Connecting the Dots Between Providers and the Village of Caregivers
StartUp Health talks with Alexandra Greenhill, MD, Founder/CEO of Careteam Technologies about how her startup is empowering patients and their hidden network of care takers to be active agents in their health journey.
Alexandra Greenhill, MD, learned at an early age that when it comes to navigating a complex healthcare system as a patient or caregiver, it’s about the experience of care, not just the outcome. At 11 months old, she suffered a broken arm that led to a series of complications and more than 25 surgeries by the time she was 12 years old. Alexandra remembers how taxing her road to recovery was on both her and her mother, requiring a stubborn tenacity on her mother’s part to ensure Alexandra received the care she needed. Later, as an emergency room doctor, she watched patients with chronic conditions become consumed with managing the logistics of their care, struggling to maintain their health because of lack of clear instructions or the inability to follow them due to lack of coordination with caregivers. She saw providers burning out in part because of the administrative burden to input the same data into an outdated EMR. For Alexandra, Careteam Technologies was the logical next step in a life spent within a fragmented healthcare system. With Careteam, she is connecting patients, families, providers and hidden caregivers in a horizontal digital support structure, giving patients the opportunity to be active agents in their care. Patients are able to organize the help they need, when they need it — even if it’s just an Uber ride to the doctor’s office — and doctors get essential data on compliance, so they can offer personalized care for patients with the most complex and chronic conditions. We caught up with Alexandra to get under the hood on her latest software offering and talked about how she became a Health Transformer.
Message Alexandra on StartUp Health HQ or email careteam@startuphealth.com.
Q&A
What gave you the drive towards health innovation and entrepreneurship?
I was a patient for the first 12 years of my life. Everyone that I see in the health system is like a relative, and I treat people as if they are my mom, sister or cousin. Some people say, “We’ve tried it three different ways, it didn’t work.” But you don’t stop if the goal is to improve the care of your loved ones. Nothing’s ever good enough and things can always be better.
How did your first 12 years as a patient shape you?
I was 11 months old when I broke my arm and it led to a series of complications, infections and 27 surgeries. Kudos to my mom who did not take no for an answer, and went out and found the best surgeon and the best antibiotic specialists she could. Along the way some people took the time to make the experience humane for a little kid who was really scared and some people didn’t. I learned first hand that it’s the little things that make the big difference in healthcare. Sometimes the surgery can be a success but the experience for the patient and the family could be a mess. And so that’s what drives me.
How did that experience inform Careteam more specifically?
The average patient, when you ask them about their experience in healthcare, they use words like lonely, confusing, scary and overwhelming. What we want to do is the opposite. Our goal is to enable families at any point of this very scary journey to spend time with one another instead of worrying about when is the next appointment and am I following the doctor’s instructions? To me, patient engagement is not about getting patients to worry about their medical conditions 24/7. It’s about letting people live their lives, and having the information they need to live their healthiest life magically appear when they need it. Then I can continue working, living, enjoying time with my loved ones. That will be the definition of success.
So Careteam is really about the experience of care, and not simply about outcomes.
Yes. The biggest challenge for the patient begins after they leave the doctor’s office or hospital. The diagnosis of stroke implies a number of things that need to happen. It literally broke my heart to see patients with fairly similar diagnoses have completely different outcomes. In one case, family stepped in and organized a binder and project-managed the illness, with other family members stepping in to support. Someone else with the same diagnosis, without that village of support, ends up with a complication and has a completely different trajectory in life.
One analogy would be to think of the different spaces designed for healthcare, from clinics to hospital lounges to family rooms. Each has a different purpose. We have created digital versions of that in our software.
We treated a single mother with a two-year-old with no living relatives who needed an abdominal surgery. She asked neighbors in her building and parents at the daycare. Instead of relying on text messages and WhatsApp, she could send off an appointment request and ask somebody to watch her child during an appointment.
Careteam extends so far beyond the EMR that it can include the driver — organizing help to get to and from an appointment. How does that organizing of tertiary helpers work?
We started with 200 patients that we followed in real life in order to understand the ups and downs and the inevitable last minute changes that occur in healthcare. One case was an older patient who needed an injection for her arthritis three times a week. The hospital had set up a system to teach patients how to inject themselves, but because she had arthritis, she couldn’t handle the needles. The hospital offered to train her husband, but unfortunately, he had Alzheimer’s. She needed to find a neighbor to drive her to her appointments three times a week, and then another neighbor to sit with her husband during that time. Before we stepped in, her only option seemed to be to hire help to watch for her husband and then take the bus. Which she literally couldn’t do, so her condition was deteriorating without the treatment that could easy help her.
How did you apply Careteam to her scenario?
In our system, a patient like her would get her appointments lined up digitally. She would then have access to a series of people in her community that she has set up as potential helpers. Our software gives you access to a series of people who are very involved in the care or the backup list of people who then can step in as needed. It allows real time adjustments so that you can have always have someone ready to step in.
One of our cases, an 82-year-old with cancer, had 26 relatives willing to support him. And so our software helps identify who needs to do what, who has a car and it organizes them. We treated a single mother with a two-year-old with no living relatives who needed an abdominal surgery. In her case she asked neighbors in the building and parents at the daycare. Instead of relying on text messages and WhatsApp, she could send off an appointment request and ask somebody to watch her child during an appointment. It’s the practicality of daily life, making sure that all of the related things that need to be handled are handled so that the healthcare actually happens.
Our software was “built for humans and for health care” — it has all the ease and intuitive design of a consumer software, as well as the strict requirements for healthcare grade software.
You’re painting a beautiful picture of connectedness and mutual communal support. What’s your bigger moonshot vision? What does this look like if it’s really embraced in terms of global connectivity and care?
Everyone talks about personalized medicine, specifically our ability to check your genome and identify a treatment that’s perfect for the condition that you have. The vision that we have is more about a personalized healthcare system. Everything about every patient is absolutely unique. They have different conditions, life circumstances, providers and community support. Our software allows you to manifest that complex universe in a simple-to-use system.
How do you manage the handoff between the provider and, for example, the neighbor helping out?
At the end of a doctor’s visit, the doctor might say, “do lab tests and see me again in six weeks.” That’s often not specific enough for patients to actually take action. In our software, they’d know which lab tests they need and have the ability right there to set up someone to drive them to that test if necessary. The important part is that the physicians can then track and see whether it’s happening or not. This gets to the issue of non-compliance. A good example is that in 2006, the Institute of Medicine said that “survivorship plans” make a huge difference for cancer survivors, in order to catch a recurrence quickly. In 2016 they published a study showing that 10 years later, even though every patient needed a “survivorship plan,” only 10% had one. Patients with dementia who get a hearing and a vision test don’t deteriorate as fast, yet only 8% of patients actually get those two simple tests on a yearly basis. It’s because there’s no project management checklist allowing physicians to see that the patient has followed up.
We see Careteam as the horizontal integrator in a space where more and more talented people are inventing amazing tools that are vertical. We connect the EMR but also the wearables and apps.
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