gets a percentage. But the platform differentiates itself in one key way: It gives healthcare workers the option to get paid immediately after their shift. “So, we take on that negative float,” Deng said. Nursing’s Tech-Forward Future Looking to the future, Clipboard Health is armed with $80 million raised in funding rounds this year and last. The company is aiming to first disrupt scheduling and adjacent services, before moving on to line extensions that fit well within its core mission. It’s moving into other areas, too, like software products to help facilities schedule their own nurses or even work with other staffing agencies. “Our philosophy’s around getting more transactions happening in the marketplace,” Deng said. “We now have different products that we’re starting to charge for that are just software based.” Clipboard Health is eyeing expansion into Canada, for example, and looking for more opportunities to innovate for hospitals and practices to help them manage and pay their own workforces. “That’s where I see the platform going, which is becoming a more full-stack solution,” she said. Pressed for “one thing” that will define the road ahead, Deng said she believes it will be the increasing realization among healthcare facilities and nurses that the old way of staffing is in extremis. She said in discussions today it’s “the more tech-forward” healthcare operations that are responding to increased flexibility around supply, demand and workforce wishes. That’s the big trendline. “Then you have a set of facilities who still prefer mostly full-time work, but if the workers want a different arrangement, they can’t force them to work a full-time schedule at their facility,” she said. “They’re almost begrudgingly acknowledging that this is a trend, so [they] might as well work with some set of players in this space.” ——————————