Boston startup disrupting health care with new caregiver listening app

22 Apr 2015 2:09 PM | Brian Kelley (Administrator)

The UpTake: Care at Hand's app taps into the observations of untrained home caregivers to gather better medical information.

retrieved from Boston Business Journal   |   Apr 22, 2015

What if the answer to reducing health costs of the most expensive patients stems from listening to the hunches of home care workers with little — if any — medical training?

That’s the premise tech startup Care at Hand Inc. used to predict and prevent an estimated $6.5 million in Medicare spending by reducing hospitalizations among aging patients in Massachusetts.

Now, company officials are taking aim at Maryland, the only state to have a Medicare payment waiver to set its own rates. Officials at Care at Hand say its online survey system, which captures and analyzes observations from home care workers, will "disrupt" the way Maryland hospitals tackle readmission rates.

"These are incredibly valuable and underutilized workers. Why don’t we use what’s in place, but use them more intelligently," co-founder and CEO Dr. Andrew Ostrovsky said. He is relocating from Boston to Maryland in May after launching the service with The Coordinating Center of Maryland.

Care at Hand developed a survey app to give to home care workers, instructing them to answer up to 15 questions about their client each day. The idea is that home care workers have more opportunities to notice subtle health changes among their clients who are trying to "age in place" in their own homes.

For instance, a worker might notice if it becomes harder to slip on a client’s shoe due to foot swelling. That could indicate a patient is suffering from symptoms of heart failure.

The system will prompt medical staff at a local hospital if a client seems to be demonstrating risk factors for hospitalization based on the survey.

"[Home care workers] don’t need to understand why those indicate problems," Ostrovsky said. "We just need to make sure that they are being brought to the attention of a patient’s medical team."

While the company's ambitions are big, it's still a small startup. Last year, it made about $250,000 in revenue and hopes to increase that to about $500,000 this year. The company's raised approximately $2 million, with a recent funding round of about $500,000. And as CEO, Ostrovsky admits his background as a pediatrician may make him sound like an odd fit for a company focused around the aging population.

But the company has some heavy hitters behind it. Eric Reis, author of the popular business book "The Lean Startup," is one of the company's investors. Other backers include Mark Leavitt, the former chairman of the nonprofit Certification Commission for Health Information Technology and former chief medical officer of HIMSS, and Dr. Barry Zuckerberg, the former chief of pediatrics at Boston Medical Center. New York-based tech venture firm Great Oaks Venture Capital is also an investor.

The federal Agency for Healthcare Research and Quality looked at hospital-generated admissions data for one elder care group in Massachusetts using Care At Hand's software. It found the program reduced 30-day readmissions by 39.6 percent among at-risk patients, for a net savings of $2.57 for every dollar spent.

Ostrovsky is betting that results like that will be crucial in Maryland, where hospitals have a five-year deadline to demonstrate improved quality through improved care coordination with outpatient providers to keep the state Medicare wavier. But first, the company has to convince the home care providers to get on board.

"We come in and say, 'You don't have to change a thing,’ " Ostrovsky said. "But we'll digitalize the hunches of your health care workers and we'll quantify the [return on investment] for your hospitals."


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