Startup Enabled Healthcare Using Remote Monitoring for Complex Care
A Seattle-based startup, Enabled Healthcare, specializes in keeping patients with complex needs on Medicare and Medicaid healthy and at home through telemedicine, vitals monitoring, and care coordination. Founder and CEO Bethany Doran, M.D., M.P.H., recently spoke with Healthcare Innovation about her company being chosen as one of four startups to be awarded a peer-selected, equity-free grant of $50,000 from Village Capital’s ADAPT program, supported by the Metlife Foundation.
ADAPT: Social Innovation for a More Resilient Future in the United States, is a new accelerator program started this year to support the innovation and development of solutions for key issues related to climate change, healthcare and wellness, and economic mobility. Over 130 startups from 28 states applied to be a part of this new accelerator program. The final two cohorts were composed of a total of 19 startups from 10 states, focused on two tracks: community resilience and individual resilience.
After participating in the three-month venture development program, the 19 participant startups evaluated each other through an investor lens, using eight specific investment criteria that leverage Village Capital’s venture investment levels. After this peer-lead evaluation, Enabled Healthcare—along with Dollarito, ISeeChange, and Pear Suite— were deemed “most investment ready” and received the $50,000 grant funding.
I asked Doran about her experience participating in that venture program. “Initally I wasn't sure what to expect. We met virtually and would do our elevator pitch, but then we also would do a 15-minute pitch. We talked to a lot of mentors and funders who would critique us,” she said. “Then we’d talk to the other co-founders in our group about their business plans, talk about the financials behind our companies. Then we had a lot of time with each other to just dig into what the other companies were doing and really learn comprehensively about everyone's startup. And then during the last week we all met in New York, and basically underwent pretty deep diligence and then ranked the different companies on viability. It was great. I ended up becoming friends with a lot of the other startup founders.”
Doran described the business model Enabled Healthcare is developing. She said the company is partnering with agencies such as the Spokane-based agency Aging & Long-Term Care of Eastern Washington that administer a lot of the Medicaid programs in the eastern part of the state, as well as an agency called Family Resource Home Care that provides homecare services.
“We basically identify patients who are at highest risk of hospital readmission or adverse outcomes, especially with chronic disease. We meet with patients either when they're still hospitalized or when they're at home and get a comprehensive understanding of what their health conditions are and how they've been doing. We gather all their information, including allergies and medications.” Her company is building a tech platform in house that includes a tablet that links to multiple medical devices. “When we meet with each patient, we develop a personalized monitoring plan for them and then provide them with the monitors that they need as well as the equipment. We work with our partners so we can manage patients as well as monitor the data, and then work together with different community partners to keep the patients out of the hospital.”
She explained that even in a fee-for-service model, there are certain ways that her company can cut costs, “since we're a virtual clinic, we don't have the same overhead as a brick-and-mortar clinic. The partners actually take on certain care management pieces, because they're actually in the home. We partner with different community-based organizations and then together we prevent readmissions,” she explained. “But the ultimate goal is really to start defining outcomes and showing how we can prevent hospital readmissions to then further refine what populations we’re the most successful with and then go to payers or different plans to find the carve-out areas where maybe we excel that certain plans don't and then start creating managed care contracts.”
Doran said one of the things that struck her in getting into this work was that the homecare agencies or partner Medicaid agencies don’t have complete information about their own patients. “Because we're a clinic, we're able to gather that information for our partners and share that so that now the homecare agency actually knows what meds the patient should be on,” she said. “Our clinic can work to also help titrate medications, to call other doctors and ensure the plan is correct. And part of our model is billing through some of the RPM [remote patient monitoring] codes. We're really trying to focus on the sub-segment that's very sick and chronically ill. Financially it makes sense to give us those patients because we'll be doing intense monitoring and care, keep them out of the hospital, and still be cost-effective.
The company is a small operation so far with only four employees. “I like to think of it as like a virtual country doctor,” Doran said. “In the same way that maybe country doctors get to know their communities really well and then start to spread through word of mouth and also through relationships. That's our model. We have a care manager who is part time, but who is very experienced, as well as a medical assistant. I also have a physician partner that I work with, as well as like multiple business development partners.”
Her clinical partner is in Hilo, Hawaii, so that is a geography they will approach next after Washington state. “We want to experiment and see what's working in which populations and what the need is and then be able to scale from there,” she said.
