It’s no secret that the U.S. healthcare system is in desperate need of change, especially as costs have continued to rise, while the quality of care remains the same. While technology will play a critical role in reversing this trend, many assume that improving outcomes is simply a matter of putting smarter technology in the doctor’s office. However, the problem isn’t a scourge of careless doctors or shoddy diagnostic tools.
Much of healthcare’s high costs only come after patients have left the hospital or clinic. Out of their physician’s immediate care, patients start acting like people. They forget to take their meds, realize they don’t understand their doctor’s instructions, and so on.
So, one of the most important steps we can take to improve the quality of healthcare? Find better ways to communicate with and engage patients once they leave the clinic or hospital. Current solutions aren’t cutting it: Today, 40 to 80 percent of medical info provided by doctors and practitioners is forgotten almost instantaneously. Pamphlets are static and confusing, and get discarded quickly.
Considering that 70 percent of older patients have difficulty using and understanding printed materials, CareMessage thinks this is where technology can really help, and is likely needed most. The Y Combinator-backed non-profit startup is launching today to provide clinics and healthcare organizations with software and interactive mobile programs that help them stay in touch with (and engage) at risk patients.
Vineet Singal, Manuel Rivera and Cecilia Corral have also built CareMessage around a “social” mission. Rather than simply developing software for endowment-rich healthcare organizations, the non-profit startup focuses on clinics that work with at-risk patients, particularly those from low-income, low-literacy and non-English speaking areas. While that may seem like a small audience, the need for a better solution is huge, considering there are some 30 million patients in the U.S. classified as “low-income.”
To close this gap, CareMessage’s software aims to help care coordinators, admins and support staff improve the quality of care at scale by leveraging the ubiquitous technology living in our pockets. Thanks to the increasing accessibility and affordability of mobile phones, Americans have become addicted to text messaging.
For those in lower income brackets, the rise of SMS, reduced costs and unlimited plans makes texting an appealing (and more affordable) to spending time talking on the phone. According to PewResearch, for example, adults earning less than $30K/year actually text twice as much as those who make more than $75/year; in turn, SMS usage is four times higher among adults with less than a high school education compared to those with a college degree.
To help healthcare organizations leverage these trends and adjust their care and communication strategies to help them better serve at-risk and low-income patients, CareMessage has developed an interactive text messaging system that offers support for both mobile and landline communication. The service enables clinics and healthcare providers to actively guide their patients through the process of managing chronic health conditions via SMS, and allows them to provide individualized educational programs that are tailored to their specific health needs.
The idea, says CareMessage co-founder and CEO Vineet Singal, is to create a user experience that can help patients create long-term habits that can significantly improve their health by opening up the communication channels between healthcare providers and patients. By allowing providers to guide their patients through the challenging first steps that come before treatment and after, doctors feel more accessible, and the entire experience becomes more engaging.
To get started, all clinics need to do is signup with one of the startup’s representatives and either upload patient data to its databases directly, or ask their patients to self-enroll. Once their data is uploaded, healthcare providers can use CareMessage’s dashboard to manage the care process and access their calendar, appointment schedule, or send reminders and collect RSVPs.
Clinics can manage group events as well, allowing patients to sign up for health awareness classes, seminars, flu shots or disease management programs, for example. They can also customize and send interactive text-based “campaigns” that are customized to each patient, while communicating directly with patients and groups via text or landline.
To support these features and allow clinics to begin engaging patients right off the bat, CareMessage has developed a catalog of content that addresses a range of the more common conditions found at clinics serving at-risk patients — like obesity, diabetes, HIV and high blood pressure, to name a few.
By providing patients with the ability to RSVP and cancel appointments via mobile or landline, access relevant info before and after appointments and send tips, reminders, and advice via text, CareMessage has begun to make a dent in the patient engagement problem. To avoid spamming patients, campaigns are limited to three to four messages a week, while allowing clinics to create a more fluid feedback loop designed to encourage real changes in behavior. Or at least that’s the idea.
Either way, it seems to be working thus far. Singal tells us that, to date, 70 percent of the questions sent by CareMessage’s interactive program have been responded to by patients, and 92 percent of patients complete the full program.
Thanks to these high engagement rates, CareMessage has been able to sign on early customers like the L.A. County Department of Health Services (the second largest in the country), Sinai Health System (one of the largest systems servicing Medicaid patients), Unite Here Health, as well as hospitals in Mexico and Nicaragua. The startup has also begun with the Stanford Prevention Research Center, the University of Michigan and the Public Health Institute to help these organizations measure their ability to improve outcomes and to reduce no shows and overall costs.
All told, more than 100,000 patients are now using the startup’s software across 16 states, and its user base is growing 25 percent week-over-week, Signal tells us.
Along with its hyper-focus on engagement, the key to driving this early growth has been finding every possible way to lower the bar to entry and increase accessibility, the co-founder explains. A noteworthy example, which is also in keeping with its social mission, CareMessage allows clinics to access its software for free.
To generate revenue, the startup offers a monthly subscription plan, with price varying depending on the number of patients clinics manage through its software. Furthermore, if customers require more advanced integration or customization, CareMessage will charge an up-front development fee, though it has been building support for EMRs like Allscripts and Epic, for example, in an effort to help companies reduce those extra fees.
Looking forward, Singal and the CareMessage team are setting the bar high. They are currently on pace to reach one million patients by the end of 2014, and have begun raising an expected $2 million in seed capital to go after its big, long-term goal: 10 million patients.
For more on CareMessage, find them at home here, or check out our coverage of Y Combinator’s latest class here.
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