Meet Lena, the AI Chatbot Fighting Social Isolation in Seniors
Alex Harb was handpicked by one of the largest medical systems in the world to address a seemingly intractable health challenge: healing alone.
The Challenge
When it comes to healthcare for seniors, a perfect storm has been brewing for years. The first issue is simple math — the number of people in the world over 60 years of age is exploding. There were twice as many people in this age bracket in 2017 as there were in 1980, and the number is expected to double again by 2050. In the United States the trend is marked by the fact that some 12,000 seniors age into Medicare every day.
On top of this, we’re living through what has been described as an “epidemic of loneliness.” Today, even young, highly connected people report feelings of isolation and loneliness, but it’s much more acute among seniors, who are living at home longer and often live far from friends and family. Research shows that when patients are socially isolated or lonely, they are less healthy overall. The stress of isolation sends people into a fight-or-flight hormone response that hinders sleep and raises blood pressure. According to one source, it’s as unhealthy as smoking 15 cigarettes a day. The results are felt in mortality rates — a 29 percent increase in risk of coronary heart disease and a 32 percent rise in the risk of stroke — as well as in pocketbooks. Health systems, particularly those that manage the health systems of seniors in value-based care, are losing around $30 million a year due to loneliness.
Healthcare providers have tried to step into the gap to provide care for seniors in a way that makes them feel connected. Nurses spend hours upon hours calling patients to check on them, trying to be a friend and motivate healthy choices. But these efforts often end in phone tag, disorganized hand-offs and burnout. It’s just not scalable, and in the end, patients still feel like their care is fragmented and impersonal.
Origin Story
Alejandro (Alex) Harb is what you’d call a health innovation native. A digital health software developer by training, Harb led the creation of consumer-facing web and mobile applications for more than a decade. He then became a digital health analyst at The Texas Medical Center Innovation Institute where he worked directly with 30 digital health startups and 25 medical devices startups. He helped companies evaluate and improve their business models and navigate the market.
When the Texas Medical Center identified that seniors experiencing isolation and fragmented care was a massive unmet need, they turned to Harb. They put the challenge to him and asked him to launch his own company within the Texas Medical Center umbrella. With their blessing and institutional support, Harb then recruited a team and began refining the opportunity and the product. After talking to more than 500 patients about the challenge of “healing alone,” a solution began to emerge.
Under the Hood
Alex Harb and his team built Lena as a text-based “companion” that uses artificial intelligence to connect with a senior while they’re at home. This chatbot checks in like a friendly neighbor, but also has the capability to instantly elevate a situation to a professional care team.
Lena starts by contracting with clinics or hospitals directly and building on existing provider-patient relationships. This was essential to Harb in order to establish immediate trust with patients who are bombarded by scams and empty internet offers. Lena arrives with their doctor’s stamp of approval.
It was also critical for Lena’s messages to arrive by text, rather than in an app. “Seniors don’t want to download an app,” says Harb. “They don’t want to memorize a new password. They’re already using text messaging to connect with family and friends. It works across ages and socio-economic status.” Text messaging allows Lena to reach 90% of their target population.
When a patient interacts with Lena, it feels like a text conversation with a friend, says Harb. A typical text might be, “how is your pain” or “how are your medications going?” Using Natural Language Processing (NLP), the system extracts important information from the patient’s response, like an increase in pain or the fact that the patient is struggling to pay for their medications. The system uses these data points — and trends over time — to know when to alert care team members and when to send additional resources. Then, a day or two later, the system automatically checks back in, to track progress and close the loop.
“Lena provides a much more personalized experience than I’ve seen anywhere else in healthcare.”
The idea behind Lena is to augments, not replace, personal interaction between providers and patients by automating simpler interactions and using data to make smarter decisions when a personal touch is needed. With Lena, nurses are still assigned to individual patients and build a relationship with them over time, but the system enables a single nurse to interact with as many as 600 patients.
“Lena provides a much more personalized experience than I’ve seen anywhere else in healthcare,” says Harb, who interviewed more than 170 digital health companies as part of his work at the Texas Medical Center Innovation Institute.
Pricing for Lena is currently on a per patient per month basis. On top of the conversational AI platform, Lena provides their partner clinics and hospitals with a dashboard for full visibility of patient and population analytics. Lena can also provide a higher level of care to patients who need further engagement, like health coaching or addiction recovery care.
Why We’re Proud to Invest
When StartUp Health launched the Longevity Health Moonshot, the aim wasn’t just to increase the average life span. It was to invest in the kind of innovation that would help people thrive as they aged, living whole, happy lives. With Lena, Alex Harb and company created a platform that does both, improving health outcomes while making people feel more connected.
One reason we’re proud to back Lena is because they’ve proven their “leap of faith assumptions” — like whether seniors would be motivated by text alerts — in the real world. In a partnership with the Greater Houston YMCA, Lena connected with 1200 seniors, saw 60% engagement and was able to increase attendance at health and fitness classes by 30%. Lena then launched with Houston Methodist, where they achieved nearly 80% opt-in rates and 90% weekly engagement rates, helping improve medication adherence, increase appointment follow-ups and reduce ER visits.
We’re also bullish on Lena because in healthcare as in life, your network matters. Lena was born out of a direct collaboration with the Texas Medical Center, and as such, Alex Harb and his team have had enviable access to some of the biggest and most advanced health systems in the world.
“Being a partner with the Texas Medical Center is huge. It’s an unfair advantage, particularly among companies trying to work with health systems,” says Harb. “Healthcare is a relationship-oriented field and sales cycles can be two years.” The proof is in the contracts. After being in market for only four months, Lena was able to sign on with Houston Methodist, the leading ACO in Houston. And there are more than 10 additional health systems in the Texas Medical Center that Lena is connected to as well. The goal, says Harb, is to dominate the Houston market, then quickly scale elsewhere. With a program about to launch in Wake Forest, this phase 2 is already taking shape.
In the end, Harb and the Lena team are building a smart, AI-augmented way to connect with patients at scale, eliminating social isolation, improving outcomes and lowering costs. It’s a triple-threat moonshot, but it’s also just the beginning of what’s possible when you combine a moonshot mindset with a powerful partner network.
Message Alex Harb via email at lena@startuphealth.com
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